Bipolar Disorder Medications and Weight Issues
Many of us with bipolar disorder have trouble with weight gain due to medications. For others, eating enough is a problem and serious weight loss can be a result. No wonder weight issues are one of the main reasons people stop medications.
My Story
As many you know, after three years of constant medications from 1995-1998, I gained over 80 pounds. I don’t know the exact amount because after a certain point I was so profoundly depressed and upset by this weight gain that I stopped getting on the scale. I simply had an out of control appetite for three years. I couldn’t stop. I know I weighed over 250 in 1998.
I asked for help from the doctors and the only reply I received was, “We will deal with the weight gain when the mood swings are under control.” I was so naïve back then. I thought I had to only LISTEN to doctors. I know now that I have to WORK with doctors as a team. There is a lot more awareness today regarding the potential for weight gain, but as the medications haven’t changed much, knowledge is not enough to deal with the problem. Gaining or losing too much weight needs to be addressed from the minute a person starts bipolar disorder drugs.
What Causes the Weight Problems?
No one seems to be quite sure why people gain weight on medications. There is the theory that the meds slow down the metabolism. I personally believe that they stimulate the hunger portion of the brain to the point that we no longer have a good sense of when we are full. I have also had food hallucinations when I’m on certain meds. I actually hear voices that say, “You are going to eat until you are sick.” No kidding! On the other side, my brother takes an anti depressant and AHDH medication and he has lost almost all of his body fat. Hey! Why didn’t that happen to me!
I’m always amazed at how quickly my appetite changes when I take medications. I sometimes take an anti psychotic when the psychosis gets bad and within hours I’m craving junk. I crave it like I’m starving. I get images of cake, cookies, ice cream and candy. I think about it and fantasize about it. I want to eat big spaghetti dinners with a lot of bread and could literally drink Coke at every meal.
It’s almost exactly like the food cravings caused by marijuana. (Before anyone writes me, I don’t use marijuana to treat bipolar disorder. It messes up the brain and I can’t risk that but I did use marijuana before I was diagnosed.) It’s an odd phenomenon. I also remember taking Prozac in the 90’s- (this was before doctors realized that no one with bipolar disorder should take an anti depressant without extensive questioning from an experienced mental health professional beforehand) and my appetite was simply gone. I used to walk into the kitchen and the thought of eating made me feel nauseas.
There are Things You Can Do
I’ve lost a lot of the weight I gained in the 90’s. It hasn’t been easy. I’ve found that consistent exercise with a lot of weight training and walking is the best way to keep my body healthy. I know that if I approach losing weight as something I HAVE to do, I will rebel and eat junk just to feel better. Instead, I approach it as just another tool to add to my Health Cards. If I see eating healthy as a way to reducing weight gains caused by meds, I am more likely to think before I put a lot of junk in my mouth. I know that eating sugar is not an option for me. I would eat it for every meal if I let myself. I’m lucky now that I don’t need to take the meds that cause so much weight gain. I just still have to deal with the weight I gained so long ago. It’s crazy!
This Doesn’t Always Work
A friend of mine has been on Zyprexa for a year. It has saved her life. She stays out of the hospital and is able to work more consistently. The problem is that she gained 30 pounds the first three months she was on the Zyprexa. She didn’t change her eating and often walked miles a day and she still gained the weight and can’t keep it off. What can a person do? Luckily the weight gain stopped at 30 pounds. Mine just kept on going. Our bodies are so different. She and I talked a lot about her dilemma. Her clothes no longer fit at all. She is depressed about the weight gain and she wants to stop the med. But her doctor doesn’t think she is stable enough. When she lowers the Zyprexa, she starts to get psychotic again. It’s so unfair. She made a decision to stay on the Zyprexa despite the weight gain. It’s all about weighing options. Weighing options- get it!
Her future goal is to switch from the Zyprexa to Abilify as it is supposedly easier on the liver and cholesterol and has less weight gain problems. I have my fingers crossed. I’m just so thankful she’s stable and of course her weight gain has no bearing on our friendship. Her partner is okay with it as well, but that is not much of a help when you can’t wear your clothes.
Are You Getting Too Skinny?
I can joke that I wish I could take a medication that made me lose weight, but if you’re thin already this can truly be a problem. Often the restless energy caused by meds takes your appetite or you simply lose all desire and pleasure in eating. If you’re in this situation, you have to treat eating as a task instead of waiting to be hungry. Even if the thought of eating makes you feel sick. Some meds can cause a drug induced anorexia feeling. So this is serious stuff. Remember, you don’t have to want to eat in order to eat. Eat foods with a higher fat content. Eat yogurt and good cheese. Have some meat. Eat tortillas and tofu. Apples and bananas are good fillers. If you’re stacking on carrots and celery, low fat foods or junk, your body will literally just burn it up. For you, eating has to be scheduled and required.
TIPS:
Walk. This is absolutely the best way to stay healthy and get the sunlight your brain needs. As you read this, maybe you’re thinking- gosh, I’m so tired of reading all this information on how I need to walk. I don’t have energy to walk! Well, guess what. You will definitely gain weight if you don’t exercise when you’re on weight gaining meds.
You can join a walking group if you won’t walk alone. Make it something you want to do, not something you have to do. In the US there is a program called USA Fit. It starts in the spring and teaches people how to walk a marathon. I’m sure that no matter where you live, there are places to walk and people to walk with. This really can make a difference with bipolar disorder. Many people never start a walking program because they are waiting for the DESIRE to walk. The truth is you don’t have to want to do something in order to do it. Depression will tell you it’s pointless anyway. You simply have to say to yourself, I am going to walk and then wait for the good feelings that come regarding your body after the walk is over.
Hire a trainer. If you have the money, hire a good personal trainer. A Pilates trainer, a professional body builder (natural, not one who uses steroids) or a really dynamic private yoga teacher can make all of the difference. When you pay good money for something there is a chance you will take advantage of it more than if you just have a monthly membership to a gym. If you don’t have the money for this, find your least expensive local gym and see what they have to offer –then really take advantage of their services. Become a regular at your favorite class and meet others who want to stay in shape. And then get a training partner. It’s too hard to stay in shape alone for most people. We need help and encouragement from someone.
Eat a protein breakfast or skip breakfast! If you’re losing too much weight, eat eggs with some meat, toast and fruit for breakfast. You don’t have to eat a ton, but get all of those food groups in there. This is not too hard to do and can make a real difference with your blood sugar. I’m in the opposite situation, so I now skip breakfast on most days. I know! That goes against all of the talk in the media, but it really works for me. I feel so much better if I have long periods between eating. It all depends on if you’re overweight or underweight.
Talk to your Health Care Professional about changing your meds: I now take Lamictal (Lamotrigine). I’m lucky that weight gain is not a side effect, because I simply don’t know what I would do. I know I will NEVER be 80 pounds overweight again. I took Serequel a few months ago and gained 26 pounds in less than three months. I had to stop it for that reason. And yet, another friend of mine takes Zyprexa and has had no weight gain. You have to keep trying different meds and talk with your doctor about your options. I say that gaining more than 20 pounds is a PROBLEM that must be addressed.
Here is Some Encouragement
If I can go from an overmedicated, sick and despondent 250+ pound woman to someone who is at least healthy, alive and kicking and getting on with her life, you can do it as well. Give it time. This has been a seven year odyssey for me. The Health Cards gave me my life back, but now I have to use them daily to stay well. This means I can take less meds. I can definitely get into why me? mode- and I feel it’s a legitimate question. But the reality is that my life is about managing bipolar disorder. This is an everyday process. I don’t get a break. This goes for my eating as well. Do you sometimes feel it’s too hard to deal with all of this? Well, you are not alone. It is very hard, but it can be done. And like me, you can be in a different place regarding your weight next year than you are now.
Remember Bipolar disorder is an illness-
Not your life.
You can get better.
Julie Fast
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My coauthor, Dr. John Preston has written an essential book for anyone with bipolar disorder or the people who love them. His book,
The Medical Treatment of Bipolar Disorder covers everything you need to know about the medication treatment of the illness. It’s now available exclusively from BipolarHappens.com. It’s available in download or hard copy format (as so many of you requested). I’ve provided links to the book and ordering information below.
We all need to stay informed about our bipolar disorder medications and their possible side effects. This last manic episode I experienced really reminded of the importance of correct medication management. Don’t be in the dark about your medication treatment!
More information about the book can be found by visiting www.bipolarhappens.com/mdtx.php If you have trouble with the link you can copy and paste or type this address directly into your web browser.
www.bipolarhappens.com/mdtx.php
