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Most, if not all, medications have the potential to cause side effects. These may range from annoying, such as feeling slightly tired to fatal (toxic chemotherapeutic agents). However, we usually don’t think of obesity as a side effect of taking medicine. But it can be. Antidepressants, anti–anxiety drugs, mood stabilizers and antipsychotic drugs (used for bipolar disorder and schizophrenia) are linked with moderate to dramatic increases in weight.
“I gained 25 pounds on my antidepressant in just three months,” a new client told me. “I ate and ate. Since I am in my office all day, I did most of my eating at home. I had always been thin but within a few weeks on the drug, I ballooned up so quickly. And the worse thing about was, I didn’t care. The drug took away all my feelings of anxiety, or guilt, or horror at what I was doing. I just felt as if I was on a cloud watching myself stuff cookies and chocolate into my mouth.” When I asked her why and when she realized that she had gained weight, she told me it occurred when not one piece of clothing in her closet fit.
Another wrote to me in despair because her doctor told her that she had to go back on an antidepressant she had taken several years earlier. She had gained forty pounds but managed to lose it after going off the drug. Now she was being told to take it again and as she told me, “I feel as if a judge has just condemned me to obesity. It is so unfair. I worked so hard to lose the weight I gained the last time and now I am doomed to gain it all back.”
Weight gain as a side effect is not limited to drugs used to treat brain-based emotional disorders. A drug to treat fibromyalgia has recently been approved and it is the first (although several others may appear soon) to help people with this chronic disorder. The drug does help with the pain and other symptoms but like the antidepressants, it is already known to cause substantial weight gain. This is a particular hardship for people who already may have difficulty moving because of pain from the disorder. Gaining weight may make physical activity even more painful.
There is nothing mysterious about why weight is gained. Ask anyone who has had this annoying side effect. More food is eaten on meds than off. “It doesn’t matter how big my dinner is,” a client told me. “I still want to eat as soon as I get up from the table. My head keeps telling me to put food in my mouth.”
One theory is that the antidepressants and other drugs that cause this overeating are doing something to the neurotransmitter histamine (neurotransmitters are chemicals which transmit messages from one brain cell to another). Some allergy drugs (the anti –histamines) block histamine. Several years ago some scientists observed that anti-histamines are associated with overeating. Perhaps, the theory goes, antidepressants, mood stabilizers, and drugs for the pain of fibromyalgia might change histamine activity so that a feeling of wanting to eat never goes away.
Fortunately serotonin, the brain’s “feel good” neurotransmitter, also acts as a brake against the overeating caused by the drugs. If you think of these drugs as a car going too fast down a street, the serotonin, which slows down the eating and causes it to stop, acts as a speed bump. And the easiest way to provoke this “serotonin-speed bump” is simply to eat a therapeutic amount of carbohydrate so serotonin is made.
Recently I learned about a new drug that causes weight gain from an e-mail sent to me from someone who had bought our book, The Serotonin Power Diet. The sender has Parkinson’s disease and is taking a medication that increases the activity of another brain neurotransmitter, dopamine. The symptoms of her disease are caused by inadequate amounts of dopamine and medications that increase dopamine’s activity have been available for several decades. One side effect of medications for Parkinson disease has been compulsive activity such as gambling. However, this writer told me that she binges compulsively. She really did not want to overeat but felt driven to do so and gained a substantial amount of weight. At her suggestion, I read comments about the side effects of this drug and found others reporting similar abnormal eating behavior. She told me that she gained weight on two nationally known weight-loss systems and her second nutritionist (the first had given up on her) was having no success in controlling her eating.
As the medication is helping her control her illness, she is obviously going to stay with it. There is a good chance that increasing serotonin will put a brake on her bingeing as it does with other types of overeating. But the verdict is not yet in as she has just started on the diet.
Weight gain does not have to be the unavoidable side effect of medications which treat brain based illnesses. As long as we can depend on serotonin to shut off overeating, we can enjoy the benefits of medications that help pain, anxiety, and depression and restore us to a state of well-being.
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Janet Podleski is one half of the sister act that wrote the bestselling cookbooks, Looneyspoons, Crazy Plates and their latest, Eat, Shrink & Be Merry! Janet and her sister, Greta, are also monthly columnists for Canada's number-one magazine, Reader's Digest, and were voted into Canada’s Top 40 Under 40 in 2000. The sisters and their inspirational, self-publishing success story have been featured on dozens of national TV programs such as The Today Show, CNN, Canada A.M. and QVC, as well as on hundreds of radio shows, and in magazines and newspapers across North America. In addition to a B.A. in Psychology, she has also earned a degree as a Registered Holistic Nutritionist. 
Brenda J. Ponichtera is a registered dietitian and author of several award-winning cookbooks, all designed to prove that "healthful eating doesn't have to take a lot of time in the kitchen."
Calorie Bargain: Oikos Organic Greek Yogurt
Calorie Bargain: Green Mountain Gringo Mild Salsa
