How to Overcome the Medication Weight Gain Cycle

Medications for depression, bipolar disorder, schizophrenia, and other mental health disorders can be lifesaving for people who need them. However, they come with potential risks and side effects-including weight gain.

Unmanaged weight gain can lead to obesity and a slew of serious health conditions, such as diabetes, cardiovascular disease, and metabolic syndrome, a precursor to these (and other) illnesses. Studies have shown that obesity-related diseases shorten life expectancy by an average of 25 years. People with mental health disorders are at increased risk for metabolic syndrome.

Obesity is a serious personal and public health problem. Since 1995, the rate of obesity has increased by 48 percent; it's tripled for children over the past three decades. Thirty percent of the population in nine states is now obese.

Medications probably do not directly cause obesity, but they do make it more difficult for people with mental health disorders to stick to a healthy lifestyle that helps prevent weight gain. Obesity among people taking antidepressants is 1.5 times higher than the general population; it's twice as high among those taking antipsychotic medications. In an ugly twist of irony, weight gain from antidepressants can worsen depression.

Medical experts are still trying to understand how mood medications increase appetite and contribute to weight gain. Psychotherapeutic drugs that alter serotonin and dopamine, two neurotransmitters involved in mood regulation, influence the hypothalamus in the brain, which controls appetite. These medications stimulate your appetite and fail to let you know you're full (satiated). Children who take antidepressant or antipsychotic drugs are at particular risk for medication-related weight gain.

Not all medications cause weight gain and some are worse than others. Furthermore, the likelihood of gaining weight on any given medication varies among patients.

Exercise. When you are depressed, it can be difficult to motivate yourself to exercise. However, exercise does help prevent weight gain and it works like an antidepressant by increasing serotonin levels.

Change medications or doses. Ask your physician to try alternative medications. Sometimes, simply lowering the dose, especially in combination with other weight management strategies, is effective.

Take antidote medications. Appetite suppressants may counter the effects of antidepressant and antipsychotic medications. They can cause their own serious side effects, however, and may not be a viable solution for many.

Lifestyle modifications. Eat slowly, stay well hydrated, monitor your calorie intake, avoid processed foods, increase your fruit and vegetable consumption, and eat meals at regular times.

Psychotherapy. A therapist can help you develop emotional strategies to avoid overeating and maintain healthy habits.

Sources

"Weight Gain and Bipolar Disorder Treatment."  PsychEducation.org. Web. November 2007.

http://www.psycheducation.org/hormones/Insulin/weightgain.htm

Hall-Flavin, Daniel K., M.D. "Bipolar medications and weight gain." Mayo Clinic. Web.  5 February 2010.

http://www.mayoclinic.com/health/bipolar-medications-and-weight-gain/AN02062

Kohlstadt, Ingrid, M.D. MPH. "Medications as Modifiable Contributors to Weight Gain." Medscape Medical News. Web. 24 March 2010. http://www.medscape.com/viewarticle/718977

Frincu-Mallos, Crina, Ph.D. "Psychotropic Medications Linked to Increased Rates of Obesity." Medscape Medical News. Web. 8processing....

March 2010. http://www.medscape.com/viewarticle/718087

"Preventing and Managing Medication-Related Weight." Facts For Families 94 (September 2008). American Academy of Child and Adolescent Psychology. Web.

http://www.aacap.org/cs/root/facts_for_families/preventing_and_managing_medicationrelated_weight

Wurtman, Judith J., Ph.D. "10 Tips to Prevent Weight Gain on Antidepressants." HuffingtonPost.com. Web. 30 June 2010. http://www.huffingtonpost.com/judith-j-wurtman-phd/weight-loss-10-tips-to-pr_b_629564.html

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Breaking the Fast-Food Cycle

In today's fast-paced world, most Americans rely on fast food every now and again. But for many U.S. citizens, these foods are more than just an occasional indulgence--at least 25 percent eat from popular chain restaurants every day, according to Eric Schlosser's Fast Food Nation.

Because fast food tends to be high-fat, high-calorie, and low in nutrition, experts warn that our national eating habits come with a variety of health hazards, including increased risk for obesity, high cholesterol, high blood pressure, and diabetes. The first step in breaking the fast-food cycle? Slow down to think about what you're eating.

In just one fast-food meal, you could meet, or even exceed, your daily calorie and fat requirements. For example, a 45-year-old sedentary woman who's 5 foot 4 inches tall and weighs 145 pounds needs approximately 1,775 calories a day. She should limit her total fat intake to less than 60 grams and her saturated fat intake to less than 20 grams.

If she stops at McDonald's for dinner and eats a Double Quarter Pounder with Cheese (740 calories, 26 grams total fat, 12 grams of saturated fat), Large Fries (570 calories, 30 grams total fat, 6 grams saturated fat), Large Coke (310 calories), and Apple Pie (270 calories, 12 grams total fat, 3.5 grams saturated fat), she's already exceeded her daily caloric requirement by more than 100 calories, her total fat by 8 grams, and her saturated fat by 1.5 grams. And that was only dinner.

Based on nutritional information from each chain's website, here's the worst of the worst from popular fast-food restaurants:

Do you stop for coffee before work in the morning? Dunkin' Donuts Vanilla Bean Coolatta will cost you a cool 450 calories. If you also enjoy a cinnamon bun, you're tacking on an extra 510 calories.What will it be for a quick lunch in between meetings: Kentucky Fried Chicken's "homemade" Chunky Chicken Pot Pie? KFC's version comes with 770 calories and 42 grams of fat, including 13 grams of saturated fat.If you're craving Pizza Hut's Big New Yorker Sausage pizza, then you're also craving 570 calories, 33 grams of fat, and 14 grams of saturated fat. And that's just one slice!If Mexican suits your preferences, Taco Bell may satisfy at 210 calories a taco. But do you stop at one? Or, do you add on the Mucho Grande Nachos for an extra 1,320 calories and 82 grams of fat, including 25 grams of saturated fat?Subway offers some healthier options, but don't let that fool you. Even a seemingly healthy foot-long Tuna Melt has 768 calories, 42 grams of fat, and 10 grams of saturated fat. If you opt for the 6-inch instead, you'll cut your calories and fat in half. According to a recent Temple University study, people who consumed three to six fast-food meals a week weighed significantly more than those who consumed one to two of these meals a week. Along these lines, if you must eat fast food, try to limit your trips to a few times a week.

In addition, there are ways to cheat the fast-food system. The American Heart Association offers the following healthy guidelines for eating on the go: Pass on the super size. Burger King's King Size Onion Rings has 550 calories and 27 grams of fat, including 7 grams of saturated fat.Skip the sides, or try a salad. McDonald's Super Size French Fries has 610 calories and 29 grams of fat, including 5 grams of saturated fat. But McDonald's Grilled Chicken Caesar Salad has only 100 calories and 2.5 grams of fat, including 1.5 grams of saturated fat.Avoid double meat and bacon. Burger King's Double Whopper with cheese has a whopping 1,020 calories and 65 grams of fat, including 25 saturated grams of fat.Eat your sandwich open-faced. By eating only half the bun, you'll eliminate unnecessary calories.Try asking for a wheat bun. If the restaurant offers it, it will help cut down on calories and add to the nutrition content.Skip the mayo. This also applies to calorie-laden dressings and sauces.Drink water. Burger King's King Size Coca Cola Classic has 430 calories. Water is the best alternative, but failing that, opt for diet soda or low-fat milk instead of regular soda.

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