Almost everyone who takes antidepressants gains at least 15 pounds. Add mood stabilizers to the mix of medications and weight can shoot up by 75 pounds or more. This is not a new side effect. Patients and their psychiatrists have been dealing with this unpleasant, unwanted and unneeded side effect for a decade or more. Yet a scan of articles about weight gain reveals pitifully little information on how to lose the weight. Stopping the medication is not an option, although oftentimes weight is lost quite rapidly when medication is not longer required.
The weight-loss advice given in medical articles and physician offices is no different than advice given to anyone who has to lose weight regardless of what caused it to be gained: Stop eating junk food, eat more vegetables and fish, eat less red meat, drink water, and exercise.
One of my clients told me the following story. "My therapist gave me a diet sheet that looked like something his mother might have followed 40 years ago. He started to mumble something about weighing my food and cutting out butter and chocolate and not cleaning my plate. I told him that I know how to follow a healthy diet because, until I started on my meds, I was thin, athletic and never ate junk food. What I need to know now, I told him, was how to turn off that voice in my head, which pushes me toward chips, candy, cookies, and ice cream. ‘Where did this voice come from?' I asked him, because I never ate these foods until I started on my medication. But he had no answer."
Even though weight gain is now seen as an almost inevitable side effect of many antidepressants and mood stabilizers, strategies for preventing or undoing the overeating that cause it are lacking. Although there are hundreds of diet plans and many weight-loss support groups available for people who gain weight the traditional way, almost nothing is available for the formerly thin individual whose weight gain is entirely due to his or her medication.
As another client told me, " I may look like any other fat person but I never had a problem with emotional overeating or using food to reward myself or dealing with stress. In fact, I have never been on a diet in my life because I never had a problem controlling my eating. So when I go to these meetings and hear people talk about food being their best friend or using food to relieve boredom or anxiety, I don't know what they are talking about. I overeat because I have a persistent feeling of needing to. It is like being thirsty all the time, despite how much water you drink. And I cannot turn off that feeling."
The ideal solution is to develop drugs that address the mood disorders without altering food intake or energy levels. But no medications that effectively treat emotional disorders have been developed which do not have the potential to cause weight gain. And no medication to halt the overeating has been found that is safe to take by people who are already on antidepressants and related medications.