I am not working and I do get what you are saying about holding down a job - I did in the past - but "you can manage the weight gain to an extent until you find something better" means that you have not read my long post, unlike all the other responders. I have tried everything but Clozapine and as has already been pointed out, it is the worst. A pdoc in the past told me it is as bad as Zyprexa. Some other data suggests it is worse. I already weigh 238 lbs, which is back to my worst weight. In spring I was down to 205 and all has been regained, most rapidly the most recent 18 lbs in several weeks on Asenapine. I am beating myself over waiting for that long - it should have been crystal clear from the get go, but I was focused on trying to sleep. I already cannot wear new clothes I bought (mind you, off ebay, cheaply, but I am sure nicer clothes won't fit either now) in late November. I cannot buy new clothes each month.

The "can be managed to an extent" runs in the face of pretty much all the evidence out there and on these boards. Virtually every long term study shows that lost weight is regained and often with more than was lost, and that weight fluctuations are worse than having stable weight, even if obese.

Again, I get the "hold down the job" but not the weight vs stability dichotomy - if I need to buy clothes again, how is that stable?

Plus, probably specifically because it is from meds side effect (effed metabolism), I do not gain weight in a womanly way - I have absolutely nothing against ample hips, thighs or butt, or all of the above, but I gain weight around my waist. When I was buying new clothes in late November, I at least had a waist. Now I do not. The unhappiness that is going to result from it will erase any advances in stability.

Besides the fact that weight gained around the tummy rather than in a womanly way does not look good, it is dangerous visceral fat that increases breast cancer risk and my mother died from breast cancer metastasis (had major weight gain from Amitriptyline and then when she found a lump, a virtually at my current age, she did not report it promptly). She gained weight in the same fashion. For her it was even more pronounced because before meds she had Sophia Lauren's waist-to-hip ratio and I had a different body type - more like a perfect hourglass with breasts equalling (fairly narrow) hips. So on me it looks hideous because I do not have hips to outweigh - literally - the large belly. All of it is visceral fat (I also have lived under extreme stress for more than a decade so I secrete cortisol, and then it is Catch 22 because visceral fat produces cortisol - it is like a hormonal time bomb in the body). Had you read my post, you would have seen that I had already been prediabetic on Risperdal, which remitted after discontinuation, but what I did not read (and I am sorry - the post was long, so I am not faulting you for not reading it, but at the same time I used short paragraphs, bolded the names of meds, and in general tried to be reader-friendly) - so what I did not write is that I have diabetes on both sides of my family, and while my grandparents were obese when they were diagnosed, my father is normal weight, and still. So it is not "weight vs stability" for me, but "extreme health risks vs temporary stability".

I thank you for the post that made me think, made me recall the heightened risk of diabetes, and made me realize just how deadly more weight gain would be for me.

So I am leaning more and more towards ECT. I have extremely good memory, long term I mean, outside of the word recall issues, but I remember events very well, and if I lose some of that but not gain more weight, I would go for it any time.

Thank you - you made me think out loud.

My total weight gain has been probably 100 lbs. I did not weigh myself back when I had a perfect figure, which I did after having three kids, the last one a 9 pounder. And I did not have to work at all to return to the pre-pregnancy weight. This was all years before meds. I did not know what was coming my way.