I had some some medication cocktails where I gained weight (sometimes a lot) and had difficulty losing. Others, not as much.

At one point, I had my medication cocktail overhauled. I was put on the big cocktail of Lithium ER (900 mg), Tegretol XR (1,400 mg), Lamictal (100 mg), Geodon (160 mg), and Klonopin (0.5 mg). On that mix, with the help of a dietitian prescribed diet and accountability to her, I lost 40 lbs in six months. That took me into my normal BMI range. I looked slim. I stayed within 10 lbs of that lowest weight for about 5 1/2 years, even with Navane added and even a small dose of Seroquel XR. Lithium and Navane were then removed and I remained the same weight. Then about a year later, Geodon was slowly removed because of severe akathisia. As Geodon was removed, my Seroquel XR had to go up because of mania. At doses of 350 mg or less of Seroquel XR, my weight stayed the same. Above 350 mg, my weight inched up slowly. At 550 to 650 mg, it went up quickly. I'm still on 550 mg Seroquel XR and struggling with my weight. Right now I'm about 22 lbs higher than my goal weight I reached about 8 1/2 years ago. That's not good, but at least I haven't regained all of the 40 lbs I lost with the dietitian.

In my case, to put things into perspective, I am only 10 lbs more than the highest weight I was before ever taking a single medication. Yes, at 32 years old, I weighed only 10 lbs less than I do now at 48 years old, having been on some moodstabilizer and antipsychotic constantly since age 34. It's possible that even without ever taking bipolar medications, I could be my current weight. Actually, I've usually always been the thinnest person in my immediate family. There are some genes in my family making us prone to be overweight.

The above is not meant to argue against the clear fact that some bipolar medications can be highly weight unfriendly, but not all are. In my case, mood has also played a part in weight gain, even before ever taking bipolar meds. At some points before meds, I was able to gain and lose 25 lbs depending on my moods. Ditto nowadays.

What has helped me get/stay thin?

* Weight neutral meds and/or
* Good energy
* Good motivation
* Determination
* Being into a good groove with physical activity and healthful or strategic eating
* Self confidence and "Can do" attitude
* Feeling that healthful cooking was fun, usually experimenting with new foods
* Being "into" things that distracted me away from eating (and drinking, back in my drinking days)