Getting fat on bipolar medications

I am 40-50 lbs over having a good figure and of those 10-15 are due to a month-long treatment with Zyprexa - treatment that was discontinued due to this weight gain. I am back on weight-neutral Geodon, just on a higher dose, and it works. The rest of the pounds is due to inactivity and overeating. So I do not really have an excuse in the form of "I am on medication", but that gain over a short period of time was pretty spectacular. No wonder I saw people who were wider at midsection than they were tall when I was an inpatient. I felt really sorry for them. And Zyprexa is such a benign drug, otherwise, and, my then doctor told me, many of her patients do NOT get fat on it, it is just a matter of bad luck (but statistical figures show more bad luck than good luck).

What exactly is happening? I do not know whether to believe the theory "calories in, calories out" - a science journalist Gary Taubes says he disproves it; I will read his books as soon as they are available at my library - he is popular. It seems that the deal with many psychiatric medications by itself disproves the theory of "calories in, calories out" - I cannot imagine that people on these medications get SO much more ravenous as to cause this drastic weight increase by "calories in" alone. Some, to be sure, but I was not eating non-stop on Zyprexa. Something else must be at play.

At the same time, I recently became afraid of turning into a diabetic, started swimming, started counting calories, and already lost 5 lbs this way. So "calories in, calories out" does work?

If some antipsychotics are better than others in this respect (I think that Geodon is the best and Zyprexa is the worst), why cannot scientists determine what it is that makes a drug weight-neutral and come up with an optimal drug? Like a modernized Haldol - why is it not possible?

Sorry this is not a very cogent post, but I am sure the questions are clear enough.

Yes, your questions are clear enough and your post makes perfect sense. I just wish I had answers for you!

With some meds is is just an increase of appetite. But Zyprexa both increases appetite (often to an extreme, I've seen people eating raw flour on this med), and it changes your metabolism and glucose levels. So even managing eating normally, you will gain. Most people gains. Several people not gaining sounds like way too much of good luck. The only people I met that didn't gain on this one was one that was anorexic and had so much control over her eating she basically didn't eat at all, and the other one was on high dose antacid (makes you less fat in combo with Zyprexa). Else than that I met one single person that naturally didn't get fat from it.

The average weight gain I read from this med is 65 pounds. Wow.

Some meds make you burn less calories. It's just fact. Same with some illness. When I wasn't yet treated for hypothyroid, my diet was 700 calories a day. Adding anything, and I would get fat in notime! So yea, the body really can hold back. It does it in many ways. One way is decreasing your activity and even microacitivity, another way is lowering your body temp. It has even more tricks.

Geodon was NOT weight neutral for me. It made me feel like I hadn't eaten for a week. I was crying every day because the hunger was so bad. One day I decided I would give in just once and eat until I was full. When I cooked my 3rd dinner on a row, I realized I will NEVER feel full. I can only eat until I physically can't eat anymore.

Risperdal made me gain weight while fasting. That is also interesting......

I've never gained weight on any medication. It's not attributable to any heroic restraint on my part though. I am not very sensitive to medications, so I don't tend to have side-effects (or success with the meds, sometimes).

As jimrat points out, on one occasion I simply wasn't eating anyway (I'm not anorexic, it was just a depression thing). At the moment, I have about 5-6kg to lose but I put this down to quitting smoking and drinking, and I absolutely have been scoffing everything in sight containing chocolate. I'm on Seroquel but I've not been taking it long enough or at a high enough dose to account for any weight gain, I think.

Hamster, your post is perfectly articulate but like Buggs, I wish I knew...

I have gained around 45 pounds now from these meds. The worst being the two Im on now. Seroquel and zoloft. Im coming off of seroquel but it looks like its going to be a long time before im off. I agree with hamster it seems they could make a new med that is weight neutral. All of your questions make perfect sense, but i have no answers either. Just another person struggling with the weight gain. Yuck.

I've always been "underweight" according to the body mass index but, it isn't a eating disorder thing. It is a genetic, metabolism, muscle mass, figety weirdo, body type thing. Weight gain isn't always a calorie thing especially with medication. My main concern with medication has been weight loss.

Zoloft, Prozac and Celexa had me losing weight,though they are generally weight neutral, generally they don't cause mania either haha. Wellbutrin which I'm on now, makes eating during the day the most annoying chore!

I take Seroquel which makes me so hungry at night I love it! No weight gain though. And lamotrigine, which is supposed to be weight neautral right?

I don't think any of the atypical antipsychotics are weight neutral. Perhaps mix a weight neutral mood stabalizer like lamictal with a low dosage antipsychotic?

Of course if you need a high dosage antipsychotic over a long period, that really sucks! For more than just weight gain issues, sigh. They're always testing out new drugs on people. An antipsychotic with no weight gain would lead to a very generous profit. Don't think they're not looking!

I've not gained weight on medications since my teens, and I believe that might have been a thing called puberty instead of a med side effect, as I gained in chest/hips.

I think calories in/out is pretty reliable. But what happens when you throw a monkey wrench (a medication that messes with the natural system) in is that you've introduced a variable that changes the equation.

I gained more (45 lbs) on Zyprexia in 10 months time than I had, age to age, 45 to 58.

I'm off of it since November and I've lost the 45 lbs by diet as well. I no longer eat every morsel of food in sight. Thank goodness.

Now, I'm on Abilify 2 mg and I hope everything's going to be ok. I cannot have that kind of weight gain ever again! It made me feel so bad about myself. That is counter-intuitive, wouldn't you say?

When I was on Zyprexa I gained almost 20 lbs in one month. I was also a highly active anorexic at the time. I was NOT eating enough calories for weight gain like that, if any weight gain at all. I have always been a one meal a day with no snacks kind of eater ( when The anorexia is active , the meal could be a few crackers and a peice of fruit maybe) This didnt change on zyprexa. I felt like I was "puffing" up, like magically just puffing. I complained and complained. But all my pdoc would say was that I needed the weight gain anyways. And he also tried to tell me it was my appetite. And his opinion was this is all good.

When he agreed to take me off tho that 20lbs was gone in a flash and faster than even an anorexic could starve it off. I don't know what was going on, or why I gained like that. But for me it was a horrible experience.

I have lost weight on Abilify and had very few side effects. The only problem is it is so expensive and there will not be a generic until 2015.

Ha! You are right, of course.

I did not expect that there would be responses with stories of losing weight. But overall still gaining hugely is more of the norm. Thank you, I see the many mechanisms through which this weight gain is produced.

i gained 40 lbs on seroquel and risperdal ,, I am now on Haldol ,, yep old school haldol and it has helped me so much stability wise ! i did have some akathasia problems but the meds took care of that .

Haldol is weight neutral and i am losing that damn 45 lbs ..not as fast as i would like but its coming off .