![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by dondon on January 12, 2006, at 3:39:46
How long does it take to loose the weight you gain from medications? I gained 40 pounds on remeron and i have been off of it for 2 months now and i still haven't lost any weight.
Posted by picklehead on January 12, 2006, at 9:31:23
In reply to weight gain and meds, posted by dondon on January 12, 2006, at 3:39:46
I'm wondering that myself... I honestly think they permanately slow down the metabolism and you gotta work hard to get it back up.... I know Topamax helps and the doctors around me are very open to giving it when weight gain has been an issue due to other meds, however, Topamax is no miracle diet pill either, it just supresses your cravings and helps you eat better... I think it does help jump start your metabolism too, but I'm no expert.
Posted by arnie666 on January 12, 2006, at 18:27:48
In reply to weight gain and meds, posted by dondon on January 12, 2006, at 3:39:46
Hi I have been off remereon and quetiapine and gained a huge amount while on them. even when I came off them until I started to exercise it did not shift .. at all.
Once I started getting fit running weight training etc it came off very quickly.My diet didn't really need to change I have always eaten healthy but that didn't stop the wieight gain while on them.I actually eat more off the drugs due to how active I am,
Posted by Phillipa on January 12, 2006, at 21:36:56
In reply to Re: weight gain and meds, posted by arnie666 on January 12, 2006, at 18:27:48
I always thought you would drop the weight once off the meds. But I've never taken that high of a dose. Fondly, Phillipa
Posted by yxibow on January 13, 2006, at 2:12:25
In reply to weight gain and meds, posted by dondon on January 12, 2006, at 3:39:46
> How long does it take to loose the weight you gain from medications? I gained 40 pounds on remeron and i have been off of it for 2 months now and i still haven't lost any weight.
I gained at least 50 lbs on Remeron. With a little more added from Seroquel, I hit 258. At that point I said enough was enough and I dont want to have diabetes or a heart attack at 30, so I joined 24 hour fitness and got a trainer (this isn't an ad, you're free to excercise how you want :). Since then, I've lost at least 30lbs, its hard to measure, since it fluctuates, I have hit a low of 221 on some days. It takes concerted effort to lose weight, the general medical guide is about 1-2 lbs a week. I've lost as much as 3 lbs a week, I sometimes tend to overdo it, but now I can actually see some of myself in a mirror, I've lost 4 clothing sizes, its great. As they say YMMV (your miles may vary), but I would seriously consider joining a gym, or if you like places like Weight Watchers and all that, then do that. Basically, you have to either burn or not eat 500 calories a day for 7 days to get rid of a pound of fat, that's about 3500 calories. If you lower your diet 300 calories and do some modest 1/2 hour to 1 hour walk an evening, you'll probably lose at least 200 calories that way, and you've lost a pound a week. More vigorous excercise of course will do more. Its hard, a slow process, but it is possible, especially if you don't have any new medications on board that are big weight gainers. I unfortunately have to fight the Seroquel a little bit (its not a huge weight gainer, but it does mess with the lipids.)
Hope that helps
-- J
Posted by Racer on January 13, 2006, at 12:52:05
In reply to Re: weight gain and meds » dondon, posted by yxibow on January 13, 2006, at 2:12:25
I know -- it seems like easy math, but it's not. Especially for women, by the way, because we actually have to prime the pump, so to speak, in order to lose weight. We have to expend 4000 extra calories to lose a pound -- which is a pound of weight, not a pound of fat, by the way -- because our bodies are evolved to protect and feed fetuses. Our bodies don't want to lose weight, because we have a more active role in reproduction.
Also, these drugs, in many cases, cause weight gain pretty directly, by affecting metobolism. That means that we can't 'just eat less and exercise more' to get the weight off. When I stopped Effexor, for example, I didn't change diet or exercise -- but proceeded to lose about 30 pounds within months. NOTHING changed, except discontinuing the Effexor. And gaining weight on Effexor? I don't overeat, as a rule, and I worked outdoors, on my feet, all day. I got exercise, and a lot of it. So how could I gain weight, when I was probably eating LESS than I had been?
When I started Paxil, I was actively anorexic. Starved myself and worked out two to three hours a day, EVERY day, weights and cardio. And I started gaining way before I stopped overexercising, or started eating more. The drug itself changed something.
I'm writing all this to let other people know that it's NOT necessarily "your fault" if you gain weight on these drugs. I know how wretched I felt when my doctor was saying, "Oh, you're gaining weight because you're eating too much, and not exercising enough." The Paxil, for example, had me suicidal when I gained 10 pounds before it had any effect on my mood.
Yes, diet and exercise can help for many people, but not for everyone, and it's respectful to remember that. Sorry if I sound defensive -- I am. Even doctors are learning that it's not productive to blame the patient in this matter, and they're starting to prescribe mitigating agents, like Topomax, to help alleviate some of the metabolic changes.
Posted by cache-monkey on January 13, 2006, at 14:21:45
In reply to It's not that easy with a lot of drugs » yxibow, posted by Racer on January 13, 2006, at 12:52:05
I appreciate Racer's point here, and agree that these meds have the potential to alter metabolism.
For people who are still on medications, I think that supplemental pharmacology (e.g. Topomax and amantadine) is useful under certain conditions:
a) exercise and dietery monitoring aren't cutting it -- and this means really giving it a go with exercise; spending half an hour at least 5 days a week doing something active
b) the augmentation doesn't deteriorate your psychological condition (e.g. cognitive slowing or anxiety)But I think the OP is interested in how to reduce weight *after getting off* meds. For people stable and going off meds, I think that exercise and diet can work. But this can take some time, unfortunately.
For me, I gained about 25 pounds (on a base of 180) when Celexa was added to my Wellbutrin. I eventually stopped meds since I thought I was healed. A mistake in restropsect, but not the point here.
At first after going off meds, I tried increasing the working out and improving my eating habits, and saw little success. But after about 8 or 9 months, I kicked it up another notch with the work-out and finally saw the pounds melting off. A couple of years later I have slowed down a little with my exercise and have not had the pounds pack back on.
Assuming that there was some sort of metabolic effect of Celexa, here's what I think happened. Exercising increases your metabolism, but less so when your metabolism is being artificially slowed down. While I was on the drug, and soon after going off, exercise might not been enough to counteract the metabolism-slowing effects of Celexa.
But I think that as time wore on my metabolism became more responsive to exercise as the effects of the Celexa faded. Also, I think that ratcheting up my exercise regime sped up this process.
Good luck and hang in there,
cache-monkey> I know -- it seems like easy math, but it's not. Especially for women, by the way, because we actually have to prime the pump, so to speak, in order to lose weight. We have to expend 4000 extra calories to lose a pound -- which is a pound of weight, not a pound of fat, by the way -- because our bodies are evolved to protect and feed fetuses. Our bodies don't want to lose weight, because we have a more active role in reproduction.
>
> Also, these drugs, in many cases, cause weight gain pretty directly, by affecting metobolism. That means that we can't 'just eat less and exercise more' to get the weight off. When I stopped Effexor, for example, I didn't change diet or exercise -- but proceeded to lose about 30 pounds within months. NOTHING changed, except discontinuing the Effexor. And gaining weight on Effexor? I don't overeat, as a rule, and I worked outdoors, on my feet, all day. I got exercise, and a lot of it. So how could I gain weight, when I was probably eating LESS than I had been?
>
> When I started Paxil, I was actively anorexic. Starved myself and worked out two to three hours a day, EVERY day, weights and cardio. And I started gaining way before I stopped overexercising, or started eating more. The drug itself changed something.
>
> I'm writing all this to let other people know that it's NOT necessarily "your fault" if you gain weight on these drugs. I know how wretched I felt when my doctor was saying, "Oh, you're gaining weight because you're eating too much, and not exercising enough." The Paxil, for example, had me suicidal when I gained 10 pounds before it had any effect on my mood.
>
> Yes, diet and exercise can help for many people, but not for everyone, and it's respectful to remember that. Sorry if I sound defensive -- I am. Even doctors are learning that it's not productive to blame the patient in this matter, and they're starting to prescribe mitigating agents, like Topomax, to help alleviate some of the metabolic changes.
>
>
Posted by yxibow on January 14, 2006, at 0:43:19
In reply to It's not that easy with a lot of drugs » yxibow, posted by Racer on January 13, 2006, at 12:52:05
> I know -- it seems like easy math, but it's not. Especially for women, by the way, because we actually have to prime the pump, so to speak, in order to lose weight. We have to expend 4000 extra calories to lose a pound -- which is a pound of weight, not a pound of fat, by the way -- because our bodies are evolved to protect and feed fetuses. Our bodies don't want to lose weight, because we have a more active role in reproduction.
I wasn't saying there was a "cookie cutter" method for losing weight, and I do recognize the differences between men and women. Men have more muscle mass than women which accounts for the greater expenditure of energy for women to lose weight. I'm not sure where the 7,500 calorie figure comes from though.
>
> Also, these drugs, in many cases, cause weight gain pretty directly, by affecting metobolism. That means that we can't 'just eat less and exercise more' to get the weight off. When I stopped Effexor, for example, I didn't change diet or exercise -- but proceeded to lose about 30 pounds within months. NOTHING changed, except discontinuing the Effexor. And gaining weight on Effexor? I don't overeat, as a rule, and I worked outdoors, on my feet, all day. I got exercise, and a lot of it. So how could I gain weight, when I was probably eating LESS than I had been?For some, and some drugs, they may actively change metabolism and other factors in the body. Seroquel has probably changed my cholesterol somewhat even though I'm a vegetarian. Its unclear how much is due to the drug and how much is due to a slow but steady increase in eating patterns, which may not be noticeable over a period of months.
> When I started Paxil, I was actively anorexic. Starved myself and worked out two to three hours a day, EVERY day, weights and cardio. And I started gaining way before I stopped overexercising, or started eating more. The drug itself changed something.
I fully agree with your statement. Some bodies are just different. Its also worth knowing that weight gain can occur more greatly in those who are underweight than overweight for some medications.
>
> I'm writing all this to let other people know that it's NOT necessarily "your fault" if you gain weight on these drugs. I know how wretched I felt when my doctor was saying, "Oh, you're gaining weight because you're eating too much, and not exercising enough." The Paxil, for example, had me suicidal when I gained 10 pounds before it had any effect on my mood.Never did I say it was "your fault." Its a combination though often of decreased metabolism and either the same amount of caloric intake or just a slight increase, over a long period of time.
>
> Yes, diet and exercise can help for many people, but not for everyone, and it's respectful to remember that. Sorry if I sound defensive -- I am. Even doctors are learning that it's not productive to blame the patient in this matter, and they're starting to prescribe mitigating agents, like Topomax, to help alleviate some of the metabolic changes.Topamax never did a thing for me in weight loss -- I guess it varies by the person. It is not without danger -- it causes kidney stones 2 to 4 times those not treated with it. There have been rare gall bladder related events as well.
Finally, as for weight differences between men and women; the BMI does take account for some of these -- women are not considered in the obese category at a higher fat percentage than men, which as you clearly pointed out has plenty to do with reproductive functions.
I wasn't saying weight loss is easy -- its sometimes a lot of work for a given individual. I have to burn extra calories even in my given weight loss plan, for the very reason that has been mentioned, that some medications change metabolism by innate reasons -- atypical antipsychotics and possibly Remeron being the big problems. But it is true, sooner or later, regardless of sex differences, if you take into account them, and the metabolism changes of a drug, and the food intake, the body, male, or female, has to maintain its caloric (fat, muscle, and water) balance at a certain number. That number may be greatly different for someone on a medication regime. Eating below that number will eventually, over time, many weeks and months, gradually show a loss in weight.
Posted by Racer on January 14, 2006, at 12:56:51
In reply to Re: It's not that easy with a lot of drugs » Racer, posted by yxibow on January 14, 2006, at 0:43:19
>I'm not sure where the 7,500 calorie figure comes from though.
It comes from a brain f*rt. It takes an expenditure of 4000 calories for a woman to lose a pound, an extra 500 calories. That's because our bodies are so very efficient...
>Never did I say it was "your fault."
No, you didn't. I included that because I've heard it from many doctors over the years. It's so painful, so devastating to hear it, that I wanted to counter it in my post, for anyone out there that hears that whenever anyone brings up weight loss and meds. I didn't mean to imply that you had made that assumption.
>Eating below that number will eventually, over time, many weeks and months, gradually show a loss in weight.
With some of these drugs, though, that number will be far below what's necessary to support life. There are some psychotropic drugs that, for some people, will simply lead to weight gain, often significant weight gain. Period. I don't know what the answer is, my therapist says I have to accept that I may become fat, no matter what I do, if I have to continue antidepressants. I'm not happy about that idea, but I don't know what else to do.
And I have a really hard time with anything that sounds like, "If you just worked harder, you'd feel better/lose weight/get things done/etc." That comes up so often for people with depression, and it's so much bootstrapping. It can be so devastating to me, that I do tend to jump on it when I see anything like that here on the boards.
I guess I'm saying that I hope we can be more sensitive to what others here go through, and respect that it can be virtually impossible to lose weight for some people on some of these drugs.
Posted by Laurie Beth on January 17, 2006, at 15:18:39
In reply to It's not that easy with a lot of drugs » yxibow, posted by Racer on January 13, 2006, at 12:52:05
I don't doubt that these meds can change metabolism.
But even if they don't, they still bear responsibility for weight gain if they cause the patient to be hungrier, crave unhealthful or high caloric foods, or make the patient sleep more than before. I don't know if my metabolism changed on Zoloft (I gained 40 while on it, probably 25 of them during the 9 months I was on 300 mg.), but I do know that it made me hungry all the time, made me sleep 14 hours a day, and made me lethargic when I wasn't sleeping. It's no answer for a doc to say "well, just eat less and exercise more," if the med itself makes that impossible.
Laurie (a little defensive too?)
Posted by yxibow on January 17, 2006, at 17:19:38
In reply to Re: It's not that easy with a lot of drugs » Racer, posted by Laurie Beth on January 17, 2006, at 15:18:39
>made me sleep 14 hours a day, and made me lethargic when I wasn't sleeping.
This actualy is importnt -- sleeping affects things too even when one is not eating any more or less, because one burns more calories while awake than in bed, nearly 75% more awake for example typing at the computer.
Posted by cecilia on January 20, 2006, at 1:20:59
In reply to Re: It's not that easy with a lot of drugs » Racer, posted by Laurie Beth on January 17, 2006, at 15:18:39
It would seem that people who sleep more would gain more weight because they're moving less, but actually the opposite is true, studies have shown that people who get less than 5 hours sleep a night are 50% more likely to be obese than those who get 8 hours. Cecilia
Posted by Laurie Beth on January 20, 2006, at 8:25:21
In reply to Re: It's not that easy with a lot of drugs, posted by cecilia on January 20, 2006, at 1:20:59
> It would seem that people who sleep more would gain more weight because they're moving less, but actually the opposite is true, studies have shown that people who get less than 5 hours sleep a night are 50% more likely to be obese than those who get 8 hours. Cecilia
Could well be that much lower than average sleep is correlated with obesity, because neither extreme is probably healtful, or an indication of good health (in general - there are always exceptions). But I'm betting there aren't any studies showing that people who sleep 14 hours a day and are lethargic most of the rest of it, are exceptionally slim (assuming no concomittant drop in appetite).
Posted by cecilia on January 21, 2006, at 2:37:06
In reply to Re: It's not that easy with a lot of drugs » cecilia, posted by Laurie Beth on January 20, 2006, at 8:25:21
You're right Laurie Beth, either extreme could lead to weight gain, plus a whole lot of other factors too, meds, genetics, stress, dieting history, psychological issues, metabolic rate and probably multiple things that haven't been discovered yet. But to doctors it's all so simple, eat less, exercise more. Oh Brilliant Doctor, you went through 4 years of medical school to tell me that. I've only been dieting for about 40 years, how come I'm not thin yet?
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.