Weight Gain in a Pill - Prescription Drugs Cause People to Gain Weight

Written by HealthyPlace.com Staff Writer

Use of the drugs, however, has expanded to include other disorders, including aggressive behavior, post-traumatic stress syndrome, and autism.

The American Diabetes Association, the American Psychiatric Association, the American Association of Clinical Endocrinologists, and the North American Association for the Study of Obesity convened an expert panel to study the side effects.

It concluded that some SGAs do cause rapid weight gain, with many patients putting on a pound a week - mostly fat -- after treatment starts. Weight gain may continue even after a year of treatment.

The panel also found a documented link between SGAs and the development of prediabetes (a condition that involves abnormally high levels of sugar in the blood), diabetes, and elevated levels fats in the blood. Those are risk factors for heart attacks.

However, the panel also emphasized the benefits of anti-psychotic drugs.

"These medications have helped millions of people manage their symptoms," the report said. "For people who respond well, antipsychotics can mean the difference between leading an engaged, fulfilling community life and being severely disabled."

The panel recommended that doctors check on each patient's body weight and risk for obesity, diabetes, and high blood fats before prescribing a SGA and during treatment. It noted that some SGAs have a lower risk of weight-related side effects, and gave doctors information they need to pick low-risk drugs for patients with weight problems.

Clozaril (Clozapine) and Zyprexa (Olanzapine), the panel said, carry the highest risk of such side effects. Risperdal (Risperidone) and Seroquel (Quetiapine Fumarate) have an intermediate risk, while Geodon (Ziprasidone (HCl)) and Abilify (Aripiprazole) cause little or none.

The SGA panel could be a model for gathering and spreading reliable information about other weight-gain drugs, according to some experts.

"I think it would be a good idea to develop an expert panel to review weight gain from specific drugs," said Dr. Samuel Klein. He is an authority on obesity at Washington University in St. Louis who served on the SGA panel.

"Once such a panel reaches some conclusions, a decision could be made on whether the information is important enough to include in package inserts or patient information sheets."

Dr. Lawrence Blonde said studies should provide specific information on the whole topic of prescription medication and weight gain. An authority on diabetes at the Oschner Clinic Foundation in New Orleans, he also served on the SGA panel.

He cited a need for information on the drugs most likely to cause weight gain, the percentage of patients who gain weight, how much weight gain is likely to occur, and how long it will last.

"I think it would be useful to provide patients and caregivers with some additional information on potential weight gain from prescription drugs," he noted.

Some of the existing information is from clinical trials that may exaggerate the seriousness of drug-related weight gain, he pointed out. In those experiments, patients were told not to make any changes in diet or lifestyle while taking the medicine.

"It may well be that patients could have avoided or reduced the weight gain if they had implemented appropriate nutritional and physical activity lifestyle changes," he said.

There are hints that patients can loose the weight with changes in lifestyle, switching to alternative medicines that don't cause weigh gain, or adding new medicines to control appetite.

A 2003 study at Dartmouth Medical School, for instance, focused on patients who gained an average of 65 pounds while taking SGAs. Lifestyle and medication changes enabled them to shed about two-thirds of the weight.

"Physicians and their patients need to choose drugs after assessing both the risks and the benefits that a particular medication might have for the condition. Depending on the clinical situation, the benefits of taking a medication may exceed the risks of weight gain.

"Before prescribing such a drug, the physician should discuss the potential risks of weight gain, and attempt to minimize it by recommending appropriate lifestyle changes," Dr. Blonde added.

"But it shouldn't be given in isolation. Patients should understand that the benefits of taking the medication may far exceed the risks of weight gain. For patients who already are overweight, there may be alternative medicines that do not seem to be associated with weight gain."

Dr. Fernstrom cautioned that patients who gain weight while taking a medication should not stop. Rather, she suggested that they talk with the doctor. Changes in lifestyle, rather than the drug, may be the real cause. In addition, there may be an alternative medicine not linked to weight gain.

Likewise, possible weight gain should not discourage patients from taking needed drugs.

"Raise the issue with your doctor," Dr. Fernstrom added. "Say that you are concerned about weight gain as a side effect and ask if there are other medications available. If the drug of choice is the only option, and you do notice weight gain, you can make some lifestyle changes."

That means steps like getting more exercise, reducing food intake, and drinking only non-calorie beverages. Even 30 minutes of walking can burn about 150 calories, she noted.

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