Accepting Weight Gain in Bipolar Disorder
People with bipolar disorder, regardless of medication, are, on average, heavier than the average person. This is likely due to sedentary lifestyles and poor dietary choices due, in part, to reduced income. I suspect it’s also because of untreated and undertreated people exhibiting major depression and never getting off the couch (something I know a lot about).
But then, of course, there are the side effects from medication and one of the big ones that effects people drastically is weight gain. Antipsychotics, in particular, can make a person put on a lot of weight and fast. (Tip: the antipsychotic that was newly approved in bipolar disorder, lurasidone, has been shown to be weight-neutral.)
And while many people work very hard to try to lose it, the fact of the matter is, most can’t. Losing weight is something that is tough in the average population let alone in a medicated one. So sometimes, acceptance is the only answer.
Battling Weight Gain
Now, don’t get me wrong, if you’re determined to battle your weight then I’d recommend seeing your doctor and working out a diet and exercise plan that works for you. That’s your call and with enough work and persistence, I suspect you’ll experience some success.
But to everyone else who just can’t win the battle or doesn’t want to wage it, then I think acceptance is key.
Weight Gain and Self-Worth
Now I know that people judge themselves (especially women) by the number seen on the scale. It’s not like I haven’t done this or don’t understand this. But this is patently ridiculous. Letting a number that you only partially control run your life is like letting the type of car you drive run your life. Not everyone can afford a Lamborghini.
And I know that this type of judgement tends to feed right into feelings of depression, which is a double whammy for people with bipolar disorder.
And while it’s true that just saying that this judgement is illogical doesn’t make the feeling go away, especially after years of judgement, if we want to feel better, it’s a feeling we have to stand up to and fight.
Other People Accept Our Weight Gain Just Fine
The thing is, most of the people around us accept our shape just fine. I’ve been through many dress sizes and I don’t remember a friend remarking on it even once. In fact, I don’t recall a lover commenting on it either. (Well, except one person who was concerned I was losing too much weight. Different thing.) While, in our heads, we think everyone is judging us for our weight, the fact of the matter is that is a self-centered view. Other people just don’t give it that much thought.
Accept the Weight Gain Already!
So, knowing that there’s only so much of the number on the scale that we control, understanding that judging ourselves for it is illogical and admitting that other people just don’t care about it, the only thing left is acceptance. Acceptance of a body change isn’t easy, it’s a process, but it’s one that we can do and that we must do for our own happiness.
And if nothing else, remember this: sanity before vanity. I’d rather be fat and happy than skinny and depressed any day of the week.
Tracy, N. (2013, October 22). Accepting Weight Gain in Bipolar Disorder, HealthyPlace. Retrieved on 2019, August 19 from https://www.healthyplace.com/blogs/breakingbipolar/2013/10/accepting-weight-gain-bipolar-disorder
Author: Natasha Tracy
I'm not advocating stopping your meds. Honestly, I'd be willing to try something else, if I could actually find a psychiatrist since moving- because you know, provider shortage. The psychosis, paranoia, and anxiety is difficult to bear, I'm constantly getting in trouble at work for acting out, and my cognition feels way sluggish and scattered. But I also feel alive again, for the first time in nearly five years. I'd rather be insane and doing things than fat, miserable, and too zombified to care.
Are you tying bipolar disorder to socio-ecnomic status? Are you saying that all people who have reduced income eat poorly and are sedentary? Maybe there was helpful information in your article but I couldn't get past that odd opening with bad stereotyping.
Bipolar disorder is related to lower income and socioeconomic status. I wasn't making that up, nor it is stereotyping.
See here: https://www.ncbi.nlm.nih.gov/pubmed/21220061
And here: https://www.ncbi.nlm.nih.gov/pubmed/20832866
And many, many other studies.
- Natasha Tracy
Losing or gaining weight is all 100% what you eat and how much of it. And the medication makes me pack on the pounds because it makes me very hungry and crave carbs.
But even more than vanity I am worried about getting diabetes.
I have also not been treated very well in other places either, because of my extra weight. Especially in places where I used to like to work out. (Believe it or not, working out a lot which I have always done hasn't changed m y weight.) I've quit martial arts for now, because its just really discouraging to be the fat one, and I can't perform well. I used to turn heads, I was really good looking, but I've even been called ugly because of my weight.
But even more importantly, I have diabetes in the family. My mom almost got it she was pre-diabetic but managed to get better again. But if I keep taking this medication, I wonder if it won't be long before I will have to start sticking needles in myself.
I've been on serequl for over 6 years and have tried numerous diets, working out, everything, and I'm sick of it. I'm gunna talk to my doctor and ask if there is something else I can take for bipolar depression. Especially since my risk for diabetes is four times as high on this medication!!
The Adderall helps me function so well, it battles my depression and gives me drive to actually go out and do things, the issue? I don't eat and lose weight. The Lamictal works okay-ish, but it makes my white blood-cell count very low, which is a problem. Who likes being sick all the time? But, again, being a weight neutral drug, it doesn't help combat the weight loss. I have tried Lithium, which did not work, and Seroquel, which just made me nauseous.
Since I started the ADHD meds, I have gone from a comfortable 130-140 to a tiny 104. I know most people would kill to be that small, but what people don't understand is that being that skinny has serious repercussions. It eats muscle tissue, your bones grate on each other, which can lead to osteoporosis, scoliosis and breaks down the cartilage in between your joints. You have NO padding when it comes to sitting down, I mean it, you are literally sitting on your tailbone. It also causes sleeping issues, no matter how many foam cushioned pads you put on your bed, your body just folds in on itself and again your muscles and what little fat you have cannot support your body, (my BMI is 18.5), which is underweight. This causes massive cramps, aches and bruising.
I know people are pissed about their self image, in our current world Fat=ugly, and people believe it. But believe me, being skin and bones is ugly too. Just look at a picture of an anorexic person, is that pretty? Is that what you want to look like? If it is, I am sorry. I only wish I was in some of your shoes.
I felt like a total and utter failure.
Ever since I started taking Latuda, I've been craving far more sweets and carbohydrates than I did before. This, after a lifetime of not having to think much about my diet or try very hard to control my weight - so I have never been challenged by my weight before. It will take some time to learn to cope with it effectively.
My feet and my joints have already told me that I can't just accept the weight gain as inevitable. But I do have to accept the battle, because I'd rather have a constant weight challenge than ever suffer an episode of uncontrolled hypomania again.
Why is there no mention specifically about the all too common Metabolic Syndrome (that's more often than not associated with the use of antipsychotics) in this article? This is a very serious issue folks. Not one that should be taken lightly. It can cause cardiovascular disease, stroke, diabetes etc. You don't have to look very hard to find numerous articles on the internet that also indicate it can shorten your life by up to 20 years or more
I'm really happy to help on this one because I know how hard it is. I'm sorry you've been going through that "rat race" with no success. Acceptance is likely a better road :)
- Natasha Tracy
I feel for you! Maybe you should talk to doc about switching meds?
I put on over 100 lbs in one year before being diagnosed and could not lose a pound for years in spite of meds, restricting calories and exercising. I was still having extreme mood swings, crying all the time or staying awake for days running up credit cards. The meds also gave me a bizarre "verbal dyslexia ". I would think one thing and something completely different would come out of my mouth! I was also in a fog that took a while to shake.
I recently switched doc and meds and am finally losing weight! Not much, just down a couple sizes but will take it. I am also sleeping, not so weepy and better about spending. Still having some depression but not as extreme. Please don't lose hope!
I already have PCOS and have to work hard to keep my weight down. I'm at a good, healthy weight and am toned, and I compete in triathlons. My psychiatrist told me we would talk about what side effects I would be willing to deal with and which ones I wouldn't, and I told her weight gain is something I don't tolerate. She has been working with me to find drugs that don't cause weight gain, and we've found a few - I'm on one that seems to be working well.
Accept getting fat if you want, but don't criticize those of us who want to maintain some semblance of health.
I have struggled with weight my whole life. Born barely over 5 lbs, then overweight since before age 5. Since becoming very depressed and bipolar and being medicated and diagnosed with fybromyalgia I have leveled off at 250 lbs. Not good for a girl that is 5'6". But I have leveled off. That is a big deal for me. I have not put too much thought into losing weight because I am having a horrible time managing my symptoms. I know once my mood is good, the weight will come next. I am SO GLAD to know that it is OK TO BE LIKE THAT! Thank you.
You seem to have misunderstood me. You seem to have got only the general gist that you would expect from someone advocating diet and exercise, and not the specific place I am coming from on this one.
I am on medication which apparently causes weight gain, which has, in me, 'caused' weight gain Lets say the mechanism of this is a changed metabolism. So to address this issue, I'm changing my diet and exercise patterns. The cause is not the medication. The cause is a diet and exercise regime that does not suit the new metabolism, i.e. you are stuck in your old patterns when a new balance is needed for the medications.
I do understand, very well, about depression and weight gain, and how a person can't just get off the couch. However it is possible to make small but reasonable goals, reasonable for the amount of depression you are suffering. In those horrible black times the diet and exercise might have to wait...
...but in general I am saying that if you blame the weight gain on your mental health circumstances, you will be powerless to change.
I am suggesting a frame of mind which might be helpful to people who do want to improve their physical health by losing weight. I am suggesting that people do not think that their circumstances are to blame, rather take an internal 'locus of control' over the situation.
Go on, change your diet. Not an over-the top diet where you beat yourself up on a daily basis. Just regular, healthy, nourishing food. If you are having emotional food cravings, try to address the basis in therapy, distract yourself with other kinds of indulgences
You may still feel powerless, as though you are not ready for weight loss, that the mental health factors are too much for you. It's how I felt for a long time, but I've found the confidence - somehow to make the necessary changes. Do not allow the mental health factors to overwhelm you. You're still allowed to be as depressed as you like while on a diet. It has no direct bearing on your actual diet, if you don't let it.
Hiking, running, biking, going out and doing things is what can help me. I can't do any of those things if I'm obese and my body can't support me.
Managing my weight is hard, lots of things are hard.
No one should accept fat and happy vs thin and crazy. Fat and on the couch watching TV, is not happy and not life.
And as for fat and happy... pretty cliche, but is it true? Health affects the brain. Fat, unhealthy body with screwed up metabolism... may not be happy too long.
And don't call this vanity. It's a health issue as well.
ACCEPT WEIGHT GAIN??? Which part of that should we accept?? NO! I refuse to believe that there is no other way. NO WAY in hell I'm going to accept that. And please, it's not about "vanity" at all! For crying out loud. I work in an industry where looks and figure is very important. So it could cost me my job, my profession, my PASSION, my life! Not eating anything and still gain 20 pounds!! NO. NO. NO. I'm done with the weight gain. And I am not gonna be a good girl who just takes her meds because I'm better than a good girl. I'm a smart girl. I THINK. I have convictions. I believe in the "Work-around." I believe that there are 101 ways to skin a cat. If weight gain is a side effect at a considerable amount, it has to go. There are other options. I will not accept that I just have to be fat to be okay.
I got fat because I ate too much junk food. I can blame the medications or my emotional problems, but those were just circumstances I didn't have to deal with before.
Now I admit what the problem was, I can admit that there is something I can do. Stop eating junk food and start eating sensibly. That is the bottom line. I haven't been able to do this to date because I blamed the emotional problems and medication, two things I haven't been able to change.
Also it helps that my emotional problems have improved lately, because I've reached out for the help I need.
So far I have lost 5kg, in just a few weeks. I'm still enjoying my food. Just not the bad food.
Ultimately, our circumstances are difficult which can affect the likelihood of weight gain. But if you have gained weight, don't tie it to irrelevant issues. Medication may have changed our eating patterns, but if you use it as an excuse to keep dong the same thing, then you are stuck. The only issues relevant to weight loss are diet and exercise. Nothing else.
You can lose weight no matter what sort of person you are, what you are taking, or even if you love to drown your sorrows in chocolate icecream. Drown your sorrows in a romance novel instead.
2 things - diet, and exercise. Keep those in mind and you can and will lose weight.
Yes, if you are on the right medications, you should be experiencing those positive effects. If you're not seeing those, that's not the right medication for you.
First, to Cyndi, that's kind of the point of taking the meds. So if it doesn't do that, then it may be worth revisiting.
Regarding the whole weight gain thing, it just makes my head spin in about a thousand directions.
Two years ago, I had a major upset in my life, tremendously so. I also had a hiking fall. And so in that entire year following I was pretty darn inactive. I'd gone from hiking 5 days a week to not at all, for the most part. In that year of inactivity, I gained 20 pounds. Then 6-8 months later, I started seroquel. Within maybe 2-3 months, I'd gained about 10 more pounds. I'm not overly concerned about it all because I work out with a trainer 2-3 times a week, and I stay as active as much as I can. But weight? I hate it. The proportionate ratios? I hate that too. I just want my old self back.
I try not to fret about it; I hardly ever even weigh myself. But I hate it all the same.
One step at a time! Literally!