Prescription for Obesity - It Could Be Your Pills

[David Baxter PhD]

Prescription for Obesity - It Could Be Your Pills; Researchers Link Some Medications to Weight Gain
May 18, 2004
Seattle Post-Intelligencer

The pills millions of people take every day for diabetes, clinical depression, high blood pressure and other illnesses are small, weigh almost nothing and carry few calories.

So it may seem hard to swallow, but certain prescription drugs can cause people to gain weight. Fast. Sometimes a pound a week.

Both doctors and patients overlook the possibility that weight gain can originate in the medicine chest, not just fast-food restaurants or couch-potato lifestyles, according to Dr. Lawrence Cheskin, director of the Weight Management Center at Johns Hopkins University in Baltimore.

"While obesity is being more widely recognized, I'm not sure the same can be said for patients' and physicians' recognition of the possible contributing role of prescription medicines," he said in an interview.

Cheskin and his associates first warned about the problem in the 1990s, after noticing that a lot of patients who sought help at their weight management center were getting heavier when they started prescription drugs.

One 42-year-old woman, for instance, gained 42 pounds after taking lithium, a drug for mood swings. A 36-year-old supermarket worker gained 240 pounds while taking prednisone, a steroid.

Weight gain is among the side effects listed in official information sheets for some of the most frequently prescribed drugs in the United States. These include drugs taken by tens of millions of people for diabetes, depression, high blood pressure, gastric reflux and heartburn, and serious mental disorders.

"Weight-gain drugs" is how Dr. George Bray, an obesity expert at Louisiana State University, describes such medications.

Nobody knows exactly how many prescription drugs fall into those categories. Lists published in medical journals vary. One provided by Dr. George Blackburn, an obesity authority at Harvard University, includes more than 50 common drugs.

Internet drug discussion sites such as RxBoard carry accounts from patients who say they got fat after starting anti-cholesterol and other drugs not thought to cause much weight gain.

Non-prescription drugs also might cause weight gain. The antihistamine diphenhydramine, for instance, is on Blackburn's list. It is an ingredient in dozens of popular cold and allergy remedies, sleep aids and drugs to prevent motion sickness. An increasing number of prescription drugs, including some linked to weight gain, are also becoming available for sale without a prescription.

In some cases, it takes years for weight gain to emerge as a troublesome side effect.

When the Prozac-Zoloft-Paxil family of popular anti-depressants hit the market, doctors thought they caused weight loss. They were even prescribed for obese people trying to lose weight. Later, doctors realized that any weight loss is temporary, with the drugs often causing long-term weight gain.

But while studies show that "weight-gain" drugs can cause obesity in individual patients, researchers can't tell how much medicines contribute to the societywide epidemic of obesity. Bray has found that the number of obese people in the United States remained fairly steady - about 20 percent of men and 15 percent of women - until the mid-1970s. Then it took off; by 2000 the rates had risen 100 percent among men and 50 percent among women.

Use of prescription drugs rose during that period, and exploded in the 1990s. In 1993, the number of prescriptions written each year edged over the 2 billion mark for the first time. It reached 3 billion by 1999, and will top 4 billion by the end of 2004, according to the Association of Chain Drug Stores.

Almost every person in the United States now takes at least one prescription drug in a given year. Factor in people who take multiple drugs, and doctors write an average of 12 prescriptions annually for every person in the country.

Since average weight has been rising during the same period, weight-gain drugs have likely played a role in the obesity epidemic, although probably not as much as changes in diet, Bray said.

DRUGS AND WEIGHT GAIN

Here are a few of the common prescription drugs that may cause weight gain:

Anti-depressants - Prozac, Zoloft, Paxil
Heartburn drugs - Nexium, Prevacid
Mental disorder treatments - Clozaril and Zyprexa
Diabetes drugs - Glucotrol, Diabeta, Diabinese
High blood pressure drugs - Minipress, Cardura, Inderal

A physician's list of about 50 "weight-gain" drugs and possible alternatives can be found at: Medications That Cause Weight Gain (Adobe Acrobat PDF file)

 

[greenwillow]

To Lose Weight Gained By Taking Prescribed Drugs.

I gained a great deal of weight from taking prescribed HRT. - The weight gain destroyed my looks and my health. But by chance I discovered a way to lose a lot of the weight gained. - I had already discovered calorie-counting and fat restriction to be absolutely futile, though this was the routine advice. - As many other people have also found, dieting DOES NOT WORK!

There are thousands of websites where one can read about calorie-controlled diets. There are thousands of doctors and nutritionists and dieticians who will advise people to reduce calories or fat or carbohydrates or take exercise in order to reduce weight. There are many diets sufferers can try and probably have tried, and yet they are heavier now than before they started dieting.

The problem may be sensitivity to salt. Salt can cause obesity and health problems in vulnerable people.

In recent years people have been eating more convenience foods and these are high in salt. Excess salt intake can cause water retention and that means excess weight because water is heavy. By eating less salt(sodium) some of this excess water can be lost and so weight is lost.

Over 90% of people who lose weight by following a 'slimming' diet regain all the weight they have lost - and more! - Yet EVERYONE who reduces his/her salt intake loses weight.

My advice to everyone who has become obese because of taking prescribed medication, and to anyone else who wants to lose weight and has found that dieting does not work, is:

Forget about counting calories!

No dieting! - No hunger! - No drugs! - No adverse side-effects! - No cost! - No exercise!

Lose weight by eating less salt! - Go on! - Try it!

For more information and advice on this subject visit www.wildeaboutsteroids.co.uk

 

[David Baxter PhD]

First, restricting salt is a diet, since it means not only not adding salt to the food you eat but restricting foods, especially prepared foods, that contain sodium. In doing this, one is forced to eat a more balanced diet - shunning fast foods and prepared snacks in favor of more fresh vegetables and fruits. That sounds like a diet to me, albeit not an unhealthy one.

Second, restricting salt tends to result in some weight loss due to reversing water retention, but that will last only as long as you continue on the salt-reduced diet. Again, this may not be a bad thing to do for other reasons.

I guess my point here is, first, that we shouldn't fool ourselves - there's nothing magic about this - and, second, that weight gain as a side effect of medications is unlikely to be helped by this method.

 

[greenwillow]

Obesity and the Salt Connection.

Well if you want to play around with words you can call restricting salt a diet...(o: - It's not what most people would call a diet. and it's not what I would call a diet.

However little you reduce your salt intake, you will lose weight. - eg changing from salted to unsalted butter, changing from cornflakes to porridge, changing from ordinary bread to low sodium bread. - Or better still, making your own unsalted bread, as I do. These are the sort of changes I made to what I eat. - My weight loss was not because I ceased to eat junk takeaways and ready meals because I never ate them anyway.

As you say, the weight loss will only continue while the sodium intake is restricted. - That hardly needs stating surely! - It's obvious. - The low salt intake needs to become a lifelong routine. Obviously if more salt is eaten again, more water will be retained again.

Your last paragraph is completely incorrect. - If you read my earlier post again, you will see that the reason I became obese was precisely because of prescribed medication, in my case, HRT. I was given too high a dose, inappropriately, and for too long. - Like many people are. - And I, sadly rather late in the day, discovered that the reason this happened is that this and other medications can, and very frequently do, cause sodium and water retention. THese side-effects are sometimes stated in the details about prescribing. Sometimes they are omitted.

So as I say, your last paragraph is completely incorrect. The very thing that people need to do to lose weight when that weight gain was caused by prescribed medications, is to reduce their sodium intake.

This is all explained clearly on my website. I urge people to read it.

 

[David Baxter PhD]

Re: Obesity and the Salt Connection.

The very thing that people need to do to lose weight when that weight gain was caused by prescribed medications, is to reduce their sodium intake.

Or perhaps change to an alternate medication? If it's the medication that is causing the problem and there are alternatives available, wouldn't it be better to address what's causing the problem?

 

[David Baxter PhD]

My apologies, greenwillow - I just now re-read your post and I realize that I had misread part of it.

I don't mean to dismiss out of hand methods such as the one you describe. My point is simply that just as there are many causes of weight gain, there are many remedies.

For example, some years ago I was taking a medication for hypertension that caused eclampsia - reducing salt intake helped a bit but didn't solve the problem - switching to a different medication solved the root problem.

 

[greenwillow]

Obviously it would be better to address the initial problem of the medication. Obviously. - But many doctors are not at all co-operative in this and continue to maintain that the weight gain is caused by over-eating, rather than by the medication. In England anyway, where I live, they often tend to be bullying, and when you are ill and very tired, this is daunting. And eventually, so much damage has been done that a change of medication would not make any difference to the weight gain anyway.

When I had worked out all that had happened to me, which took me many months, as you may imagine, because I wanted to be completely confident in what I said, I tackled the endocrinologist who had caused me so much harm. When you have an understanding of what had previously been inexplicable, you are given a special confidence and strength. She came to my home. She spent a Thursday evening, then the whole day Saturday, then the Sunday morning with me. She wept. She sobbed. She hugged me and begged my forgiveness. I am not remotely vindictive. I promised not to sue her.

She said that she had been taught that any woman who was overweight and 'claimed' not to be over-eating was a liar and should be ignored, so she had ignored what I had said! (You realise that in the stress of her emotion and guilt she was speaking the truth!)

She also said that she knew nothing about sodium retention until I drew her attention to it and explained it to her. - It's a deplorable state of affairs when an endocrinologist responsible for the prescribing of tablets all of which have the potential to cause sodium retention as their most common side-effect, has no knowledge whatsoever about that side-effect! - No wonder my GPs were equally ill-informed. - And every other doctor I have encountered...(o:

I'd like others to benefit from the discovery I made. - It is the fruit of very great suffering and should not be wasted. - You posted about patients who have gained weight because of medications they have taken. - I have posted the only truly effective therapy for this. - I hope you will in no way seek to dissuade those damaged people from taking my excellent advice. No possible harm can come from it and their lives could be transformed, as mine was, and as others have, when they have made a serious effort to take my advice.

 

[David Baxter PhD]

You make a good point about needing to be persistent when discussing your case with physicians - sometimes, the patient is in the best position to know what is going on (actually, this is the basis for Carl Rogers' Client-Centered Therapy).

I experienced excessive fatigue from a medication a few years ago and went to my doctor with my belief that it was the blood pressure medication (not the one above - that was my second attempt - the third worked!). He said I would be the first person to complain of that side-effect with that medication and he didn't believe it was the cause. However, he is an excellent physician and changed medications anyway and of course the proof was in the pudding - my problem disappeared with the medication change.

Every patient is different. And that is even more true when it comes to psychoactive medications: Listen to your body and hear what it is telling you.

Thanks for posting this, greenwillow, and for raising the issue - it's an important one.

 

[greenwillow]

Thank you for your apology, David. - No problem.

I do hope that when you encounter people who would benefit from the information on my website, you will tell them about it.

No one else is likely to!...(o:

 

[sammy]

My doctor confirmed last week that a lot of my weight gain is excessive water retention, because of being extremely hypo-thyroid, and has prescribed a low dose diuretic, as my lower legs and ankles are seriously affected, in fact I have discovered that I seem to have gone into the myxoedema stage of hypo-thyroidism, as my dose wasn't high enough for a long time...
I am also reading of people who have gone onto natural, rather than synthetic thyroxine, (which is available in the States, but not the U.K.), are finding their symptoms drastically alleviated, including weight gain, that they had lived with for years...
I know it's not over-eating that causes it in a lot of people...one thing I have realised is that some of us need to eat more and better, to actually stop our metabolism being so sluggish.
I will certainly review my salt intake...
My thyroxine are called thyroxine sodium though, I wonder if this might be a problem, although at 200mcg daily, I shouldn't think much of it is sodium.

 

[David Baxter PhD]

One thing that can help is increasing water intake - a physician in a recent interview suggested that in modern society we are seriously below a reasonable water intake (water in coffee, tea, soft drinks, juices, beer, etc., doesn't count as "water intake" for a variety of reasons) and that this causes or contributes to a lot of "minor" health issues - among them, he estimated that insufficient water intake was the number 1 cause of daytime sleepiness and excessive fatigue.

It's also pretty good at flushing toxins, excess salt, etc., out of the body...

 

[greenwillow]

It's certainly a good idea to drink plenty of water. But if drinking bottled water, check the sodium level. Some are high in sodium. I drink Evian water for preference. It is very low in sodium - just 5mg per litre - which is much lower than the sodium level in the water from my tap.

Re sodium in tablets. There is sometimes a rather high sodium content. Effervescent tablets are likely to be high in sodium, so if you take any of these it is worth checking to see if there is a non-effervescent version you could take instead.

 

[David Baxter PhD]

That's also good advice -- recent studies have also shown that some bottled water actually contains more impurities, bacteria, or even toxins than tap water, depending on the brand and on your geographical location. It's always wise to do a little research...

Years ago, my daughter pointed out to me that "Evian" backwards spells "Naive"...

That's not a condemnation of the Evian brand, of course, but it is a reminder that, as with anything else, it is "buyer beware" (I was about to type "caveat emptor" there but I recently made a joke in another forum suggesting that the correct translation for this is actually "we're out of caviar").

 

[greenwillow]

I now have two further pages on my www.wildeaboutsteroids.co.uk website. One is Obesity and the Salt Connection. - This is an article I wrote for British Mensa magazine and which was published in the December 2004 issue. The other is Socio-Economic Considerations.

By the way, a Mensa member whom I had advised a few years ago that all she needed to do to lose weight was to reduce her salt intake, has a letter in the April 2005 issue of British Mensa's magazine. In it she writes that she lost 5 stone (70 pounds) in a year by following my advice! - Fantastic, that, isn't it?