Medications That May Contribute to Weight Gain

Martha Allen-Madrid, RN, BSNWeight Loss Coach

Bariatric Hypnotherapist

Objectives

• Identify medications commonly associated with weight gain

• Name the common mechanisms that make weight gain a side effect of some medications

• Discuss with their doctor and question alternative medications if weight gain has been an issue

• Review the actions that can minimize or reduce the weight gain associated with certain medications

Although not often considered in the list of risk factors for obesity, the medications taken by many people may be contributing to it

Unlike poor diet or lack of exercise, medications alone aren't a separate fast track for obesity

They may undermine a person's efforts at lifestyle modification by raising the incline on the uphill struggle to stick to diet and exercise regimen

Diet and Exercise:First Line of Defense

Increase Activity

To rev up your metabolism, exercise more. Combine aerobic and weight bearing exercise. If you already exercise regularly, increase the length of time you exercise, or exercise at a more strenuous level. Incorporate more exercise into daily activities, such as taking the stairs instead of the elevator, parking farther from stores or taking up an active hobby such as dancing or hiking.

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Cut CaloriesDecreasing the amount of calories you consume, so that you take in less calories than you burn, will result in weight loss. This can be tough, especially if you already watch what you eat, or if the medication you're taking increases your appetite. Substitute low-calorie, nutrient dense foods such as vegetables and fruit for higher calorie starches and fats. Drink lots of water to help you feel full.

Diet and Exercise:First Line of Defense

Consult your doctor about trying a different medication that may not cause you to gain weight. For instance, not all antidepressants cause weight gain. You may be able to decrease the dosage of the medication you're taking. You might also be able to switch to a different class of medications entirely or an alternative treatment that doesn't involve medication. Don't make any changes regarding your medication without first consulting your doctor. Some medications must be withdrawn gradually in order to avoid complications

Consider Possible Alternatives

Need help with diet?

Phase One, or the Weight Loss Phase, controls calories, fat, protein and carbohydrates…all the factors that effect weight gain and weight loss. This phase continues until dieters achieve their weight loss goal. There is a modified program for those who have been eating a highly processed diet and for type II diabetics.

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Phase Two introduces more grocery foods into the diet while still controlling Calories, Fat, Protein and Carbohydrates to continue with weight loss for another few weeks. Then…

Need help with diet?

Phase Three begins the Maintenance Process where dieters now start doing their own meal planning and recommendations are created for each individual that support maintenance of their new weight. This is not a starvation program…it is designed to teach dieters how to successfully enjoy a diet free life. You now just do what you need to do to stay healthy, lean and full of energy. ..and it feels great.

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How do we know? Because our coaches are experienced and well educated when it comes to weight loss and maintenance and we pass that knowledge onto you.

The Program worked for All these people… It Will Work for You Too!

G.L. Blackburn, MD, PhD, has done extensive research surrounding obesity and has identified

various medications that can affect weight.

He is an Associate Professor of Nutrition and Associate Director of the Division of Nutrition at

Harvard Medical School Chief of the Nutrition/Metabolism Laboratory, and Director of

the Center for the Study of Nutrition Medicine Boston, Massachusetts

Author of “Break Through Your Set Point”

Image from http://en.wikipedia.org/wiki/George_L._Blackburn

Blackburn’s findings and recommendations are included in this presentation

This list is NOT all inclusive

Why Does It Matter?

In most cases, weight gain is an undesirable side effect Informing patients of the possibility of appetite changes may prompt a joint decision with their Doctor to choose another medication, use a lower dose, or modify environmental factors Collective decision-making can improve adherence to a treatment plan Forewarned patients may be better able to recognize an increase in caloric intake and take preventive measures before weight gain occurs

How Do Medications Effect Weight?

Interestingly, some medications can cause weight gain in some individuals and weight loss in others

Also, there are medications that initially cause weight loss and then lead to weight gain when used long-term

Increasing appetite by stimulating insulin secretion Encouraging the division and differentiation of fat cells, thus, the potential exists for a combined weight gain effect from increased appetite and more fat cells to store the accompanying excess food intake Reducing the cardiac response to exercise, so that patients expend fewer calories during exercise Patients may exercise less because of fatigue Patients may select less healthful foods or overeat as a result of a medication-induced slump in mood

How MedicationsMay Effect Weight:

Which Medications May Affect Weight and What Alternatives Are There?

G.L. Blackburn (2008). Break Through Your Set Point

NEVER just stop a medication!Discuss medications with the prescribing doctor

Alternative medications and/or alterations in diet and exercise are typically the

solution to medication related weight gain

Medications for Type II DiabetesDrug Class/Type Generic Name Trade

NameAlternative Drugs Trade Names

Insulin Insulin lispro Humalog Metformin, pramlintide

Glucophagesymlin

Thiazolidenideone RosiglitazonePioglitazone

AvandiaActos

Acarbosemiglitol

PrecoseGlyset

DPP-4 inhibitors SitaglyptinVildapliptin

JanuviaGalvus

GLP-1 analogs Exenatide Byetta

Sulfonylureas Glipizide

glyburide,Glimepiride

GlucotrolGlucotrol XLGlynaseAmaryl

G.L. Blackburn (2008). Break Through Your Set Point

Effect: Among diabetes treatment medications, insulin is associated with the most significant weight gain over time. Some type II diabetic medications stimulate insulin production or activity, which lowers blood sugar and may increase appetite.

What to do: Increase activity and/or cut calories and/or seek alternatives.

Medications for High Blood Pressure

Drug Class/Type

Generic Name

Trade Name

Alternative Drugs TradeName

Beta Adrenergic Blockers

Propanolol

Metoprolol

Atenolol

InderalInderal LALopressorToprol XLTenormin

ACE InhibitorsRamiprilBenazeprilEnalaprilLisinopril

Angiotensin II Receptor BlockersLosartanCandesartan

Calcium Channel Blockersamlodipine

AltaceLotensinVasotecPrinivilZestoril

CozaarAtacand

Norvasc

G.L. Blackburn (2008). Break Through Your Set Point

What to do: Increase activity and/or cut calories and/or seek alternatives

Medications for Allergiesand Sleep

Drug Class/Type Generic Name Trade Name

Alternative Drugs

Antihistamines

Sleep

DIphenhydramine NytolBenadryl

Zyrtec Claritin

Ambien

G.L. Blackburn (2008). Break Through Your Set Point

Effect: You’ll find that common culprit, diphenhydramine, in over-the-counter sleep aids, such as Tylenol Simply Sleep, Sominex, or Nytol, or “nighttime” versions of cold and pain medicines, like Sudafed PE Nighttime Cold or Excedrin PM. Also, Allergy drugs containing diphenhydramine (such as Benadryl) have a sedating effect that saps your energy if you take them regularly. You’re not as active, so you’re burning fewer calories, Blackburn says.

What to do: Ask about another antihistamine for allergies like Claritin or Zyrtec that doesn’t include sedating ingredients. For sleep, your doctor may prescribe an option like Ambien that’s designed to cut carryover sedating effects. Increase activity and/or cut calories and/or seek alternatives

Medications for Anxiety, Depression, Etc.Drug Class/Type Generic Name Trade

NameAlternative Drugs

Trade Name

Anti-psychotics

HaloperidolLoxapineClozapineOlazapineRisperidoneQuetiapine

HaldolLovakaneClozarilZyprexaRisperdalSeroquel

ZiprasidoneAripiprazole

AbilifyGeodon

TricyclicAnti-depressants

AmytriptillineParoxetinePhenetizineTranylcypromineNefazadoneBupriprion

ElavilPaxilNardilParnateSerzoneWelbutrin

Bupropionnefazadone

WellbutrinSerzone

SSRIs ParoxetineFluvoxamineCitalopramescitalopram

PaxilLuvoxCelexaLexapro

FluoxetiSertraline

ProzacEffexor

G.L. Blackburn (2008). Break Through Your Set Point

Effect: Some antidepressants affect neurotransmitters in your brain that control appetite and mood, both of which can make you eat more.

What to do: See a psychiatrist instead of a family physician or internist and ask about antidepressants that don’t typically cause weight gain, such as Wellbutrin or Zyban. Increase activity and/or cut calories and/or seek alternatives.

Medications for Birth Control

Drug Class/Type Generic Name Trade Name

Alternative Drugs

Progestin only injectable

Depot medroxyprogesterone acetate (DMPA)

DepoVera Birth Control pills, IUD, etc.

What to do: Ask about a low-estrogen pill like Yasmin, or the progestin-only minipill. Or consider trying the NuvaRing, which releases lower doses of hormones than the birth control pill, or try an intrauterine device. Increase activity and/or cut calories and/or seek alternatives

Medications forSeizuresDrug Class/Type

Generic Name Trade Name

Alternative Drugs

TradeName

Antiseizure/Migraines

Valproate

GabapentinCarbamazipine

DepakeneDepakoteDepaconNeurontinTegretolEpitolCarbitrol

TopiramateZonisamidelamotrigine

TopamaxZonegranLamictal

G.L. Blackburn (2008). Break Through Your Set Point

Effect: Depakote and Depakene, medicines which are sometimes used to prevent recurring migraines, can make you want to eat more, says Harminder Sikand, clinical director of pharmacy at Scripps Mercy Hospital in San Diego.

What to do: Ask your doctor about Imitrex or other migraine drugs that are less likely to increase your appetite. Increase activity and/or cut calories and/or seek alternatives

Acosta Scott, J. (2012). Fattening Medicine: What to do when the drugs you need also put on the pounds. Retrieved from http://www.health.com/health/article/0,,20410272,00.html

Medications for Heartburn and RefluxDrug Class/Type Generic

NameTrade Name

Alternative Drugs

TradeName

Gastroesophageal Reflux

OmeprazoleLancoprazoleRabeprazolePantoprazoleEsomeprazoleZegarid

PrilosecPrevacidAciphexProtonixNexium

Sucralfate Carafate

What to do: Increase activity and/or cut calories and/or seek alternatives.

Medications forInflammation/Pain

Drug Class/Type

Generic Name

Trade Name

Alternative Drugs

Natural Approach

Corticosteroids Deltasone Prednisone NSAIDSIbuprofen, Advil, etc.

Glucosamine

G.L. Blackburn (2008). Break Through Your Set Point

What to do: Increase Activity and/or cut calories and/or seek alternatives.

NEVER just stop a medication!Discuss medications with the prescribing doctor

Alternative medications and/or alterations in diet and exercise are typically the

solution to medication related weight gain