Ambrish Mithal, M.D., D.M.
Chairman, Head Of Department, Division of Endocrinology and Diabetes, Medanta, The Medicity, Gurgaon, Haryana.
Senior Consultant, Endocrinology & Diabetes, Department of Endocrinology, Indraprastha Apollo Hospitals, New Delhi.

    
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Certain kinds of medications can promote weight gain by increasing our metabolism and appetite
THOUGH most of us know plenty about the dos and donts of weight gain, the information that some of the medicines we take for our health problems may promote a piling on of the pounds may come as a shock. We may be aware of other negative side effects of these drugs, but are usually unprepared for the weight gain they may result in.

Every single prescribed medicine has side effects and weight gain is one of the visible ones. Since informing people that they may gain weight from eating a certain medicine might actually discourage them from taking this, doctors may withhold this information. However, such an approach goes against those who suffer from hypertension, high cholesterol, diabetes, arthritis, etc., as a slight gain in weight can aggravate their conditions.

Withholding this information may also prevent people from taking potential measures to reduce the risk of weight gain.

“ There are many life- saving medicines which may result in weight gain. This can be dealt with by adopting the right approach, consulting the doctor about this, and maintaining a careful diet and exercise routine which controls the weight,” says Dr S Chatterjee, senior consultant, Internal Medicine, Indraprastha Apollo Hospitals.

Prolonged use of drugs such as corticosteroids taken by those with severe allergies, asthma or arthritis, diabetic drugs, birth control pills and psychiatric drugs are known to cause people to gain weight by increasing their metabolism and altering the hormones in the body that control appetite. Not just that, sometimes even the most innocuous drugs if taken for a long time could add to more pounds. “ Many people keep taking Vitamin B or other multivitamins especially with vitamin B1 without consulting the doctor for a long time. This can cause weight gain due to thiamine in B1 which stimulates appetite,” says Dr Ashutosh Shukla, Head, Internal Medicine, Artemis Health Institute.

PSYCHIATRIC DRUGS

THE PROLONGED use of many psychiatric drugs such as antidepressants can cause weight gain. This side-effect must be weighed against the fact that they provide relief from emotional trauma suffered by those with mental problems.

The essential factor to keep in mind is to stay in touch with the doctor and follow a few important instructions. “Medicines alone should not be blamed for such side effects as most of the time patients dont do what the doctor tells them. Despite being repeatedly advised, patients dont visit the doctor regularly especially once they start feeling better. They continue on the same dosage.

Also, they usually dont exercise regularly which is most important while taking such drugs,” says Dr S Sudarshan, senior consultant, psychiatry, Rockland Hospital.

One of the reasons for the weight gain caused by Certain kinds of medications can promote weight gain by increasing our metabolism and appetite psychiatric drugs is that they speed up the metabolic rate and stimulate the appetite, prompting a person to eat more. Certain chemicals in such drugs are also believed to regulate the receptors in the brain that interact with the moodaltering hormones serotonin and dopamine.

However, each individual reacts differently to such drugs and not all experience weight gain problems. “It is very difficult to say which medicine could possibly lead to weight gain, as every patient reacts differently to drugs. Moreover, there are many who are predisposed to gain weight, which is why we advise patients to visit us regularly as in such a case we usually change the medicine or lower the dosage or can add an appetite suppressant for some time,” Dr Sudarshan.

Second- generation antipsychotic drugs, used to treat mental disorders like bipolar disorder and schizophrenia, such as olanzapine ( Zyprexa), aripiprazole ( Abilify) and risperidone ( Risperdal) are especially infamous for the weight gain they cause. They are known to cause metabolic syndrome and excess fat deposits in the body. In 2003, the US Food and Drug Administration asked the drug manufacturers to carry a warning on labels of second- generation antipsychotic medications stating that blood sugar levels should be monitored in people with diabetes or with symptoms of high blood sugar. Thats the reason why anyone on such drugs is advised to get their blood lipid and sugar levels checked regularly. However, doctors say that those on longterm psychiatric drugs and not just atypical antipsychotic drugs who also suffer from diseases such as diabetes, heart disease, hypertension, kidney problems and others, should go for annual check- ups. “ I advise patients to get their blood sugar and cholesterol levels checked every six months,” says Dr Sandeep Vohra, senior consultant, psychiatry, Apollo Hospital.

Apart from this, doctors emphasise on following a healthy dietary regime and taking regular exercise, as such drugs tend to induce lethargy and make the person sleep more, leading to weight gain over a period of time.

ANTIDIABETIC DRUGS

PRESCRIBING diabetes drugs is usually a big challenge. Such drugs increase the insulin levels in the body, which leads to weight gain over a period of time.

Doctors often struggle to find the medication that matches the patients profile as any added weight may affect the person adversely. “ Treating diabetes is a complex task as any weight gain due to medicines can be harmful for the body. Usually, we prescribe drugs such as metfornin, gliptin and byetta which balances the weight gain side effects of antidiabetic drugs,” says Dr Ambrish Mittal, chairman, Endocrinology, Medanta - The Medicity. Apart from this, its important to keep weight in check while on such medicines with regular exercise and an exercise regimen.


ORAL CONTRACEPTIVES

PROLONGED use of birth control pills usually causes weight gain as these alter your metabolism, leading you to eat more, and also relax your body, just the way sedatives do. The progesterone in the pill also causes fluid retention, which can make you feel as if you've put on weight, particularly in your breasts, hips and thighs in the same way some women gain weight during their menstrual period. But, its believed that the new birth control pills are more body friendly due to the change in the molecule of progesterone and lower estrogen level. However, its advisable to consult the doctor in case you see a sudden increase in body weight. Doctors sometimes prescribe diuretics to deal with fluid retention.




Contact for Appointments: At Medanta: 93 508 76124      At Apollo & Vasant Kunj Clinic: 98 104 74552  (10 A.M. - 5 P.M., Monday - Saturday)