Psychotropic Medication and Obesity




A few weeks ago I had the pleasure of meeting a fitness trainer who shared her journey with clinical depression and obesity.  Mary (not her real name) told me at one time she was 250 pounds and clinically depressed. She was frustrated with her conventional treatments, which included numerous medications and psychiatric hospitalizations.  Mary said “You don’t know how they treated me.”   She decided that method was not working and instead improved her diet and incorporated exercise. Mary said her mental health drastically improved.  She eventually lost 85 pounds and is no longer clinically depressed. 

When a person is seeking help for their mental illness, they’re not expecting to trade one problem for another.  Medication works for some but not everyone. I have heard countless clients share feelings of hopelessness over their rapid 30-40 pound gain from their medication. 

Child psychiatrist Dr. David Rettew said “Recent research has revealed that many of the risks of medications may have been under appreciated while the benefits somewhat overblown. As a result, enthusiasm for psychopharmacology has diminished.

According to a 2011 report published by National Center for Biotechnology Information (NCBI), “A majority of psychiatric medications are known to generate weight gain and ultimately obesity in some patients.” What’s even more upsetting is the client is lead to believe that the medication is the only recourse for their treatment.  The negative effects of a chronic illness or a poor diet are not considered as contributors to their mental illness, but they should.  Clients are often given these medications as a life sentence. If the client’s symptoms don’t improve, the dosage is often increased or the medication is switched all together.

Obesity and mental illness are both epidemics that share a stigma.  People who suffer from either one or both often feel powerless and trapped in their bodies. Those feelings can worsen if their practitioner does not understand or even support the benefits of mental wellness derived from a healthier lifestyle. The co-morbidities associated with weight gain are hypertension, cardiovascular disease, diabetes, osteoarthritis and even many cancers.  It is not uncommon for me to see clients taking over ten powerful medications daily in an attempt to control their numerous illnesses.  Eight of the 10 most commonly used drugs in 2011-2012 were used to treat weight-related health conditions: hypertension, diabetes and dyslipidemia. 

Many antipsychotics, antidepressants and mood stabilizers prescribed for depression, anxiety or bipolar result in excessive weight gain.  Here are a few:

·      Zyprexa (Olanzapine)-increase insulin resistance.

·      Clozaril (Clozapine)-increase insulin resistance.

·      Seroquel(Quetiapine)-increases insulin resistance.

·      Remeron (Mirtazapine)

·      Depakote (Divalproex)

·      Paxil (Paroxetine)

·      Lithium (Lithobid)

·      Valproic Acid (Depakene)

·      Carbamazepine (Tegretol, Equetro)

Mental health practitioners are a product of how they are trained. If they were trained to only identify symptom clusters and refer for medication then that will be their modus operandi.  Integrating the benefits of dietary changes and even supplements is still met with some resistance but the science is there which I will discuss more in upcoming blogs.

Recently I posted the following on positive psychiatry:

“Positive psychiatry seeks to understand the underlying biological mechanisms of health and well-being through behavioral and biological interventions.”

This is a field of medicine that is gaining momentum because the current system is not producing the results they are always taunting.  When clinicians understand that their job is too look for underlying reasons for mental health issues, clients will have much better outcomes. Obesity by medication should not be considered the lesser of two evils.  No one’s health should be compromised in that matter and clients deserve better.

I would love to hear your thoughts!

 

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Priyanka Kapoor
Priyanka Kapoor
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