Psychiatric Meds and Fat

psychMost of us who have been treated with psych meds gain weight, there are a lucky few who escape this side effect, and then many that gain a moderate amount and then what seems a large significant minority for whom major weight gain is a problem. I fall into the last category.

Before I started my journey into the med trap I was a thin, muscular athlete. I was a cyclist and swimmer. I cycled about 40 miles a day four days a week. I swam an hour several times a week. I lifted weights, used the stair master, went running and played tennis. I also went on long hikes. I was strenuously active almost everyday of my life. I was proud of my strength and fitness and liked my body.

Enter Depakote and Risperdal. Gained 60 lbs. One pound after another for several years. The reason was two-fold. I was so sedated and depressed I had no energy and I slowly stopped my athletic routines. Secondly the drugs simply made me gain weight–it wouldn’t have mattered if I continued to work out or not–some weight gain would have happened regardless–this I know as later I did start exercising . After about 12 or 13 years of continuing increased doses of Risperdal, Seroquel was added and I gained another 20 lbs. Seroquel gave me serious uncontrollable munchies. I never had an eating disorder–this was something else. It was caused by the drugs. I was also on an assortment of other drugs which have weight gain associated with them, but the ones I name are those most guilty of it. Again the sedation caused by the other drugs, most notably the Klonopin, made things worse.

Three years ago when I started neurofeedback and some of the lethargy abated I found that I could exercise again. I went to the gym daily and hiked several times a week. I lost 40 lbs over a two year period. I was still on a lot of meds and in spite of working out hard one to three hours a day six days a week I could not lose more than those 40 lbs. I was still fat in spite of working my ass off and eating healthy food. I have never eaten classic junk food. No McDonald’s or any other fast food. Only very occasional sweets or high fat foods. Working out was not enough. After the two years of losing I maintained the 40 lb weight loss for a year–continuing to work my butt off at the gym and in the mountains on trails.

A year ago I improved my diet further. I cut out all refined grains, all sugar, all alcohol and all processed foods. No change in weight. I ate better than most to begin with, now I have a stellar diet.

I had been casually cutting down my drugs during this period, then nine months ago I committed myself to it ferociously. Since then I’ve begun to suffer from chronic fatigue. I go for occasional gentle walks. I can’t work out hard anymore. What used to be a source of joy and an endorphin high now makes me feel worse. It’s a drag and from what I hear about withdrawing from drugs, it’s not unusual. I’ve gained back the weight I lost–all but maybe 5 lbs, in spite of eating healthy. I am fat. People assume I’m a glutton. (this I know from living in a fat-phobic society) I try not to let it bother me, but it does.

To make matters worse, when I was about thirty years old after a 40 lb weight gain, I had a sadistic therapist who blamed me and told me that I ate too much. (I ate normally–in fact I once spent a week with a thin friend we did everything together 24 hours a day–I saw what she ate and I ate less then her) I tried to tell the therapist that the drugs make people gain weight and she insisted they did not. I unfortunately let her make me feel it was my fault. There was not a lot of information about the drugs back then and she did not work with people on them. I knew different, since I did work with people labeled mentally ill, but she pounded away at my self-esteem and so I continued to blamed myself for many years.

I saw a production on PBS that focused on fat. Everyone whose life was featured on the show ate horrible, shitty food. A couple of them did it unabashedly and one chose bariatric surgery over changing his diet. One woman courageously radically changed her diet and worked out three hours a day–she lost weight but was not thin. (even after several years) The message of the program was that our bodies become programed to be the weight they are once fat. Our chemistry demands that we take in a certain amount of calories to maintain the weight our bodies are used to being. The depressing reality–90% of people who lose large amounts of weight gain it back and according to the program it’s not really their fault. I have to wonder though, how many people maintain healthy diets. I imagine not most. I have to hope that maybe my diet will work for me in the end.

I’m hoping I fall into some different category than those people talked about on the program, but I fear that I don’t. My body is now used to this weight. I’m not so sure it will come off once I am off the drugs. I do know that once I can work out again I will again at least lose those 40 lbs–I know I can do that as long as I maintain a heavy work-out schedule. I like working out when it feels good–when I’m healthy. And I am quite confident I will again feel good enough to work out again though it may take a couple of years. Even so, I’m imagining I’m probably never going to be thin again regardless of what I do.

I will hopefully be healthy enough to return to work eventually–this adds another troubling dimension to the problem–three hour physical work outs several times a week will not be an option. My losing 40 lbs in the last several years was predicated on my being on disability. I had the time. There would be no way in hell I could do that and maintain a full-time job. I imagine I will be fat for life. Less fat rather than more fat maybe, but fat none the less. I am hopeful that I might not need to work out quite as hard once off the drugs.

I was actually okay being 40 lbs lighter than I am right now. I was able to accept my body and feel good about what I had managed, so it’s not all so bad. I’m just not happy with my body now. If I am able to lose the 40 lbs again and am at that level of fat, I will be happy. For me fat is now relative. It’s not so much about what I look like, it’s how my body feels. One roll of fat is okay, but two leaves you feeling bound up when you lean over or stretch or sit cross-legged. I just want my agility back like I had when I lost the 40 lbs. At that point I will be able to say I don’t give a shit what people think because I feel good. Right now I don’t feel good and I do care what people think. I think they go together.

More posts on psych meds and fat here.

Update: I did lose all the weight eventually after coming off all the psych drugs. It took several years with many dietary and lifestyle changes that all simply amounted to learning to listen to my body. I did not diet to lose weight. I found an optimal diet for a complete sense of well-being without any sense of deprivation. See: Mental health and diet — Nutrition and gut health

See also:  Everything Matters: a Memoir From Before, During and After Psychiatric Drugs

About Monica Cassani

Author/Editor Beyond Meds: Everything Matters

27 Responses

  1. Stephany

    Gianna,
    This is a great post. I gained weight on Xanax [which Im going to be removing incredibly slowly soon, as it is extended release to boot]–The PCP told me I was over eating due to stress when I complained about the weight gain. I had not been over eating, and I can relate to when you said, you ate less than another person, etc. I could go days w/out food and still gain weight. I was also an active person, I was a runner, and all kinds of stuff. I too, hit a wall where the chronic fatigue syndrome that I have caused me to feel worse after working out. I’m down to slow walks now, and have to monitor exercise due to horrible exhaustion later. I commend you on calling the shot here, by saying society looks at fat people as gluttons. You know, some days I actually worry about this so much, that I start wondering what people think when they see me. It erodes away a self esteem. Especially knowing how I used to look. Anyway, thanks for the post, I am sure many people on psych meds can relate.

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  2. Jayme

    Gianna, what an excellent post! I hate that people actually blamed you for the weight gain. You were doing everything you could, and most people don’t even do that much. I was impressed that you gave up processed foods and sugar, etc. It’s so hard to get in the groove of dieting with the American diet always in our faces. The best thing I ever did for myself was food combining. It helps your body get back to its natural rhythm of digestion. I never weigh myself anymore, but I went from a size 12 to a size 6 — and without exercising. Look up “food combining.” It’s a simple concept and very healthy. Good luck in getting off the meds. I know you can do it. I finally did.

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  3. Gianna

    thanks for the feedback gals it feels good to know I connected with people.

    Jayme,
    If you feel so inclined would you send me an email and share your drug withdrawal story with me? I always like to hear personal details about individual journeys.

    I have had a look at your blog so I know your ongoing story is there, but I’d like to hear your process from “consumer” to ex-consumer…maybe a post for your blog?

    Otherwise, if you like you can send email to gianna_kali at yahoo dot com

    thanks again for the comment and I’m planning on looking up food combining!

    Stephany,
    Good luck with the xanax withdrawals. I have to do Klonopin and I’m saving it for last since I’ve heard benzo’s can be the worst.

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  4. Stephany

    I agree food combining works. –about the xanax..yeah the pharmacist told me to get generic 1/4 mg. pills and use those, because she said I cannot split the extended release. I went on XR due to that stuff wearing off at exactly the 6 hour mark, sweats, stomach pain etc. and I was at work. I can hardly wait to remove that stuff–I told my pdoc to send me to a fancy rehab place so I cant go detox in style. HAHA. Kinda wasn’t kidding though.

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  5. Gianna

    Stephany,
    You can switch to a benzo with a longer half life–like valium–and cut down much more slowly that way.

    If you cut down by 1/4 mg of xanax at a time it may be too much. About 10-30% of people withdrawing from benzo’s have severe reactions.

    I’m part of benzo withdrawal groups–if you’re interested in getting hooked up with any let me know–I’ll give you the info.

    Or check out:
    http://www.benzo.org.uk/manual/index.htm

    for advice on weaning off of benzo’s.

    again–good luck!

    oh and in rehab they tend to go cold turkey which can be really ugly for some people…I don’t think it would feel like you were doing it in style.

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  6. Stephany

    Thanks Gianna, and that is one of my fav sites. When i start the removal I will definitely be asking for tips. ive read that xanax is the one med that can’t be switched out w/ another to come off of the benzo–is that true? thats why ive been so reluctant to start the process.

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  7. Gianna

    Stephany,
    I’ve heard that one can have a potential problem switching any of the benzo’s. When I read the Ashton Manual I just remember it saying a lot of people have trouble doing it with Klonopin (which I’m on) I don’t remember a comment about xanax…but if you take a look at the Ashton Manual you’ll get a better idea…and if you want lots of individual experiences the groups I’m aware of can be helpful–they can also be scary because some people are having such hellish times. I always have to remind myself that it’s 10- 30% that have the hellish time and I don’t have to assume it will be me.

    Sometimes I think the groups have a preponderance of people in that percentage group–which is why if not taken with a healthy perspective it can be scary–I’m glad I have all the info I have from them though. I’m not currently paying attention to them…but did for quite a while. Will check in again once I being the K taper.

    Tell me what you find out about switching the x. I think it’s possible to try–but maybe I’ve just not been clued in sharply enough on X issues because of being on K.

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  8. Doe

    Yep, I relate to, and have experienced the same thing. Started out lean and athletic…I was a runner. Over the 13 plus years of being on meds, I put on 25 pounds. I guess I would be in the moderate weight gain category, but I am 4 feet 11 inches, so this looks like much more on my small frame. I wish I could attach pictures! Even with intense working out and eating well, I never could recapture that lean looking body I once had. I eat less than I did in those lean years. I work out more, yet people would probably look at me and not guess that I worked out. And now that I’ve been withdrawing slowly over the years, I can’t work out like I used to, I don’t have the energy, and it makes me feel worse rather than better. It kind of has an abusive rather than healing feel. I too think that this will pass, although it will probably be years. It’s confusing because I have thought too that maybe it’s just aging and everyone gains weight and doesn’t look like they did in their 20’s…but it feels different. Plus, my sisters, who aren’t on psych meds, have keep their lean bodies and they are older than me….
    It is frustrating, I must say. But I guess I still have hope.

    And Gianna, I want to pummel that shrink that was so abusive to you! There are so many screwed up shrinks out there and people are so vulnerable when they come to these sadistic folks–it’s very sad and also enraging. I had a 3 year experience with an abusive shrink too. Luckily, I ended up being friends with one of the folks in a group therapy session that she led, and this friend left too, and we were able to share our mutual stories and heal some from the experience. This friend told me that she went to a restaurant the other day where this shrink had her card posted on the bulletin board and someone had written on the card “Stay far away from this one!”, and we both had a big amen to that.

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  9. Doe

    I’ve heard that being on meds long term stresses the adrenals (I’m sure you’ve heard this too), and we know also that it stresses the body to go off them and withdraw….I think it has something to do with adrenal fatigue and I’m sure it also involves a whole host of other stuff that I don’t know anything about! Healing the adrenals takes years, and I’ve heard that it involves feeling worse before you can feel better and also talks about a necessary period of weight gain before the loss can occur and it being harmful to try and diet and over-exercising while trying to heal the adrenals.

    I was thinking about gentle exercise like yoga as I was vigorously exercising on the Nordik Track the other day. I just felt like crying and it occurred to me that I was just abusing myself. I have heard also that gentle exercising is what seratonin deficient people need more rather than vigorous exercise. It is also feeling, intuitively, like what my body wants.

    I know there are all sorts of theories and opinions about the whole seratonin deficiency theory…but I do know that I responded very robustly to the seratonin type drugs while the non-seratonin drugs did nothing for me but make me more anxious (wellbutrin).

    I once got my saliva tested for amino acid supplements to try and tell which brain chemicals I was deficient in (which I’ve also heard is bullshit and impossible to do…so many conflicting theories it’s confusing!) and it reported back deficient seratonin and excess dopamine and noriepinephrine, which makes total sense when I see what drugs worked and what drugs didn’t.

    Anyway, I rambling. I totally agree with you on focusing on the health and not the weight, and not getting down on yourself about it. Our culture is definitely fucked up on the issue and it’s in our bones to soak up that sickness. I actually like the look of fleshier women and I actively look for those images to admire (though it’s hard to find them!). As I near 40, I’m also looking for images of healthy, vibrant women rather than looking at the young thangs.

    I read something recently that commented on how we spend so much time on our physical appearance before going out in public…we can spend 30 minutes to an hour applying make up, doing our hair….but why not spend that half our working on our spirit before going out…preparing our spirit to be with other people, rather than our bodies? I thought this was a great idea! Working on the beauty of our spirit rather than the focus on the physical. Because when it comes down to it, it really is one’s spirit that makes one beautiful.

    Thanks for the discussion.

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  10. This is a good topic. I was once in great shape–a college wrestler, had sit-up record in college. Then, as a senior in college I was hauled off to a mental ward and placed on a mixture of psychoactive drugs for years. In less than a year, I lost my athletic body because I had gained over 100 pounds. Probably worse was that my body was the only thing that I felt good about. So, my self-esteem sunk to zero. I hated being fat. Back then there were few fat people–not like today. I would go to basketball games with over 600 people in the gym. I was the fattest–by far. There was no way I could hide my 100 pound pot belly.

    Eventually, I slowly worked my way off of the pills, lost the weight, and became an athlete again. One of my jobs I have is teaching PE in college. My students have told me that I’m an inspiration because I lost weight and kept it off.

    I have written an article about losing weight on my website.
    Jim S

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  11. I agree – this is a good topic –

    Depakote and Zyprexa both made me gain a ton of weight – and it’s so slow coming off…….

    I think the doctors who don’t see this as a major issue are really missing something here……

    I don’t know how anyone is to believe that the same meds that destroy the body help heal the brain – this simply makes no sense to me…….

    Looking back, I would have never gotten on these meds had I known the fallout – is weight alone enough to get off meds (slowly withdrawal) – when you consider type II diabetes, heart problems, and other things……yes

    And, the fact that it’s incredibly hard to exercise when you put on a bunch of weight – and how the psyche is injured – the feeling of defeat that comes along with the weight – adds to the depression – a vicious cycle……

    If a person wanted to get off psych drugs due to weight gain alone, I think they would have all the reason they needed – (notwithstanding, the zombie-like affect, the loss of memory, higher thought, and deeper emotion) –

    Weight gain – a great topic – thanks for posting.

    Duane

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  12. Sloopy Cowbell

    Hi Duane!

    Boy, it’s good to hear someone talking about Zyprexa in the past tense!

    I’ve been stuck on that muck for nearly a decade 😦

    I didn’t even notice I was getting fatter, but it showed when the quack weighed me.

    The doc told me I’d put on more than 20kg in the last year alone. He didn’t even seem bothered. I suppose I’m only a mental patient.

    Just before Christmas I decided to cut out a third of the dosage.

    Whew!

    Within ten days, I suffered a discontinuation syndrome that I wouldn’t wish on my worst enemy.

    Symptoms were partly psychiatric – wild mood swings – suicidal thoughts then, minutes later, a euphoric mania, fluctuating states of consciousness, and hallucinations.

    But even more disturbing are the psychomotor-related symptoms including painful muscle tics, spasms, movement retardation and acute mental and physical restlessness.

    I don’t want to be overly optimistic, but now, a full two months later, and I sense the neurological trauma is slowly subsiding.

    I can only hope and pray that the recovery continues, and at somewhat faster pace.

    I won’t even chance a further dose reduction until all those symptoms have subsided.

    So it’s great to know from good people like you that Zyprexa withdrawal can be done!

    Best,
    Sloopy

    ——————————————————————-
    Hi Jim S!

    Thanks for sharing your story.

    Everyone who posts here is an incredible inspiration. This is the best peer support forum I’ve ever come across.

    What I particularly love about your personal account is that you are telling a vivid story of recovery that took place years ago!

    That’s especially heart-warming for those of us struggling in the midst of it!

    I can personally relate to using booze to self-medicate. I too sought solace in drink. It seemed like a good crutch. It comes with a ready-made social life, bars and clubs full of so-called friends.

    Bad move.

    At the time, I was too sensitive, too vulnerable, for the rough and tumble of bar banter. And after a while, alcohol turned into a severe mood depressant for me.

    Do hope you can drop in again very soon, to share some more!

    Best,
    Sloopy!

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  13. jan

    I am suffering abysmally from coming off of, first, clonazepam, then a month later Depakote, and then another month and a half later, Tofranil. I gradually decreased each one of these, but it doesn’t seem to matter: I am suffering greatly, and after having been drug-free now for almost 10 weeks, it’s hard for me to believe I could still be suffering so much. I would love a reply from ANYONE going through protracted withdrawal, possibly from Depakote in particular, to know that I’m not losing my mind and that it can get better. I feel hopeless. I don’t sleep, am anxiety-ridden all day, have depression and the fatigue is off the charts. Exercising makes it so much worse, too. I’m DEPERATE for reassurance!

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  14. jan

    Hi Gianna:

    WOW! It’s good to be e-mailing to someone in the know. I have improved my diet greatly – no refined sugar or honey, no alcohol, no caffeine, very little white or wheat flour, very little dairy, and lots of veggies, fruit and try to get lean meat. I never mentioned how long it took me to get off of each one of the meds, but I think I know already that it was way too fast. I was on 750mg Depakote, started weaning off of it in mid-February, and was completely off of it by the end of May. I was going through withdrawal the entire time I was doing it. My stupid psychiatrist wanted me to get off of it, but her schedule was this: 250mg AT A TIME every 3 days until I was done. She thought I wouldn’t have a problem. Can you believe it? She would have landed me in the hospital. I knew not to do it, but I actually did make the first cut of 250mg. I knew nothing of someone compounding this when I was doing it. I will certainly join Withdrawal and Recovery, and I’m glad it’s not too late. I just hate to start back on the meds again when I’ve been off of them for this long. They scare the crap out of me!

    Thanks,

    Jan

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  15. Jan

    Gianna:

    Who is the woman who has been dealing with the psych med recovery for 20 years? I would love to get in touch with her and pick her brain about what to do if she is up to it and feeling better.

    Thanks you so much for your input.

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  16. jan

    Hi Gianna:

    I have a question re: protracted withdrawal which I am definitely in the midst of BIG time. Can one of the symptoms be that your body gets very achy with the joints feeling as if they are swelling and the muscles getting extremely tense all over the body, accompanied with extreme exhaustion? This is just one of the many nasty symptoms I’m dealing with. I used to exercise a lot before but now I can’t even do much walking without it hurting.

    Thanks

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  17. Jan

    Gianna:

    Thanks for the info. You have been of tremendous help. And WOW! It’s truly amazing the far-reaching and devastating effects these meds have on the body. It is very difficult to find anyone, especially a doctor, who has any understanding whatsoever of withdrawal. It is really a shame and a crime. I believe this is all happening to me so that I can be an advocate and also educate people. I live in the eastern part of the country and we really seem to be a bit behind on things like this (although there is an excellent alternative psychiatrist near Baltimore).

    Thanks again,

    Jan

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  18. Jan

    Gianna:

    As you were and are healing, do you experience random moments of some relief, only to find the next moment or next hour feeling horrible again? And then wondering what the heck you may have done or eaten that set you back, only to realize that your body is still healing and this is the way it will be? Please tell me this is “normal” in the way of healing through all of this. It makes me crazy!

    Jan

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  19. Jan

    Gianna:

    WOW! You capture how I’m sure many of us feel, including myself. You have answered my questions. You are an extremely talented writer (and obviously very compassionate person, too). Thanks for sharing your story – I know it is and will be helping so many. When we share, it helps others take courage to do the same, and that great cycle continues. There are too many people suffering. And, just like you, I wonder every day how long I’ll be suffering, and if it’s the drugs or some weird disease. It always boils down to this – it’s the drugs and IT IS withdrawal!

    Jan

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  20. downcastmysoul

    Years ago at the mental “health” center I picked up a pamphlet on Zyprexa and it said to avoid weight gain essentially by will power. It’s not so easy as that, is it? They want us to be fat shuffling idiots and I refuse. I used to go to the drop in center for the mental “health” system and there were very few thin fit people outside (or even amongst) the staff. Almost everyone seemed to grow fat over time (at least the 3 years I was there).

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