Transcript Medications That May Contribute to Weight Gain

Medications That May
Contribute to Weight Gain
Martha Allen-Madrid, RN, BSN
Weight 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.
.
Diet and Exercise:
First Line of Defense
Cut Calories
Decreasing 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.
Consider
Possible Alternatives
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 Some medications must be withdrawn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
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.
.
Need help with diet?
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.
What about Maintenance? We continue supporting
you for as long as you need us while you live your new
maintenance lifestyle. We measure certain things
during your maintenance journey…the things we know
are key to long term success.
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 longterm
How Medications
May Effect Weight:
 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
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
Diabetes
Drug Class/Type
Generic Name
Trade
Name
Alternative Drugs
Trade Names
Insulin
Insulin lispro
Humalog
Metformin,
pramlintide
Glucophage
symlin
Thiazolidenideone
Rosiglitazone
Pioglitazone
Avandia
Actos
Acarbose
miglitol
Precose
Glyset
DPP-4 inhibitors
Sitaglyptin
Vildapliptin
Januvia
Galvus
GLP-1 analogs
Exenatide
Byetta
Sulfonylureas
Glipizide
glyburide,
Glimepiride
Glucotrol
Glucotrol
XL
Glynase
Amaryl
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
Beta Adrenergic
Blockers
Propanolol
Inderal
Inderal LA
Lopressor
Toprol XL
Tenormin
ACE Inhibitors
Ramipril
Benazepril
Enalapril
Lisinopril
Metoprolol
Atenolol
G.L. Blackburn (2008). Break Through Your Set Point
Trade
Name
Altace
Lotensin
Vasotec
Prinivil
Zestoril
Angiotensin II Receptor
Blockers
Losartan
Candesartan
Cozaar
Atacand
Calcium Channel Blockers
amlodipine
Norvasc
What to do: Increase activity and/or cut calories and/or seek
alternatives
Medications for Allergies
and Sleep
Drug Class/Type
Generic Name
Trade
Name
Alternative
Drugs
Antihistamines
DIphenhydramine
Nytol
Benadryl
Zyrtec
Claritin
Sleep
G.L. Blackburn (2008). Break Through Your Set Point
Ambien
Effect: You’ll find that common culprit, diphenhydramine, in over-thecounter 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
Name
Alternative
Drugs
Trade Name
Antipsychotics
Haloperidol
Loxapine
Clozapine
Olazapine
Risperidone
Quetiapine
Haldol
Lovakane
Clozaril
Zyprexa
Risperdal
Seroquel
Ziprasidone
Aripiprazole
Abilify
Geodon
Tricyclic
Antidepressants
Amytriptilline
Paroxetine
Phenetizine
Tranylcypromine
Nefazadone
Bupriprion
Elavil
Paxil
Nardil
Parnate
Serzone
Welbutrin
Bupropion
nefazadone
Wellbutrin
Serzone
SSRIs
Paroxetine
Fluvoxamine
Citalopram
escitalopram
Paxil
Luvox
Celexa
Lexapro
Fluoxeti
Sertraline
Prozac
Effexor
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 for
Seizures
Drug
Class/Type
Generic Name
Antiseizure/ Valproate
Migraines
Gabapentin
Carbamazipine
Trade
Name
Alternative
Drugs
Trade
Name
Depakene
Depakote
Depacon
Neurontin
Tegretol
Epitol
Carbitrol
Topiramate
Zonisamide
lamotrigine
Topamax
Zonegran
Lamictal
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 Reflux
Drug Class/Type
Generic
Name
Trade
Name
Alternative
Drugs
Trade
Name
Gastroesophageal
Reflux
Omeprazole
Lancoprazole
Rabeprazole
Pantoprazole
Esomeprazole
Zegarid
Prilosec
Prevacid
Aciphex
Protonix
Nexium
Sucralfate
Carafate
What to do: Increase activity and/or cut calories
and/or seek alternatives.
Medications for
Inflammation/Pain
Drug
Class/Type
Generic
Name
Corticosteroids Deltasone
Trade
Name
Alternative
Drugs
Natural Approach
Prednisone
NSAIDS
Ibuprofen,
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