Conditions and Medications That Make Weight Loss Difficult

Conditions that make weight loss difficult

• Metabolic conditions
  • Metabolic syndrome
  • Polycystic ovarian disease
  • Cushing's disease
  • Diabetes
  • Hypothyroidism
• Eating disorders
  • Bulimia
  • 'Carbohydrate craving' syndrome
• Cardiovascular
  • Congestive heart failure
  • Idiopathic hypertrophic cardiomyopathy
  • Valvular disorders
• Sleeping disorders
  • Obstructive sleep apnea
• Upper airway resistance syndrome

Medications that may cause weight gain

• Anticonvulsant
  • Sodium Valproate (Depakene)
• Antidepressants
  • Tricyclic
    • can add up to 9lbs (4kg) a month
  • Lithium based
    • can add up to 2.5lbs (1.14kg) a month
  • SSRI (Selective Serotonin Reuptake Inhibitor)
    • may increase hunger
  • Potential alternative drug
    • Bupropion
• Antihistamines
  • Cyproheptadine
  • Diphenhydramine
• Antipsychotics
  • Clozapine
  • Haloperidol
  • Neuroleptics
  • Phenothiazines
    • these drugs can add up to 5lbs (2.25kg) a week
    • ask your psychiatrist about atypical antipsychotics
• Birth Control
  • Progestins
  • Oral contraceptives with low progesterone are less likely to cause weight gain
• Blood Pressure Medications
  • Alpha blockers
  • Beta blockers
    • either drug can cause fatigue which may decrease activity
    • amount of weight gain varies
      • Older β-blockers, such as atenolo (Tenormin) and metoprolol (Lopressor, Toprol-XL) can cause weight gain. The average weight gain is no more than 4 pounds (about 2 kilograms).
      • β-blockers, such as Carvedilol don't increase weight.
  • Methyldopa
  • Potential alternative drugs
    • ACE inhibitors
    • Calcium Channel Blockers
• Cancer Therapy
  • Chemotherapy
    • Women with breast cancer will likely gain weight
      • may possibly slow metabolism
    • May induce early menopause
      • menopause may result in increased abdominal fat
  • Tamoxifen
    • estrogen antagonist used to treat postmenopausal breast cancer
    • may increase appetite
  • Decadron
• Cholesterol Medication
  • Statin (HMG-CoA reductase inhibitors)
    • Statin therapy depresses fat metabolism in older individuals (Limprasertkul 2012)
      • Subject who took statins appears to have depressed fat metabolism compared to those who had similar diets and exercise habits but did not take statins.
      • Despite elevated free fatty acid levels, Fat oxidation was significantly reduced during exercise in older subjects taking statin drugs
• Diabetes Drugs
  • Insulin
  • Sulfonylureas
    • may induce bouts of hypoglycemia (low blood sugar) which stimulates appetite
    • can add up to 11lbs (5kg) first 3 to 12 months of treatment
  • Potential alternative drug for those with type II diabetes
    • metformin
• Migraine Medicines
  • Valproic acid based
  • Alternative drugs
    • Most physicians are more likely to prescribe safer medications not associated with weight gain including
      • Topamax
      • Imitrix
• Sleep Aids
  • Diphenhydramine
• Steroid Anti-inflammatories
  • used to treat chronic inflammation or rheumatoid arthritis
  • can add up to 28lbs (13kg) on therapy
  • Potential alternative drug
    • NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)
      • eg: Ibuprofen
• Tuberculosis
  • Isoniazid (Nydrazid)

Modest dietary improvements along with an increase of physical activity may be enough to counteract the weight gain from most drugs.