Medications that cause weight gain are also called weight positive medications. Sapna, Danish, and Dr. Arreaza mention some of those medications in this episode.
Introduction: Some meds cause weight gain
By Hector Arreaza, MD.
You will see patients who keep gaining weight regardless of their sincere efforts to eat better and exercise. Some people experience serious difficulties to lose weight. If you want to know how frustrating it can be, imagine your doctor telling you to add one more inch to your height when you are 35 years old. For some people, losing weight is just as hard. One important step you can take to help your patients lose weight is performing a detailed medication reconciliation. Review the medication list, and you may find some meds that are proven to cause weight gain. Today we will discuss some of those medications, but it takes practice to learn all of them. I hope this episode is helpful for you.
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This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.
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Weight Gain Meds.
By Sapna Patel, MS4, and Danish Khalid, MS4. Ross University School of Medicine. Comments by Hector Arreaza, MD.
S: Medications associated with weight gain: See Table 1.1 for medications associated with weight gain and alternatives.
Antipsychotic agents:
A: Ziprasidone is an antipsychotic medicine that causes the least amount of weight gain.
Antidepressants:
Antiepileptics/Antiseizure:
Antihypertensive agents: Beta Blockers
Hypoglycemic medications:
Steroids:
Antihistamine Medications:
Fun Fact: Although it is a common belief that combined oral contraceptives cause weight gain, data suggest that significant weight gain is not a common side effect of combined oral contraceptives.
A good practice: Medication reconciliation: Weight positive, weight neutral, or weight negative.
Weight positive: Deprescribe or change for another medication if possible. Weight neutral and weight negative: Keep them. Don’t be afraid to prescribe anti-obesity meds. We should learn about them, become familiar with side effects, contraindications, dosing, and more, and prescribe them appropriately as part of a weight loss program. Also, don’t forget that these medications are used in conjunction with a proper diet.
Category | Drug Class | Weight Gain | Alternatives |
Psychiatric agents | Antipsychotics | Clozapine, risperidone, olanzapine, quetiapine, haloperidol, perphenazine | Ziprasidone, aripiprazole |
Antidepressants/mood stabilizers: tricyclic antidepressants | Amitriptyline, doxepin, imipramine, nortriptyline, trimipramine, mirtazapine |
Bupropion, nefazodone, fluoxetine (short term), sertraline (<1 year) | |
Antidepressants/mood stabilizers: SSRIs | Sertraline, paroxetine, fluvoxamine | ||
Antidepressants/mood stabilizers: MAOIs | Phenelzine, tranylcypromine | ||
Lithium | |||
Neurologic agents | Anti-seizure medications | Carbamazepine, gabapentin, valproate | Lamotrigine, topiramate, zonisamide |
Endocrinologic agents | Diabetes drugs | Insulin (weight gain differs with type and regimen used), sulfonylureas, thiazolidinediones | Metformin, acarbose, miglitol, pramlintide, exenatide, liraglutide |
Cardiologic agents | Antihypertensives | Beta-blocker | ACE inhibitors, calcium channel blockers, angiotensin-2 receptor antagonists |
General | Steroid hormones | Corticosteroids, progestational steroids | NSAIDs |
Antihistamines/anticholinergics | Diphenhydramine, doxepin, cyproheptadine | Decongestants, steroid inhalers |
Table 1.1: Medications associated with weight gain and alternatives.4
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Conclusion: Now we conclude our episode number 107 “Weight Gain Meds.” Sapna and Danish did an excellent job in this episode. Performing a good medication reconciliation is a key element in a weight loss visit. Some patients cannot stop taking medications that cause weight gain, also called weight-positive medications. I recommend you be cautious when discontinuing any medication. If you are not the prescriber, consult with the prescriber to discuss the possibility to lower the dose, finding an alternative medication, or determining if the medication can be discontinued. If none of those options are feasible, you may consider starting metformin if not contraindicated, I hope you learned something new today.
This week we thank Hector Arreaza, Sapna Patel, Danish Khalid, Valerie Civelli, and Arianna Lundquist. Audio edition by Adrianne Silva.
Thanks for listening to Rio Bravo qWeek Podcast. If you have any feedback, contact us by email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week!
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