Eli5: If gaining weight is simply the result of calories in and out, then why does taking certain medications (birth control, anti-depressants) commonly lead to weight gain?

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Eli5: If gaining weight is simply the result of calories in and out, then why does taking certain medications (birth control, anti-depressants) commonly lead to weight gain?

In: Biology
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Gaining weight is mostly the result of calories in and out. Some medications can alter how your body processes those calories, making you more likely to gain weight. Others can cause you to feel more hungry than usual, so you are likely to eat more calories than you would otherwise.

“Calories in, calories out” works for the majority of cases, but isn’t an absolute rule with no exceptions.

Various hormones levels in your body will effect how many calories you burn while at rest(calories out). If you don’t also alter how many calories you’re consuming(calories in) you’ll suddenly be consuming the same but gain weight because of the lower calorie out.

Usually it’s because they change your body’s regulation of hunger and satiety. Essentially you get hungrier and feel less full for the same amount of food from before.

Some medications can also cause your body to hold more water that is would without that can cause minor amounts of weight gain.

because it makes hormones crazy and people tend to overeat when their hormones are crazy. They send crazy signals to the brain, which can transform a simple ‘I’m stressed” into “I’m hungry”, and we fall for that shit. The problem is keeping ourselves aware and above all this craziness while trying to show some control of our own lives to others around us, so that we’re not treated as the crazy beings we are.

So yes, in the end, calories in and calories out does, in fact, decide our weight gain.

Those medications cannot disobey the laws of physics. They might be responsible for some water retention. Thats not excess fat tissue but is still an increase in net weight. They also might be responsible for increased appetite but that doesn’t directly point to them violating thermodynamics by creating energy.

The increased appetite doesn’t reflect the number of cells you have and thus your energy needs.

If you eat more food energy than you needed per day, the excess is stored as fat. Likewise if you don’t eat more than you needed, excess energy is consumed. CICO should not be thought of as a diet but just an energy balance equation. It helps to think of it as just income/expenditure for your bank balance.

As someone who gained… way too much weight… with COVID anti-depressants; they screw with your pleasure/reward system. So when eating a spoonful of Ben and Jerry’s used to give you a shot of dopamine, suddenly you’re binging a whole pint and not getting that reward. Multiply that by 6 months and suddenly your pants don’t fit.

A medication might cause you to gain weight if it:

* Makes you hungrier

* Makes you not feel full as long

* Gives you cravings for sugar or fat, even if the volume of food you eat doesn’t change

* Makes you more tired, so you spend less time exercising

* Fixes a problem that was preventing you from eating/digesting properly

* Decreases your resting metabolism (lowering thyroid hormone for example)