I hear and see a lot of mention of weight gain as a side effect of some medications. I believe it happens but I’ve never understood how it works. For example, could an athlete who eats perfectly still be struck by weight gain as a side effect? What’s the biological mechanism that would make weight gain happen in a person with a healthy balanced diet?
I’ve taken a medication for years that a doctor just told me they’d rather never raise the dose on because it can cause metabolic syndrome. My A1C, cholesterol, and virtually the rest of my labs were in the healthy range, but I have noticed some weight on me that seemed oddly persistent. My diet ranges from average to healthy nowadays and I’m moderately active. Yet I can think back to a time before the medication when I was eating horribly, never exercised, smoked and drank nonstop, and my labs were looking nasty – yet my extremely consistent max weight was a solid 20lbs under what it is today which a noticeably better lifestyle all around. I’m by no means the athlete in the perfect diet example, I’m more fascinated by how something like that is even possible. Definitely interesting.
In: Biology
There are medications that impact your metabolism (looking at you antipsychotics), some lead to water retention and some make you more hungry or crave certain type of foods that are highly caloric or make you feel more fatigued or lethargic so you become less active and may increase food intake to try and increase energy or impact mood.
It is not always calories in vs calories out. Some medications only impact weight whilst taking them or initially whilst you adapt to them but there are some that permanently affect your metabolism and even if you stop them you will still have lifelong consequences (again, looking at you antipsychotics).
There is a fair amount of research around the impact of antipsychotic medications on metabolism and weight, we know it happens but don’t really know why. Although at least a part does seem to attributable to impaired glucose uptake.
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30416-X/fulltext
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