As a physician who is certified by the American Board of Obesity Medicine (ABOM) who sees patients seeking help with weight loss, one of the things I do is to go through their list of medications and help identify any they take that are known to promote weight gain. Then they can decide (along with their prescribing healthcare provider) whether the effects on their weight are outweighed by the benefit they are getting from the drug.
One of my goals with this website and blog is to impart some of the knowledge I have about weight management to the public. Not everyone is lucky enough to have access to an Obesity Medicine specialist who can give you personalized advice based on your own medical history, so I thought I’d give you a list here of many of the medications that I look out for (and try to eliminate if possible) in my own patients. (Next week, I’ll focus on the medications that can have the opposite effect, and cause weight loss.) Here are some of the most common meds known to cause weight gain, though not an exhaustive list. How many of these do you take?
A. DIABETES MEDS — promote weight gain by storing more blood sugar as fat stores:
insulin (Short or long acting)
Medicines that increase your own body’s insulin secretion or make insulin more effective:
pioglitazone
glipizide
glyburide
glimeperide
chlorpropamide
tolbutamide
B. HORMONAL AGENTS — thought to promote weight gain by stimulating appetite:
Oral (or injected) steroids used to treat inflammation:
prednisone
cortisone
dexamethasone
methylprednisolone
Inhaled steroids (usually for asthma/COPD):
budesonide
fluticasone
ciclesonide
Hormone replacement therapy and contraceptive agents (birth control):
estrogens
progestins (like Depo-Provera or Megace)
Anabolic steroids
testosterone
oxandrolone
methyltestosterone
C. MENTAL HEALTH/NEUROLOGICAL AGENTS — various mechanisms for weight gain but mostly thought to be related to effects on the brain’s appetite-regulating neurotransmitters:
Anti-seizure drugs/mood stabilizers/pain meds:
gabapentin (Neurontin)
pregabalin (Lyrica)
valproic acid/valproate/divalproex
carbamazepine
lithium
Antidepressants:
paroxetine (Paxil)
fluoxetine (Prozac)
sertraline (Zoloft)
duloxetine (Cymbalta)
fluvoxamine (Luvox)
mirtazapine (Remeron)
trazodone
amitriptyline
nortriptyline
imipramine
doxepin
Antipsychotics:
olanzapine
quetiapine
haloperidol
risperidone
clozapine
chlorpromazine
loxapine
thioridizine
Other:
tetrahydrocannabinol (THC in marijuana/cannabis)
dronabinol (Marinol)
cannabidiol (CBD)
D. BETA-BLOCKERS & ALPHA-BLOCKERS (for blood pressure/heart, tremor, migraines, prostate, PTSD nightmares) — thought to promote weight gain by dampening the sympathetic nervous system and decreasing energy expenditure:
metoprolol
propranolol
atenolol
terazosin
prazosin
doxazosin
E. ANTIHISTAMINES/SLEEP AIDS — act on the brain to stimulate appetite:
diphenhydramine (Benadryl)
doxylamine (Unisom)
hydroxyzine (Atarax)
cyproheptidine
chlorpheniramine
If you are concerned that one or more of your medications might be making you struggle more with your weight, please remember never to stop taking a prescription medication before first discussing it with your provider. He or she may feel that the benefit of the medication on your health clearly outweighs the risk of weight gain, or it may be a medication that is dangerous to stop abruptly and instead needs to be tapered off slowly. In some instances your provider may be able to try you on a different drug that is more weight-neutral — it certainly never hurts to ask!
2 Responses
Is it that the actual medication makes you fat or that it that the drug makeswant to eat more then you should. you get thoes urges.
Allison, antihistamines (especially the first generation ones that make you sleepy, like Benadryl or Unisom) increase appetite in the brain, so weight gain would be due to naturally eating more as a result.