People living with issues like autoimmune diseases, from Crohn’s to rheumatoid arthritis (RA), or mood disorders like depression have powerfully effective medications out there to help minimize or eliminate their symptoms so that they can live comfortably.
Unfortunately, some of the common drugs for these issues — like prednisone and other corticosteroids, and bupropion (Wellbutrin) and other antidepressants — have less-than-desirable side effects — namely: weight gain.
And while you should go easy on yourself — you’re battling an illness, after all — it can be a frustrating adverse effect.
Read on to find out the best ways to lose unwanted pounds brought on by medication you need.
What medications cause weight gain?
Antipsychotic drugs, antidepressants, and mood stabilizers are common drugs that have the most potential to increase weight gain. All 12 of the leading antidepressants — including fluoxetine (Prozac), sertraline (Zoloft), and escitalopam (Lexapro) — make gaining weight more likely.
With approximately 13 percent of Americans currently taking antidepressants — and without medication options that don’t cause fluctuations in weight — a lot of people can’t avoid being put at higher risk for unhealthy weight gain.
Steroids like prednisone may also have similar effects. Steroids are often “used to tackle inflammatory conditions, for conditions like IBD, Crohn’s, arthritis, lupus, and osteoarthritis,” says Alanna Cabrero, MS, registered dietician at NYU Langone Health’s IBD Center.
For some of these medications, nearly 70 percent of users reported weight gain as a side effect.
You might assume that you’d notice the pounds sliding on right away if your body is sensitive to this side effect. But a recent study found that isn’t the case. People taking antidepressants are most at risk for weight two to three years into treatment.
Medications that cause weight gain include:
- Antidepressants, such as:
- serotonin reuptake inhibitors (SSRIs) — like fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro), citalopram (Celexa), and paroxetine (Paxil)
- serotonin-norepinephrine (SNRIs) — like duloxetine (Cymbalta) and venlafaxine (Effexor)
- tricyclic antidepressants (TCAs) — like desipramine (Norpramin)
- Corticosteroids, such as:
- Drugs commonly prescribed for bipolar disorder and schizophrenia, such as:
Why do some drugs make putting on extra pounds more likely?
Drugs like corticosteroids alter the body’s electrolyte and water balances, and metabolism.
“Drugs like steroids decrease the body’s flushing out of sodium,” explains Cabrero.
Many people on steroids report increased fat in the abdomen, face, and neck. Even if you can control the steroid-driven weight gain, it’s possible to look heavier because of redistributed fat.
Antidepressant-induced weight gain is tied to appetite changes. “With medications for depression, increases in appetite occur. Generally, then, anything becomes a little bit more appetizing — and our cravings usually don’t fall under fruits and vegetables.” Cabrero points out.
How to control weight gain caused by medication
If you want to lose a few extra pounds that you’ve put on since taking a weight gain–inducing medication, you’re already on the right track.
Armed with that knowledge that gaining weight is a potential side effect, you can make more-conscious choices when it comes to meals and exercise.
“If you know that these medications have the potential side effect of weight gain, you can take the appropriate steps to be prepared,” says Cabrera.
Here are six ways she recommends you take off — or fight off — unwanted pounds.
1. Make conscious choices about sodium
Avoiding too much sodium in your diet is smart for anyone looking to eat healthier. But patients on steroids or antidepressants might want to consider paying extra close attention.
That means avoiding processed foods, canned foods, and fast foods, since they’re often packed with sodium.
“Eight percent of our sodium intake comes from these foods,” says Cabrera. “The general population in the U.S. has 3,300 to 3,500 mg of sodium per day, when it should fall more around 2,300 mg. Reduce these foods that have naturally a ton of sodium.”
Cabrera recommends you learn how to read nutritional labels in order to understand what’s in your food.
To curb weight, use the same strategies you’d use to control weight with or without the added effects of medication. Choose low-calorie foods like fresh fruits and vegetables, eat fiber-rich and slow-to-digest complex carbohydrates, and drink lots of water.
2. Increase potassium in your diet
Eating a potassium-rich diet is great for people who are looking to lose weight gained because of medication — potassium flushes out sodium. And a potassium-rich diet is linked to other health benefits, such as reduced blood pressure, protection against stroke, and osteoporosis prevention.
Potassium-rich foods include:
- sweet potatoes
- coconut water
- black beans
3. Eat small, frequent meals
Because your appetite can increase while taking specific medications, if you let your hunger hormones totally control your meals, you’ll eat more.
Instead of having three massive meals throughout the day, breaking up your food into smaller, more frequent meals can make you feel like you’re consuming more calories because you have little time between snacks to be hungry.
It’s recommended to stave off hunger by eating six small meals a day versus three large ones.
Cabrera suggests you try to integrate nonstarchy veggies, or what she calls “volume-rich foods,” into your diet. “They’re nutritious and don’t have a lot of calories,” says Cabrera. Experiment beyond cut-up carrots: try veggie soups and salads.
4. Stay active
Staying active is important for overall health as well as weight loss or maintenance. Depending on your level of health or current symptoms, you may want to consult your doctor first.
“Depending on what other symptoms are going on, physical activity is something to be sure to do,” says Cabrera. “You might not be as active as you were before, but light yoga, walking, or something along those lines helps to keep you mobilized and improves overall health.”
5. Try intermittent fasting
For people who have come off medication, intermittent fasting can be an effective way to lose weight, provided it’s recommended by your doctors.
“I usually suggest a gut rest. This is a 12-hour window when you don’t eat, which should start about 2 to 3 hours before bed,” says Cabrera. “A lot of times after dinner we end up snacking on foods that are not nutritious, nor are even related to hunger.”
6. Get some quality shut-eye
A good night’s sleep can do wonders when you’re trying to lose weight, especially if you’re on steroids for any condition.
“With steroid use, patients find that they won’t sleep well, and that increases your appetite for sugary foods because you need that energy burst,” says Cabrera.
7. Ask your doctor about your options
Managing your condition is a priority, so there may not yet be any options that cause little to no weight gain.
Still, ask your doctor if there are any alternative medicines or treatment protocols that would maintain your health — without the extra pounds.
For people on steroids, ask if going on the shortest, most effective dose is a possibility.
If you’re on antidepressants, bupropion (Wellbutrin) may be less likely to cause weight gain.
Meagan Drillinger is a travel and wellness writer. Her focus is on making the most out of experiential travel while maintaining a healthy lifestyle. Her writing has appeared in Thrillist, Men’s Health, Travel Weekly, and Time Out New York, among others. Visit her blog or Instagram.