Having attended numerous depression and bipolar support group meetings, I have heard one complaint from new people over and over again – weight gain. When the new person timidly asks if anyone else has experienced weight gain, the usual response is a lot of stifled laughter as nearly every person in the room raises a hand. According to researcher David J. Bond at the 2014 meeting of the International Society for Bipolar Disorders, “Up to 75% of people with bipolar disorder are overweight or obese, and these patients suffer more severe psychiatric symptoms than normal-weight patients. Obesity can cause more frequent depressions, more suicide attempts, lower response rates to pharmacotherapy, and greater inter-episode cognitive impairment.” This was reported in the May 19, 2014 edition of Bipolarnews.org
Anyone whose read this blog once or twice knows that I’ve struggled with weight my entire life, and the problem became much worse after beginning my regimen of bipolar meds. I didn’t just gain weight – I skyrocketed. I gained 75 pounds and my weight topped off at 303 pounds. After years of attempts to eat right and exercise I’ve lost around 50 pounds. While it feels better to have shed the weight I’ve lost, obesity is still a challenge.
We all know the risks involved with obesity: heart disease, cancer, diabetes to name a few. Now, according to Bond, obesity is associated with decreased total brain volume, and in children, decreased gray matter volume. Obesity increases the risk of cognitive impairment, and decreases memory, attention, and executive functioning. Obesity increases the risk of Alzheimer’s disease, as well as multiple sclerosis, Parkinson’s, and depression.
In a 2010 article by Tammy Worth of Health, as the number of atypical antipsychotics has soared, so has dramatic weight gain. In a 2007 study involving mice, researchers at John Hopkins University and the University of Vermont found that Zyprexa and another antipsychotic, clozapine (Clozaril), quadrupled the levels of a brain enzyme that spurs appetite. And a study in humans published in the journal Obesity earlier this year found that men who took Zyprexa for just two weeks increased their food intake by 18%, on average.
Hunger increase is not the entire problem. Many of those who saw no increased appetite still experienced weight gain. In these cases, metabolic changes—such as a rise in insulin resistance—may be responsible, says James Phelps, MD, a psychiatrist at Samaritan Health Services, in Corvallis, Ore.
Apparently there are those who gained as a result in increased appetite, those who experienced a change in their metabolism and then there are those, like me, who experience both. I was doomed.
As with anyone who’s overweight, people on antipsychotics who follow an intensive regimen of diet and exercise can slow and even reverse weight gain stemming from the drugs. But as some experts have pointed out, a program like that may be too much to ask from people who are depressed, mentally ill, or feeling sedated, a familiar side effect of antipsychotics.
What a sad choice to make; I choose medications to keep me balanced, but it’s at the risk of causing my body further damage – including my brain. The other option is not to take medication, and maybe have a healthier body. Even if I choose not to take my meds I’d be putting my body at risk. I have a voracious appetite when I’m depressed and certainly do not have the energy to exercise. At the other end of the scale, I have a history of risky behavior when manic.
I know a small number of people with bipolar disorder who do not take medication. They choose other methods to stay balanced. Sometimes they use natural herb remedies, meditation and other methods. As for me, stopping my meds is not an option. I remember my life too well before being properly medicated. I cannot take that risk.
Before I lost weight my physician suggested I have gastro-bypass surgery. Instead of the surgery I chose a healthy diet and exercise. Year’s later obesity is still a challenge as I’m still nearly 100 lbs overweight. Perhaps it’s time to consider the surgery again. My goal is to live a long healthy life and at this point I’m at a crossroads as to how that should be done.