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Weight Loss – Antidepressants May Be Stopping Your Weight Loss – What to Do About It

Fluoxetine
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Guest article by Richard Lipman M.D.

Weight gain due to taking antidepressants, mood stabilizers and antipsychotic medications is very common. The issue of weight gain is often postponed when medications are first started -the concept being that it might be better to stabilize the mood and worry about potential weight increase latter. However, after a few months, the increasing weight gain without any change in exercise or food intake becomes more and more an issue.

Here are some of the medications taken for depression, bipolar disorder, obsessive compulsive disorder and panic attacks that may be causing increasing weight:

Currently, Paxil is the worst offender, with Prozac and Zoloft taking second place. Some antidepressants may be less likely to affect weight. Effexor and Serzone generally do not cause increase weight, while Wellbutrin can cause weight loss. More than 25% of people taking most SSRI type of antidepressant medications — drugs like Prozac, Lexapro, Paxil, and Zoloft will experience a weight increase of 10 lbs. or more.

Other antidepressant medications, including Elavil and Tofranil and MAO inhibitors drugs like Parnate and Nardil, may also inflluence fat accumulation with both long-term and short-term use.

Animal and human studies have shown these drugs can cause weight increase by several different pathways:

• Increase carbohydrate cravings.

• Blockage of histamine receptors causes increase appetite.

• Moving about slower, less fidgeting.

• When depression causes weight loss (not very common) improving the depression can cause weight gain.

Drugs most commonly associated with weight increase:

Selective Serotonin Reuptake Inhibitors(SSRI’s) and weight gain:

The five most common SSRIs currently prescribed in the United States today are as follows:

• Citalopram (Celexa®)

• Fluoxetine (Prozac®)

• Fluvoxamine (Luvox®)

• Paroxetine (Paxil®)

• Sertraline (Zoloft®)

Paroxetine (Paxil®) appears to have the most significant impact on weight of all of the SSRIs. Some studies even showed an average weight gain over time of 15-20 pounds with Sertraline (Zoloft), Fluoxetine (Prozac®), and Citalopram (Celexa®).

Tricyclic Antidepressants (TCAs) and weight increase:

TCAs were the most commonly prescribed antidepressants before SSRIs became widely available.They are used to treat pain and for sleeping. There is evidence that they increase cravings for carbohydrates and may lower metabolism.

• Amitriptyline (Elavil®)

• Amoxapine (Asendin®)

• Clomipramine (Anafranil®)

• Desipramine (Norepramine®, Pertofrane®)

• Doxepin (Adapin®, Sinequan®)

• Imipramine (Janimine®, Tofranil®)

• Nortriptyline (Aventyl®, Pamelor®)

• Protriptyline (Vivactil®)

• Trimipramine (Rhotramine®, Surmontil®)

Other Antidepressants and weight gain:

Other antidepressants that do not fall strictly under the classifications of SSRIs, TCAs, or MAOIs include the following:

• Buproprion HCL (Wellbutrin®)

• Mitrazapine (Remeron®)

• Nefazadone (Serzone®)

• Trazadone (Desyrel®)

• Venlafaxine (Effexor®)

Venlafaxine (Effexor®) has been shown to cause weight increa but not as bad as the SSRI’s (Paxil®), fuoxetine (Prozac®), and sertraline (Zoloft®).

Mitrazapine (Remeron®) has been associated with significant weight increase, possibly secondary to interactions with the histamine (H1) receptor

Trazadone (Desyrel®) is an antidepressant with sedative properties that is frequently used as a sleep aid as well as treatment for depression. It appears to cause less weigh increase than amitriptyline (Elavil®) but more than buproprion HCL (Wellbutrin®).

Buproprion HCL (Wellbutrin®) has not been associated with weight increase and is commonly used with some success in smoking cessation.

The first solution is to lower doses and then switch to another medication (with a doctor’s help). This is not as easy as one might expect. Often people that have gone thru some really bad times with their depression and feel good are very reluctant to lower doses or change medications fearing a return of the “blues.” Most individuals have very individual responses to their medications. So one has to be really careful in adjusting doses and picking the “right” medicine for the “right” person. For this to work you need to consult with the physician prescribing the medication. Making changes in the medications without supervision may be dangerous.

More and more evidence is accumulating that increasing daily exercise, even by 15 to 20 minutes a day may have an effect not only on weight loss but on depression. In a study from Finland, researchers found that those men who exercised at least two to three times a week experienced

While experts may not be certain about why antidepressants cause weight gain, they do know that switching drugs may make a difference.

Richard L. Lipman M.D., a board certified internist and endocrinologist has been treating weight and metabolic problems for 25 years in his Miami office. His recent book, The 100 Calorie Secret, describes how thousands of his patients lost weight and kept it off. Lean more weight loss and tips from a doctor who actually takes care of metabolic problems and obesity problems at http://www.the100caloriesecret.com.

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“Food” may not really be what you think it is…

Enticing displays of juicy, tasty cheeseburgers flash across your TV screen.  Fit people in a serene setting are chomping them down voraciously.  Then, the next commercial comes on.  It starts with a person doing his afternoon jog.  He jogs right home, then the next frame shows him at the bar with buddies slugging down the newest light beer.  Next, the baseball game comes back on.  The camera pans across the crowd.  You see dozens of people munching on hot dogs, peanuts, and candy, all-the-while sloshing it down with large sodas.  The ads displayed on the outfield fence include more beer advertisements, fast food icons, soda companies, candy logos, car manufacturers, and well…you get the picture!

What does all this remind you of?

Now, think about shopping at the supermarket, especially in the inner aisles of the store.  You may be envisioning shelves lined with colorful and attractive boxes.  Picture yourself strolling through the cereal aisle where this is overwhelmingly evident.  Fun-faced characters are almost literally leaping out of the boxes, grabbing your attention.  Then, upon a closer look, you see something like “15 vitamins and minerals” or “no cholesterol.”

In many of the aisles, you see highly-branded and vivid displays that vie for your attention even more.  Every other one of them seems to be filled with some form of alcohol, soda, or snack.

Now, think of what your cart may look like when it is time to roll through the check-out lane.

Do you see these things in your cart?

But the most important question of all is:  Does all of this seem like just your regular perception of what food is?  Does it just seem to be the way it is?  Is it all you have ever known?  In other words, are these boxes, plastic bags, bottles, cartons, and cans filled with concoctions what has come to be your daily sustenance?

If you answered yes to most or all of these questions, you certainly are not the seeming minority!

In my opinion, here in North America, this is what most of us have grown up with.  As a result, it just seems to be the way it is.  Long lists of ingredients.  Lots of sugary substances in almost everything.  Salt literally overflowing.  Saturated fat very prevalent.  Loads of calories in every tasty treat.

Most of all though, lots of “flavor.”  It’s what keeps us coming back for more.

It is possible that many of our palates have become conditioned into thinking that this is what food is – lots of “taste” filled with different kinds of fats, many kinds of sugars, and lots of salt.  With endless combinations, it seems to make everything good.  But really, it may not be good for us, and it certainly doesn’t work well to help us along toward the goal of a healthy equilibrium of mind, body, and spirit.

If you do find that your diet mainly consists of items similar to what I mentioned above, and you don’t really consider yourself to be one who ventures too far out of that realm, for fear of the unknown or a remembrance of one incidence many years ago when you tried a different kind of food and found that you “didn’t like it,” just remember that there is a whole other world of food out there that awaits you.

And if that makes you feel a bit uneasy because you feel that it may not be as good as what you are used to, think again!  Now I’m not saying that you should totally abandon every type of food that you currently eat, but I am suggesting two things:

1.    Consider really looking into what is in the food you currently eat, especially if it typically comes out of a box, bag, or carton.  Pay close attention to the ingredients.  Understand the nutrition facts.  Analyze the amount of calories and fat.  And very important, see if it contributes to an overall balanced diet.  But there are many definitions about what a balanced diet really is.  More on that in another post.

2.    Learn about and try new foods, especially from other cultures and ethnicities.  Many varieties of Asian, Indian, Middle Eastern, South American, and others are extraordinarily flavorful, and usually quite healthy.  They tend to be filled with vegetables, grains, lean meats, spices, and lots of flavor.  Some are lower in fat and calories too, and have quite natural ingredients.

So in summary, don’t let your current views about what food is stand in the way of breaking free from a diet centered around the box or the fast food joint.  Reconsidering your perceptions about food in general can be an important step toward the way of eating which may suit you best!

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What is conditioning, and how does it influence eating?

Have you ever stopped for a moment and thought about how conditioning may affect us all?  What exactly is conditioning?  Does it really apply to our lives?

From my experiences, this isn’t really a widely discussed topic, but it is something that I feel is intricately weaved within most of our lives, a lot of the time without us really realizing it.  But once we do realize it, we have the opportunity to reverse it and start on a direction toward freedom from the whims of unwanted habits, the whims of society, and the will that it and others unconsciously force upon us every day.

To start though, by no means am I suggesting that realizing this relieves a person from taking accountability for many things that he or she has experienced or contributed to inflicting up him- or herself.  Taking the stance of being a victim can only lead to powerlessness, which is contrary to the sense of empowerment which can accelerate your progress toward the life and habitual changes that you seek.

But to understand the powers that be is another thing.  Understanding that they can consciously and unconsciously influence your behavior and thought patterns and understanding what they are is imperative toward weeding them out from yourself and declaring your independence.  Realizing their influence and realizing how these influences can weave themselves into what you have control over and the actions that you take can be a very motivating factor to establish your defenses against them.  This can be very empowering and can help you plant your own roots deeper into the soils of your beautiful inner self, your true belief systems, your true happiness, and not someone else’s whims.

From my point of view, conditioning is the result of human societies and others’ desire for money, desire for control, and desire for power.  It can be the product of group “consensus,” superstitions, doctrines, traditions, habits, education, and a vast myriad of other systems.  It can be good, it can be neutral, and it can be bad.  Conditioning is very apparent in almost every aspect of life, and after all, we have to learn somehow.

So I am not going to label it really as anything in particular, and I especially don’t like to look at things as only good or bad, black and white, this or that, friend or enemy, or anything totally exclusive of one another.

It follows that conditioning is no exception.  It acts in a very good way, for example, when we were conditioned as young children to always look both ways before crossing the street.  The ingrained habit that resulted keeps us safe, most of the time without us realizing its influence.  Out of this habit, we barely even think about it every time we come to a crosswalk.  We “just do it” and cross.

The same goes for those of us who learned how to drive.  We learned that red means “stop,” and green means “go.”  How many times do we pass right through a green light, or stop at a red one, without really thinking about it?  We don’t really need to exert much though into it.  We “just do it,” because we have reinforced that habit for so long that it just comes natural.

Well, that is a good way to look at the conditioning that has affected us in not as good of ways.  With these habits that may be detrimental to our well-being, we “just do them” because we have reinforced them for so long that they just seem to come natural.  We can’t really get ourselves to think there is any other way.  I mean, could you ever imagine stopping at a green light?  In the case of safety, it certainly wouldn’t be advised, and it certainly would take a lot to get over the impulse to go right through it.

Enter the world of food.  As everyone has been eating it ever since they have been alive, this is obviously an important habit for every person and every other species on earth.  It is what keeps us going, gives us sustenance, nutrition, and much more.  It is what allows for our existence.

The biological impulse to eat is one of the most primal drives that we have.  It is what, in our ancestral times, kept us on the move.  It kept us in pursuit of survival.  It was our instinct to scour the land to find enough for ourselves and others within our community.  It was likely not as abundant as now, was likely much more simple and limited in variety, and there, in the earliest times, was likely no profit motive behind the distribution of it.

That impulse and instinct – hunger – has not really biologically changed within us over thousands of years.  But the way food is cultivated, produced, manipulated, advertised, distributed, and sold sure has!  Furthermore, the types of foods available to us certainly has as well!

During this evolution in the world of food, the by-product of habitual conditioning has resulted – a by-product which latches onto our most instinctual drive and can help create deeply ingrained thought-patterns, behaviors, emotions, and even obsessions.  Left unchecked, left misunderstood, or left powerless to them, the mind and its conscious behaviors can compel a person to react in certain ways around food – certain ways which can contribute to unhealthy habits.  This is one way to view conditioning, and a good starting point for you, if you feel that you have trouble with how you react to food, to begin to become part of an ongoing discussion about this, and a good starting point for you to condition yourself away from what you may determine is bad for you, and toward something brighter.

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