Medications that Can Cause Weight Gain

Medications that Can Cause Weight Gain
Derrick Cetin, D.O. Obesity Medicine Clinical Assistant Professor Dept. of Medicine Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Bariatric and Metabolic Institute Digestive Disease Institute
9/15/18

Drug-Induced Weight Gain, Audience Should Know:
• A possible serious side effect of many commonly used drugs used for a variety of disease states
• Leads to exacerbation of co-morbid conditions related to obesity due to associated weight gain
• While some medications are more common than others to cause weight gain, not all individuals gain weight from every drug that has weight gain listed as a side effect
• In many cases if possible, substitute an alternative medication to treat the same condition that is weight neutral or weight negative

Case Study
55 year old Caucasian female referred by bariatric surgeon for medical evaluation of weight regain. S/P RYGB 2003 with 125 lbs weight loss. Regained her weight and now at highest post operative weight. Her current weight is 285 lbs with a BMI of 55 kg/m^2. Concerns that she has been noncompliant with her vitamin, mineral supplementation and dietary recommendations. She has not been able to exercise regularly due to a back injury. T2DM, HTN, and major depressive disorder.

Approach to Post Operative Bariatric Surgery Weight Regain

Anatomical

Post Operative Weight Regain
Physiological

Behavioral Psychosocial

Approach to Post Operative Bariatric Surgery Weight Regain

Anatomical

Post Operative Weight Regain
Physiological

Behavioral Psychosocial

Physiological Causes of Weight Gain
• Pregnancy • Menopause • Smoking cessation • Endocrine disease • Hypothyroidism • Cushing's disease • Adaptations: hypoleptinemia, energy efficiency, gut hormones (PYY) • Weight-gain promoting medications

Physiological Causes of Weight Gain
• Pregnancy • Menopause • Smoking cessation • Endocrine disease • Hypothyroidism • Cushing's disease • Adaptations: hypoleptinemia, energy efficiency, gut hormones (PYY) • Weight-gain promoting medications

Classification of Drugs That May Lead to Weight Gain

CNS drugs

Endocrine agents

Miscellaneous

Atypical antipsychotics

Glucocorticoids

Beta Blockers

eg. olanzapine

eg. prednisone

eg. metoprolol

Anti-epileptics (AEDs)

Hormonal contraceptives

Anti-histamines

eg. valproate

eg. medroxyprogesterone

eg. diphenhydramine

Lithium

Diabetes agents:

Sleep aids

eg. zolpidem

Antidepressants:

Ø Insulin

HIV medications

Ø Selective Serotonin reuptake inhibitors (SSRIs)
eg. paroxitene

Ø Sulfonylureas
eg. glyburide

Ø Tricyclic agents
eg. nortriptyline
Ø Others
eg. venlafaxine, mirtazapine
Leslie, et al. QJM. 2007; 100: 395-404

Ø Thiazolidenediones
eg. pioglitazone

Chemotherapies
Common Migraine Medications (prophylaxis) Gynecological medications

May substantially increase body weight:
Clozaril (Clozapine)

Antipsychotics and Weight Gain

May somewhat increase body weight:

Variable/neutral effects on body weight:

Saphris (Asenapine)

Solidan (Amisulpride)

Zyprexa (Olanzapine)

Thorazine (Chlorpromazine)

Abilify (Aripiprazole)

Fanapt (Iioperidone)

Haldol (Haloperidol)

Invega (Paliperidone)

Latuda (Lurasidone)

Seroquel (Quetiapine)

Geodon (Ziprasidone)

Resperidol (Resperidone)

Serdolect (Sertindole) Lithium
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