Meds causing weight gain?

Medical Q&A [Moderated]
1

Hey there, I’ve had issues with my weight the past few months, I’ve gained nearly 55 lbs in the past year, I’m 5’11” 258 lbs 27 years old male, waist is around 43”, I used to be around 205 lbs in September 2021, I started a small dose of abilify (aripiprazole) and since then my weight has skyrocked along with cravings for high calorie foods. I saw my psychiatrist today, he recommended to stop the meds and see how my appetite does, I take this med for anxiety so it does stabilize my mood. However, I’m starting risperidone on a low dose hopefully without the side effects. I’m going to see what it does for the weight gain since I am concerned.

I recently joined the joinsequence app to see what can be done for weight loss meds, however my insurance denied me semaglutide since I don’t have type 2 diabetes. I’m not sure what to do at this point for weight loss meds, if I come off the aripiprazole and the weight goes off should I hold on a potential GLP-1 medication? Or is my case still one that should include weight loss meds specifically if I still lose some while coming off the meds I’m on? I also take Fluvoxamine 250 mg for Obsessive Compulsive symptoms, this has been a complicated scenario and the weight just seems to keep coming back faster.

Thanks for the feedback if you have any and one small nuance is my doc said if some weight doesn’t come off within a month of following up we could try a dose of I think he said metformin.

2

Hi there,

Sorry to hear about this. It is likely that the aripiprazole played a role in increasing appetite and thus driving weight gain, as this is a known effect of this entire class of medications. There is variation within the class with respect to how much of this effect they cause, with ziprasidone generally being thought of as causing the least weight gain, on average, and olanzapine/clozapine the most.

It’s wise to work with your psychiatrist on alternative options and dosages to control your symptoms while minimizing undesirable effects. If the weight comes off relatively quickly and easily at this point, then augmenting with medication like a GLP-1 agonist isn’t necessary, but if it proves to be too difficult to get both the anxiety issues and weight under control, then I would strongly consider one of those types of medications. Sometimes it requires some investigation to see what coverage is available, or trying an alternative class – which the docs at Sequence will be familiar with.