Weight gain is clearly caused by medications used to treat bipolar disorder, some more than others.
This weight gain can be so large as to have its own serious health consequences, so we need to take it very seriously.
Physical activity and diet can help prevent this weight gain, and sometimes reverse it — but simply telling patients to eat right and get exercise as a means of coping with the weight gain medications can induce is pretty close to an insult and generally simply attempts to shift the responsibility for the problem to the patient. It takes more than this simple advice.
Weight gain may be, just may be, associated with causing mood problems that look like bipolar disorder. If this was true people could “look” bipolar from weight gain; and weight gain caused by medications for bipolar disorder could make mood problems even worse! This obviously bears some examination.
Finally, there are some ways to cope with the weight gain/medications problem, outlined below — although these are not entirely satisfactory.
Some medications have become famous for this: olanzapine/Zyprexa, divalproex/Depakote, lithium and others are all guilty some of the time (not always; it doesn’t happen to everybody).
Although there are numerous research studies under way trying to figure this out, the mechanism by which mood medications increase appetite and weight is not clear.
When people talk about medication-induced weight gain, you almost always hear about “diet and exercise”, and usually not with much conviction. Face it, this is hard enough for people who don’t have mood problems, let alone people who have cyclic phases of depression that include being extremely hopeless and unmotivated — not at all conducive to sticking with either diet or exercise. However, the importance of this step should not be forgotten. Exercise clearly has antidepressant effects, for example, that along with all its other known health benefits make it a “no-brainer”.
Start with exercise, start with exercise, start with exercise, get up and walk 10 minutes saying to yourself “start with exercise”, and so forth as above. It just has to be said, as the starting place, before we turn to other approaches that have known risks. None of these other approaches comes close to the positive effects on overall health risk offered by exercise. Obviously the trick is to find a way to do it on a regular basis, and that is in the same league with quitting cigarettes!
There is no specific bipolar diet. Nevertheless, it is important to make wise dietary choices that will help you maintain a healthy weight and stay well. These choices include:
Avoiding the "Western" style diet that's rich in red meats, saturated fats and trans fats, and simple carbohydrates. This eating style is linked to a higher risk for obesity, type 2 diabetes, and heart disease. Eating less saturated fats and simple carbohydrates can help overall health but does not directly affect the symptoms of bipolar disorder.
Eating a balance of protective, nutrient-dense foods. These foods include fresh fruits, vegetables, legumes, whole grains, lean meats, cold-water fish, eggs, low-fat dairy, soy products, and nuts and seeds. These foods provide the levels of nutrients necessary to maintain good health and prevent disease.
Watching caloric intake and exercising regularly to maintain a healthy weight. Some findings show that those with bipolar disorder may have a greater risk for being overweight or obese. Talk to your doctor about ways to avoid weight gain when taking bipolar medications.
Instructions for most psychiatric medications warn users not to drink alcohol, but people with bipolar disorder frequently abuse alcohol and other drugs.
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