Common Medications Linked To Weight Gain

***DO NOT STOP MEDICATIONS WITHOUT TALKING WITH YOUR DOCTOR***

Weight gain after starting a medication is common, real, and often missed in routine care, so we walk through which prescriptions and OTC drugs are more likely to contribute and why it varies by person. We also share how to ask for a full medication review and what safer, more weight-neutral alternatives you can discuss with your prescriber. 

• why you should never stop certain medications abruptly and when tapering matters 
• how a “brown bag” medication visit works and why we recommend it yearly for 6+ meds 
• using metformin alongside a weight-promoting medication as an option to discuss 
• mood medications that may contribute to weight gain and why Paxil stands out among SSRIs 
• gabapentin and pregabalin for nerve pain plus seizure risk with abrupt stopping 
• steroids like prednisone, weight gain risk, and why to monitor fasting glucose or A1C 
• type 2 diabetes medications tied to weight gain and why newer GLP-1 and SGLT2 options matter 
• beta blockers that may cause weight gain and weight-neutral blood pressure alternatives 
• hormones, birth control, HRT, and the importance of individualized choices 
• OTC Benadryl and how long-term use can add subtle weight gain 

If you live in Missouri, I would love to help you through this. And you can schedule an appointment through my telehealth clinic, MissouriMetabolic Health.com. 
If you found this information helpful, please share with a friend, a family member, or a colleague. We need to do all we can to combat the dangerous misinformation that is out there. Please subscribe and write a video. This will help others find the podcast that they may also improve their metabolic health. 

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Transcript

Welcome And Medical Disclaimer

Dr. Lindsay Ogle 0:01

Welcome to the Modern Metabolic Health Podcast with your host, Dr. Lindsay Ogle, a board certified family medicine and obesity medicine physician. Here we learn how we can treat and prevent modern metabolic conditions such as diabetes, PCOS, fatty liver disease, metabolic syndrome, sleep apnea, and more. We focus on optimizing lifestyle while utilizing safe and effective medical treatment. So please remember that while I am a physician, I am not your physician. Everything discussed here is provided as general medical knowledge and not direct medical advice. Please talk to your doctor about what is best for you.

Could A Medication Cause Weight Gain

Dr. Lindsay Ogle 0:44

Have you ever wondered, is your medication causing weight gain? Have you ever started a medication and noticed fairly quickly that you started to gain weight? Did you ever bring this concern up to your doctor? Did they ever warn you that certain medications may cause weight gain? Well, there are a handful of medications that we know are more likely, although not guaranteed, to cause weight gain. And I want to go over what these medications are with you. Now in this video, more than any other video, I really want to emphasize that this is information only. This is not direct medical advice. Anything that you learn here, you need to take back to your prescriber, your medical doctor, your medical team, and ask them about it and see how it applies to your specific situation. Several of these medications can be dangerous if you stop them all of a sudden. So by no means am I saying never use these medications and stop them if you're taking them. I am not saying that. What I am saying is I want you to be aware of this potential side effect because in certain situations there are alternatives that you can change your medication to for a more weight neutral option that will overall be better for your metabolic health and well-being.

Why Medication Lists Need Reviewing

Dr. Lindsay Ogle 2:12

I currently see patients through a telehealth company called Missouri Metabolic Health, and I see adults all throughout the state of Missouri and help them become metabolically healthy. And much of that is through medication adjustment, whether I'm adjusting their current medicines or adding new medications to their treatment plan. And when I was doing primary care, I was constantly looking at medication lists, and many patients were coming to establish care with me, and they were prescribed certain medications that were in the past our only option to treat certain conditions, but now we have better options that can either manage that condition in a more effective way or have less side effects. And oftentimes, once someone has started on a medicine, they're kind of just continued on it. It takes more energy to evaluate and ask a question: should we continue this medication? Should we try reducing it or going off of it or switching it to something else? But this is something that I feel very strongly about. And your medications should be constantly evaluated and seeing if they are necessary, seeing if they're beneficial to you, are they causing any side effects? Should we optimize your treatment plan? We should always be optimizing your treatment plan. So if your doctor is not actively doing this, and this may be something that they're doing in their mind and not uh verbalizing out loud, but if you have any question, there is nothing wrong with asking your doctor.

Brown Bag Medication Visit Walkthrough

Dr. Lindsay Ogle 3:57

What I would do with my patients would be what we sometimes call brown bag medication visits. And so what I would ask my patients to do would be to collect all of the medicines that they're taking, bring them physically into the office, and we will go through them one by one to make sure we're on the same page about what dose you're taking, why you're taking it, when was it started, is this gonna be a forever medication? Should we switch it to something else? Do we need to monitor for certain side effects? We go through all of it during that visit, and these are very, very productive and helpful, important visits you should be having, especially if you're taking six or more medications. You need to be doing this at least once a year. So, back to the point of this visit to go over certain medications that may cause weight gain. Again, take this information, have an appointment with your doctor, and determine what are the most appropriate medications for you specifically.

Metformin To Protect Metabolic Health

Dr. Lindsay Ogle 4:58

One really important tip that I want you to be aware of, and that again you can bring to your doctor as an option, is if you determine that you do need to start one of these medications, you can consider also starting metformin along with these medications. And the combination of a medication that is known to cause weight gain and taking metformin along with it, which is known to help protect against weight gain by treating insulin resistance. That combination of those two medications can prevent weight gain. It can also prevent the development of metabolic dysfunction, it can keep blood sugar levels normal, it can keep cholesterol levels normal, and it can keep you metabolically healthy while you're on a medication that may be necessary for a certain reason, but we want to avoid those unwanted side effects.

Mood Meds Linked To Weight Gain

Dr. Lindsay Ogle 5:54

So, first category of medications is mood-related medications. So we're talking about depression, anxiety, bipolar disorder. So some of the medications that help with mood that may contribute to weight gain or metabolic dysfunction are zyprexa, ceroquil, amitriptyline, martazepine. SSRIs are fairly variable, so some people gain weight, some people don't. But Paxil out of that group is the one that is more likely to cause weight gain. So I tend to avoid that medication for many of my patients and choose one of the other SSRIs to start with. Oh, and SSRIs are selective serotonin reuptake inhibitors, meaning they help us to increase our serotonin, our feel-good hormone in our body. We also have SNRIs, um serotonin and norepinephrine reuptake inhibitors. So these increase serotonin and norepinephrine in our system, and the combination, for whatever reason, it helps us to have a little bit more of a weight neutral effect. These medications are used for both anxiety and depression. Um, and the SNRIs, um, I sometimes lean more towards if I'm worried about weight gain in a patient. Um, examples of those are duloxetine, the brand name is Cymbolta, or Effexer. Again, if you're on any of the ones that I mentioned that cause weight gain, please do not stop them. Talk to your doctor, talk about potential other options, and if your doctor brings up maybe starting one, ask about starting metformin along with it. And by no means is this an exhaustive list, these are just some of the more commonly prescribed medications that are more likely to cause weight gain.

Gabapentin And Pregabalin Cautions

Dr. Lindsay Ogle 7:49

The next category are the medications that we are commonly using for neuropathy or nerve pain. They could be used for other things, but this is what they're most commonly used for. And the two medications are gabapentin or neurotin, um, is another name for it, or pregablin or lyrica is the brand name for pregaballin. These medications, if you are taking them, there may be a very good reason that you're taking them and you should continue to take them, talk to your doctor. Especially these medicines, you need to taper off of them. If you stop them abruptly, you are putting yourself at risk for a seizure. So we are wanting to taper them down over time if we do make the decision to stop them because of a side effect like weight

Steroids Prednisone And Blood Sugar

Dr. Lindsay Ogle 8:38

gain. The next category are steroids. Prednisone is a commonly prescribed steroid. It is used for lots of different things. I can't even begin to go over everything that it is used for. There are some very important reasons that you would need to be on a steroid. There are some less important reasons that you may need to be on a steroid. Oftentimes they're prescribed short term for acute issues like respiratory infections, inflammatory conditions. Sometimes they're needed long term. These are another one that it is very important to taper off if you are on them, especially long term. It can be dangerous to stop them all of a sudden. And again, there are often times that you need to be on a steroid. So talk to your doctor about this medication, but be aware that it may have the side effect of weight gain and higher blood sugar. And so, screening for diabetes with the fasting blood sugar or an A1C on a regular basis is important if you have either been taking steroids long term or you have had a lot of short-term prescriptions of steroids in your life. We often see this in people who have asthma or other lung diseases that get flares of their condition and periodically use steroids for a few days or a week or so several times a year. That use of steroids can add up over term. Of course, it's so important that you use them in the moment so you can breathe and have your condition treated. But we just need to be aware of the side effect and monitor for that potential development of weight gain and high blood sugar.

Type 2 Diabetes Meds And Weight

Dr. Lindsay Ogle 10:23

The next class of medicines is one of my favorite to talk about. It's the diabetes medications, and I'm talking about type 2 diabetes. Okay, type 1 diabetes and type 2 diabetes are very different conditions. They are actually the exact opposite of each other. Type 1 diabetes is the absence of insulin in the body, the body is not making any more insulin. Type 2 diabetes is when you are insulin resistant. Your body is not responding to the insulin. You actually have very high levels of insulin. And so these are very different. Type 1 diabetes, low insulin, type 2 diabetes, high insulin. Type 1 diabetes, you absolutely have to be on insulin to survive. Absolutely. Type 2 diabetes. Many people are prescribed insulin because possibly when they were diagnosed their blood sugar was sky high and they needed to have that managed and brought back down to a safe level. And often this happens if someone was hospitalized when they were first diagnosed. But sometimes they are continued on the insulin indefinitely, and that is often not necessary. Many times we can switch somebody to an alternative medication that is more beneficial for managing the diabetes, but also preventing complications that are common in diabetes, specifically cardiovascular disease and kidney disease, which are very common and potentially deadly complications of diabetes. In my opinion, it is extremely important for anybody who has type 2 diabetes to be transitioned from insulin treatment to one of our newer options, our GLP1 agonists andor our SGLT2 inhibitors. Common names of the GLP1, I'm sure you've heard of them, Ozempic and Monjaro are what are used for type 2 diabetes. And the SGLT2 inhibitors, two of the common names are Jardiance and Farsega. And these medicines have been proven to be effective in controlling blood sugar, they have been proven to aid in weight loss, they have been proven to protect or treat chronic kidney disease as well as cardiovascular disease. And so there are so many benefits of these medicines, and insulin, truly the only benefit, is controlling the blood sugar. It does not help us to lose weight. In fact, people gain weight on insulin, and it does not prevent heart disease or kidney disease. And so ask your doctor, can I switch to one of the other medications? Metformin is also a great option. We know it's safe, it's very inexpensive, it's a much better option than insulin if you tolerate it. Other diabetes medications that can lead to weight gain that I would want you to talk to your doctor about if you are on them are safoniurheas. Common examples are glypazide, glimeparide, gliboride, and P.A glitzone. Um brand name is actose. These are older medications for type 2 diabetes. They are inexpensive, which is a benefit. They can be very effective at lowering the blood sugar, but they do not have any of the benefits of the newer medicines or metformin that I mentioned. And sulfoniureas and the P. aglidosone can cause weight gain. Again, insulin, sulfoniurias, pia glitosone are three types of type 2 by type 2 diabetes medications that can lead to weight gain. And if you or someone you love who are prescribed these medications, do not stop them. Just schedule an appointment with your doctor to talk about maybe switching to an alternative.

Beta Blockers And Better BP Options

Dr. Lindsay Ogle 14:23

The next category are beta blockers, and the two that are more likely to cause weight gain are propranolol and ethenol. Beta blockers are used for many different reasons. They can help slow the heart rate if someone has a fast heart rate. They have been used for the treatment of cardiovascular diseases. They have been proven very beneficial in that in the past. They're often also prescribed for anxiety symptoms. So they help the physical manifestations of anxiety. It's something that I very commonly prescribe to use as needed. As with all of the other medications that I mentioned, do not stop them if you're prescribed. This is just a warranted conversation. The times that I see these medications should probably be switched to something else is when propranolol, etenolol, or another beta blocker, um, mitoprolol is another common one, are used to treat blood pressure. Now, there was a time when these were some of our only options, but we have better options now that are more weight neutral. And these include lysinopril, low sartin, amlodipine. Those are just some common examples of other options that are weight neutral and have also had other proven benefits. The beta blockers, unless you're taking them prescribed by a cardiologist for your cardiovascular disease or fast heart rate, your arrhythmia, or you take it periodically for anxiety, I recommend that you talk to your doctor and ask them, help determine why you're prescribed it and if there is an alternative. Again, especially if you're on it for high blood pressure.

Hormones Birth Control And HRT

Dr. Lindsay Ogle 16:12

Next category is hormones. So this is variable from person to person what their experience is, but um birth control, especially higher strength birth control pills, may lead to weight gain in some people. And hormone replacement therapy may also lead to weight gain in some people. So this is something to watch out for. If you are noticing that, talk with your prescriber about alternative options. I did a whole talk about contraception and birth control that I will link here, and so you can, you know, learn about your other options and bring that back to your doctor and find what is best for you if you have noticed

OTC Benadryl And Subtle Weight Gain

Dr. Lindsay Ogle 16:54

weight gain. And last, there are some over-the-counter medications that may cause weight gain. The most common one that is used fairly often is Benadryl or diphenhydramine. People may take it for allergies or they may take it before bed as a sleep aid, but over time this can lead to a little bit of weight gain as well. So there is a fairly comprehensive list of several of our most common medications that are prescribed that may lead to weight loss. Again, everybody is different. Not

Next Steps Plus Share And Subscribe

Dr. Lindsay Ogle 17:28

everybody prescribed prescribed these medications gains weight. Sometimes it may only be two, three, four pounds. Other people, it may be 10, 15, 20 pounds. It's variable. We are all different. And sometimes we need to be on these medications for legitimate health reasons. Other times we were started on them because it was the only thing that was available and we've just continued to take them. If that's the case, maybe we should consider some newer options. Whatever the case, do not stop your medication, schedule an appointment with your doctor, bring all of your current medications to them, evaluate why you're taking each one of them. Is there a newer, better, safer option that you can change to with the guidance of your doctor? Hopefully, you can take this knowledge and be prepared for that appointment, and you can create a health plan that is truly designed and individualized for you so that you can improve and maintain your health long term to live the life that you want to live. And if you live in Missouri, I would love to help you through this. And you can schedule an appointment through my telehealth clinic, MissouriMetabolic Health.com. Thank you for listening and learning how you can improve your metabolic health in this modern world. If you found this information helpful, please share with a friend, a family member, or a colleague. We need to do all we can to combat the dangerous misinformation that is out there. Please subscribe and write a video. This will help others find the podcast that they may also improve their metabolic health. I look forward to our conversation.