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Antidepressants and hunger

Posted Sep 30 2008 5:21pm
For most people, it is very hard to stop eating when you have eaten enough. You clean your plates as your mothers taught even though the portion of food served for one person today would have fed your entire family when you were younger. You announce that you are full and cannot eat another bite as the dessert menu is presented and then order dessert. Tasting dish after dish at buffets and accepting uncountable numbers of appetizers during a reception or cocktail party long after any feeling of hunger has stopped is the norm. And even though hunger is long gone, you continue to munch and nibble to satisfy a need to feel better, entertain yourself, socialize, or relieve boredom. Yet as hard as it is to stop eating when food is tempting or acts as the evening’s entertainment, it is considerably more difficult to stop eating when a person is on most of the drugs that are being used to treat mental disorders. With few exceptions, antidepressants, mood stabilizers and antipsychotic drugs leave people feeling that they must eat long after they have consumed enough to take away their hunger. “I can eat three times as much as my husband does for dinner and yet an hour or so after we are finished, I am back in the kitchen looking for something to eat,“ complained Jeanne, a social worker. “Before I went on the mood stabilizers for my bipolar illness, I never ate after dinner. Now I am prowling the kitchen until I go to sleep.” A client on one of the drugs used to treat psychotic behavior as well as other types of emotional disorders told us despairingly, “I eat lunch or dinner and an hour later I eat the same amount of food again. My stomach feels so stuffed that I am physically uncomfortable but there is something in my head telling me to continue to eat.” “The feeling is like being continually thirsty,” a third client told us. This man, a former research scientist before his illness, knew that his cravings were caused by his medication. “I know that the need to eat is coming from my brain but I just can’t seem to turn it off. I even wake up at night to stuff myself.” Although the medical community acknowledges the connection between medications used to treat emotional disorders and overeating, understanding why this is happening is still being investigated. And doing something about it is, as a psychiatrist colleague told me, “limited to telling our patients that they may gain weight so they better pay attention to what they are eating.” But we are doing something about it, based on results at our weight-loss center that treated many clients on antidepressants and medications for bipolar and other disorders. We had no special program for these clients whose major weight gain was linked to the drugs they were taking. But we knew from our research that the way to turn off appetite was to increase serotonin levels. Serotonin is made only when carbohydrates (with the exception of fruit) are eaten. The carbs must be eaten alone, not with any protein, and with very little fat. We had been using this approach for our clients whose weight gain was due to overeating caused by stress, PMS, menopause and the winter blues. We tried this approach on clients with medication-caused weight gain and it worked. To make things easy for them, we suggested they use a drink called Serotrim, which is the most effective combination of carbohydrates to make new serotonin. The drink removed the possibility of bingeing or not paying attention to snack size. And of course we supported their weight-loss efforts with a healthy low-fat meal plan. We also encouraged our clients to exercise because it took away the fatigue and sleepiness caused by some of their medications. Our plan had amazing results. One of our greatest success stories concerned a client whose weight had soared over 500 pounds. This individual lost over 250 pounds and kept them off. I know because I bumped into this person five years later and the weight hadn’t returned.
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