Doctors and therapists don’t care about weight gain?

Has anyone else had this same issue? With my therapist every time I lose even 5 pounds she has a total meltdown and freaks out that I have an eating disorder. Yet when I voice my concern about a new med causing weight gain she says “well at least the med is working.” And doesn’t seem to validate my feelings. It’s kind of annoying. Plus she’s saying now I shouldn’t be losing weight for medical reasons? Wtf?

I've had a similar experience. With Escitalopram, I gained 26 kg (57 lb) in a little over a year (I went from 80 kg/176 lb to 106 kg/224lb). My psychiatrist denied my weight gain had anything to do with my medication. My GP and cardiologist (my father died young from heart disease, so for many years, I had a regular checkup) were worried about the health-effects of my weight. Needless to say my self image sufferd from turning from lean to chubby and - being an avid mountainbiker at the time - I was really frustrated about losing the one thing that had made me fee lgood about myself for years (that is to say, I kept riding but for a long time felt bad on the bike). I eventually ended up with a back-hernia which was partly attributed to my being overweight.
At the time, I wasn't even seeing my psyshicatrist: I just picked up my prescription when I went to the hospital to see my psychologist. I made one appointment to discuees my weight and other health issues. ccording to him, there was no link between my weight adn the medication. Just as there was supposedly no link between my sleepiness and my medication (I have to add to this that it was the same doctor who gave me ritalin to cure my sleepiness). Maybe my medication worked for me (but I've never felt a real difference), but if they did, their side-effects had a larger impact on both my physical and mental well-being.


You're not alone with this. I think medication is too often regarded as a safe quick-fix. There's nothing wrong with wanting to lose weight for your health, nor is there with being concerned with medication related weight gain and the associated health effects but you do have to keep in mind she probably sees far too many people who are obsessed with weight-loss for the wrong reasons (the eating disorders you mention).

Personally, I've grown weary of therapists who over-focus on the "benefits" of medication while they ignore the fact that no pill works for everybody, that side-effects can have an enormous impact and are unwilling to discuss the effectiveness of your medication. Even if an antidepressant works, I think a side-effect can be so severe that it undoes its positive effects and a therapist should be open to discussion.

The most sympathetic response I’ve gotten was well it could be worse...lol....the antipsychotics are notorious for gaining 80+ pounds and I’ve only gained 40.

I swear my therapist is just jealous or something. She says I’m “restricting” and it’s an “eating disorder” when what I’m doing is intermittent fasting and there’s been a ton of buzz on the news recently about how healthy it is.

I don't think there are psychiatrists who don't seem to acknowledge these risks, I know it. I saw it during my last hospitalization, when half the hospital was on massive doses of Seroquel and becoming diabetic. It is a major, major problem. I understand that they have a hard job balancing these things and that there really aren't an endless number of med options for them and us, but geez, this is like, a crisis for some people. It's part of why I stopped my Abilify. But in the end, I couldn't do it. I get psychotic off it, so, there you go. I am stuck.
If I didn't ride my bike 7000 miles a year, I would probably easily weigh at least 40-60 pounds more.

And then when I lose weight my therapist tattles on me to my Pdoc and then he wants me to get bloodwork done. For what reason? Does he want to pay the balance my insurance won’t cover? I’m just going to talk my therapist rationally on Monday. But it just seems like in her mind any type of weight loss is bad no matter how or what you do to lose it.

I have not met even one pdoc who seems to give a flying eff about med weight gain, and that angers me to no end. Before I was on Seroquel I weighed 110lbs. I'm 5'6". I was thin - too thin. Well, I've gained an immense amount of weight on Seroquel. The whole time I was on it (7 years) I told the 3 pdocs I saw that I was extremely concerned about the weight gain. I swear, they'd look at me blankly like I was speaking Martian. I assume they didn't believe that I had been so thin.

I now weigh 265lbs. My cholesterol is elevated, my bp is up, my glucose is borderline diabetic. I have chronic pain in my legs and back from the weight gain.

So now I finally insisted to be taken off of Seroquel...and my pdoc put me on Zyprexa. And Metformin, 2 meds to lower my blood pressure and has mentioned a statin to lower my cholesterol. For the chronic pain, ibuprofen.

My therapist...all she'll do is nod sympathetically, then tell me that I need to speak with Dr. W. about the medication issues.

I'm furious and I feel defeated. I've gained 10 lbs. this year. I feel like I'm starving hungry ALL of the time. The Metformin helped decrease my appetite for 3 wonderful days.

The worst, worst part of it all is that I don't think the Zyprexa is doing jack shite. Oh, it's deadened my creativity. I'm an artist and that was the biggest thing that enriched my life. Now I don't even have that.

I'm sorry for this vent. I am just so, so, so frustrated. Everything GOOD stolen away and the BAD barely gone.

I next see my pdoc in 5 days. I'm planning on stopping the Zyprexa now & see how I feel in 5 days. Also, I can cancel and reschedule for the following week. I'm ready to lie to her, do whatever it takes. Because this weight gain is going to kill me, seriously. Kind of ridiculous, isn't it? "They're suicidal so we give them medication that kills them".

Rant over

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Originally Posted by bpcyclist I don't think there are psychiatrists who don't seem to acknowledge these risks, I know it. I saw it during my last hospitalization, when half the hospital was on massive doses of Seroquel and becoming diabetic. It is a major, major problem. I understand that they have a hard job balancing these things and that there really aren't an endless number of med options for them and us, but geez, this is like, a crisis for some people. It's part of why I stopped my Abilify. But in the end, I couldn't do it. I get psychotic off it, so, there you go. I am stuck. If I didn't ride my bike 7000 miles a year, I would probably easily weigh at least 40-60 pounds more.

Hi bpc, how do you manage to bicycle when on an AP? What I mean is, do you experience the "who cares" (flat feeling) and the depleted exhaustion?

And Mountaindewed, maybe she is envious. My T saw a photo of me, taken some years ago, before I gained all the weight. She said, "Oh, my goodness...you were really beautiful!" She said that several times and she treated me differently afterwards. I don't know what her trip was, but she was definitely different.

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Originally Posted by Mountaindewed And then when I lose weight my therapist tattles on me to my Pdoc and then he wants me to get bloodwork done. For what reason? Does he want to pay the balance my insurance won’t cover? I’m just going to talk my therapist rationally on Monday. But it just seems like in her mind any type of weight loss is bad no matter how or what you do to lose it.

OMG! YES! The tattle-telling!!! I have straight-up asked my therapist if she would please not mention something to my pdoc (they work together). She'll agree not to, then it comes right back to me that she has! When I have mentioned it, therapist says, "Hmmm...she must have read my notes..."

Well, however Dr. W. gets the information, whether by spoken word or by computer notes, to me it feels like a breach of confidentiality. So now I just don't tell my T some things. It all adds up to just plain stupid.

Yes this is how it is for me too. They work together and one week I’ll say “please don’t tell Pdoc” and she’ll agree not to and then at our next session she will say “so I talked with Pdoc about what we talked about last week.” Um, I told you not to tell him and you agreed not to. Yeah it seems like a breach of confidentially at times for me. Maybe I just won’t bring up my weight loss anymore with her. She’ll just notice all of a sudden that I’ve lost 20 pounds and be like “wtf?” Then I’ll deal with her then.

My insurance called me about a year ago and asked if I’d switch from Geodon to seroquel. I said hell no. I’ve heard what that stuff does to people both physically and mentally. My new secondary insurance comes with a free gym membership. I’ll put it to good use next year.

Good for you, MD.

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Originally Posted by Mountaindewed Yes this is how it is for me too. They work together and one week I’ll say “please don’t tell Pdoc” and she’ll agree not to and then at our next session she will say “so I talked with Pdoc about what we talked about last week.” Um, I told you not to tell him and you agreed not to. Yeah it seems like a breach of confidentially at times for me. Maybe I just won’t bring up my weight loss anymore with her. She’ll just notice all of a sudden that I’ve lost 20 pounds and be like “wtf?” Then I’ll deal with her then.

Exactly. I don't understand...to me, unless I sign something, or even if there's a verbal agreement, a therapist talking to anyone is a breach of confidentiality. And I understand how you feel...like you just won't talk about certain subjects. I feel the same way. Maybe I'll just lay it out there, tell my T that I am avoiding certain subjects because I feel like I can't trust her not to tell my pdoc. See what she says.

My long-time private psychiatrist hasn't been as concerned about my weight as he's been about my blood work results. He actually is concerned about them, in many ways more than my GP or nephrologist (kidney doctor) that I see at least a couple times per year. My psychiatrist has bugged me a lot in the past about exercising more. He is right that I should, but I still don't for various reasons, even though I used to be an avid exerciser. Once he suggested I try becoming a vegan. Oh my! I tried for two days and it was not happening for me. I asked if he was a vegan or vegetarian, and he said "No". I don't think being a vegan is necessary at all, but I definitely should adjust my eating. I know it, but it is tough. Only occasionally do I manage to diet successfully, but it usually ends when a mood episode (mania) develops.

I remember several years back first hearing about Metformin for weight loss. That was when I was at my heaviest. I was on Depakote and Invega at the time and had been depressed for quite a while. I asked him about it and he literally yelled "NO!!!!!" I didn't say any more. Then only a few months back (perhaps 9 years later) he brought up Metformin because he heard so many good things about it at a psych med conference. He decided to prescribe it for me (as his first patient he prescribed it for). I got home with it and researched it more to find it was contraindicated for people with kidney damage. Ooops! I called him about that, and he told me to stop taking the Metformin. The next time I saw him he kinda apologized. He did look guilty about it. He is lucky that I adore him. Some patient out there might have filed a complaint. I told him that he was lucky to learn a bit more about the med from someone like me, rather than the type that would complain.

Unfortunately, medicine has gone to hell, at least in the U.S. it has...this type of thinking is entrenched in the culture. It's very superficial and dumbed down these days-if A do B; as opposed to-if A and B and C, do D despite E and F. Critical thinking is considered 'old school'.

Also, there are lazy doctors out there but also much apathy in general. Good on you for researching on your own.

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Originally Posted by vifemina Unfortunately, medicine has gone to hell, at least in the U.S. it has...this type of thinking is entrenched in the culture. It's very superficial and dumbed down these days-if A do B; as opposed to-if A and B and C, do D despite E and F. Critical thinking is considered 'old school'. Also, there are lazy doctors out there but also much apathy in general. Good on you for researching on your own.

That's the truth. Sometimes I feel like saying, "So...do I get your paycheck this month, 'cause I've done most of the work for this appointment..."

The way I see it at least half the doctors and therapists out there graduated in the lower half of their classes. I stopped going to my doctor because she became so nasty. The final straw was when I made an appointment to discuss how the medication I was taking was making me gain weight (and to once again ask if I could not try something else) and before I could get a word out she started haranguing me about my weight gain, as if it were a character flaw she needed to address.

I resolved then and there to get off the anti-depressant I was on, for three reasons: it didn't seem to be helping (she only wanted to give me more of the same); it made me hungry all the time, and if I went even a few days without it (which happened all the time because I could not get to the pharmacy promptly to fill the prescription) I went through horrible withdrawal.

Well, the withdrawal was absolutely dreadful, even though I did it as slowly as possible. The last week before the symptoms abated I couldn't work, they were so bad.

The end result is, I am still depressed, but no more so than I was on the drug, and I am finally losing the weight. Unless or until someone can tell me I won't pile on the pounds and suffer withdrawal from hell, I am never taking an anti-depressant again.

I do NOT recommend what I did to anyone. I hope what my story does is makes you resolve to put some steel into your voice and say "My concern is serious and deserves attention! If you cannot address it, please refer me to someone who can!!!!!"

My former doctor had no business prescribing psychotropic drugs nor treating emotional concerns. Just because they can prescribe, doesn't mean they know how, in my opinion.

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Originally Posted by IceCreamKid The way I see it at least half the doctors and therapists out there graduated in the lower half of their classes. Ha, good point. I stopped going to my doctor because she became so nasty. The final straw was when I made an appointment to discuss how the medication I was taking was making me gain weight (and to once again ask if I could not try something else) and before I could get a word out she started haranguing me about my weight gain, as if it were a character flaw she needed to address. That's what my GP does. Almost every reason I see her for she says it's "because of the weight". And she says it in a snotty way, as if she's accusing me of a wrongdoing- but then she snaps out that the medication I'm on causes weight gain, and that there's nothing that can be done about it. All of her words condescending, or at least that's the way she sounds to me. I resolved then and there to get off the anti-depressant I was on, for three reasons: it didn't seem to be helping (she only wanted to give me more of the same); it made me hungry all the time, and if I went even a few days without it (which happened all the time because I could not get to the pharmacy promptly to fill the prescription) I went through horrible withdrawal. Yes, w/d from every AD I've been on is horrific. Well, the withdrawal was absolutely dreadful, even though I did it as slowly as possible. The last week before the symptoms abated I couldn't work, they were so bad. The end result is, I am still depressed, but no more so than I was on the drug, and I am finally losing the weight. Unless or until someone can tell me I won't pile on the pounds and suffer withdrawal from hell, I am never taking an anti-depressant again. I do NOT recommend what I did to anyone. I hope what my story does is makes you resolve to put some steel into your voice and say "My concern is serious and deserves attention! If you cannot address it, please refer me to someone who can!!!!!" I like that- "steel in my voice". That's what I'm planning to do today - seriously assert myself and insist that Dr. W. pays attention to the weight gain issue - which is causing other medical problems that are very serious. My former doctor had no business prescribing psychotropic drugs nor treating emotional concerns. Just because they can prescribe, doesn't mean they know how, in my opinion.

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You know what they call the person who graduated last in my medical school class?

MD.

I don't agree with this. Their primary mandate is to manage your mental health needs. It is unfortunate that medication causes weight gain but this is a fact of life when you take it. Mental health care needs by far outweigh the side effects of weight gain. I don't believe they are ignoring that this happens. In my own experience my healthcare providers have acknowledged this is going to happen and feel badly about it but they have informed me up front that this is going to happen. I can choose to manage mental health or I can ignore it. But they won't support the later.