When you start putting on weight, you look to the usual suspects: The dusty treadmill in the corner of your bedroom or that stash of chocolate in your desk drawer. But for 30-year old Zaheer Khan, the culprit sat in his medicine cabinet. In six years, Khan gained 60 pounds from taking prednisone, a steroid used to treat his asthma.
Khan is just one of a growing number of individuals who can blame their excess pounds on the drugs they’re taking for everything from allergies to migraines. The chances of finding yourself on a drug that can lead to weight gain have more than doubled in the last 20 years. In fact, the number has increased from one in ten to one in four, says George Blackburn, MD, associate director of the Harvard Medical School Division of Nutrition. The problem is so critical that Blackburn teaches a course for physicians on the weight-gain side effects of medications. “The drugs we’re most concerned about are drugs for chronic diseases, like diabetes and psychiatric problems, because you have to be medicated for life,” Blackburn says. But even innocuous-sounding meds like over-the-counter sleep aids can cause snug-jeans syndrome - some by slowing your metabolism, others by altering the hormones in your body that control your appetite. And the problem isn’t just affecting your waistline: Some are even choosing not to take drugs critical to their health for weight-control reasons.
If you suspect that meds are making you gain weight, check our list below for the most common culprits and expert advice on what to do about it.
Drugs That Can Pile On Pounds
Antihistamines
The fat effects: Allergy drugs containing diphenhydramine have a sedating effect that saps your energy if you take them regularly. You’re not as active, so you’re burning fewer calories, Blackburn says.
What to do: Ask about another antihistamine like loratidine that doesn’t include sedating ingredients.
Sleep Aids
The fat effect: You’ll find the same culprit, diphenhydramine, in sleep aids and some versions of cold and pain medicines.
What to do: Your doctor may prescribe an option like zolpidem that’s designed to cut carry-over sedating effects.
Antidepressants
The fat effect: Some antidepressants affect neurotransmitters in your brain that control appetite and mood, both of which can make you eat more.
What to do: See a psychiatrist instead of a family physician and ask about antidepressants that don’t typically cause weight gain.
Migraine meds
The fat effect: Medicines like valproic acid which are sometimes used to prevent recurring migraines, can make you want to eat more, says Harminder Sikand, clinical director of pharmacy at Scripps Mercy Hospital in San Diego.
What to do: Ask your doctor about sumatriptan or other migraine drugs that are less likely to increase your appetite.
Birth control pills
The fat effect: Birth control pills may add up to five pounds because the estrogen in them can cause you to retain water.
What to do: Ask about a low-estrogen pill or the progestin-only minipill. Or try an intrauterine device.
Steroids
The fat effect: Prednisone, often used to treat rheumatoid arthritis and chronic inflammation, can make you feel ravenously hungry.
What to do: Your doctor may be able to give you prescription-strength NSAIDs (nonsteroidal anti-inflammatory drugs, such as ibuprofen) to help. If you need to stay on steroids, for e.g. as in asthma, work with a trainer to increase the calories you’re burning.
Suspect drugs are sabotaging your diet?
Use the five-pound rule. “Anybody on a new medication who gains five pounds in a month should see her doctor immediately,” weight-control expert George Blackburn, MD, says.
Take note. Rule out the other reasons you might be gaining weight by keeping a log of what you eat and how much you exercise for a week. If you don’t appear to be eating more or exercising less, take the journal to your doctor.
Don’t stop taking your medicine. Wait until you see your doctor, who may be able to prescribe an alternative.
Get help. If you need to stay on your medicines, see a dietitian or personal trainer (or both). In many cases, lifestyle changes will be enough to keep the extra weight off.
