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Abilify and Weight Gain: Causes & Contributing Factors

Abilify (Aripiprazole) is an atypical antipsychotic drug that is commonly used to treat severe psychiatric conditions like schizophrenia and bipolar disorder. In recent years, it has been heavily marketed as an antidepressant augmentation strategy. Despite the fact that this has been one of the most profitable medications of recent years, some research has suggested that its efficacy appears to be average.

In fact, most people end up eventually discontinuing treatment as a result of either the drug failing to treat their symptoms or tolerability issues. Like all antipsychotics, Abilify is capable of causing severe health problems such as neuroleptic malignant syndrome, high blood sugar, and increased risk of death. Additionally, even among individuals for which the drug is working well to manage symptoms, side effects like weight gain may be highly discouraging.

Abilify and Weight Gain

There is a lot of conflicting information regarding whether Abilify actually causes weight gain. Some doctors will explain that the drug is “weight neutral” and unlikely to affect your body-weight, while others may suggest that you’ll gain a marginal amount of weight throughout treatment. While compared to other atypical antipsychotics, Abilify tends to result in less “weight gain,” it doesn’t mean that the drug should be considered weight neutral for everyone.

The truth is that most people end up gaining some weight throughout their treatment with this drug. It is believed that its antagonist effect upon the 5-HT2C receptor is what may cause the gain.

How Abilify Causes Weight Gain

There are many ways in which this drug is capable of causing you to gain weight. Understand that what causes you to gain weight from this drug may be different for someone else. One person may experience an increase in appetite and start eating more, while another may believe their metabolism slowed. In other cases, a combination of these factors could lead to weight gain.

  • Appetite increase: Some people that take Abilify notice that it makes them have a bigger appetite than they did prior to taking it. If you constantly feel hungry and find yourself eating whatever food is in sight, it’s probably related to the medication. For some individuals the increase in appetite is modest, while among others it’s significant.
  • Blood sugar spikes: This is a drug that has been noted to affect levels of blood-glucose or blood sugars. When blood sugar levels are not stabilized, their instability may foster weight gain in some people. It is best to keep blood sugars in check throughout treatment and know that Abilify may be contributing to glucose spikes.
  • Cravings for food: If you find yourself craving food throughout the day, it could be from this medication. Many people taking antipsychotics have noticed that they start to crave unhealthy foods such as refined carbohydrates and sugars (e.g. candy) during treatment. Craving food as a result of Abilify is a factor that may lead to weight gain.
  • Fat storage: It is believed that antipsychotics have potential to modify the body’s fat storage mechanisms. This leads to more fat being stored in unwanted areas of the body and thus more overall weight gain. If your fat mass has significantly increased throughout treatment and your weight has gone up, it’s likely a result of Abilify.
  • Going out to eat: Assuming this drug helps with your psychiatric condition, you may start to feel more comfortable in public and/or may even start hanging out with friends again. Being social and more comfortable with yourself could lead you to go out to eat more frequently. Dining out tends to involve eating unhealthy foods with large portions. Additionally, if you start going to get “fast food,” it should be relatively obvious why you’re gaining weight.
  • Hormone levels: Abilify is capable of altering levels of naturally occurring hormones throughout the body. Disrupting homeostatic hormone levels with an antipsychotic drug may account for weight gain in some cases. Any drug that significantly affects the hormones naturally produced by your body could result in substantial weight gain.
  • Motivation deficit: Although the drug may affect everyone differently in terms of motivation, some people notice that their level of motivation significantly wanes throughout treatment. If you become less motivated to stay in shape or eat healthy, this makes it relatively easy to gain weight. Some people end up becoming lazy largely due to the fact that the drug has an uncontrollable influence over their physiology.
  • Side effects: You may experience unwanted side effects from the drug such as fatigue, drowsiness, and sleepiness that make it difficult to get adequate physical exercise. These side effects may be so severe, that it becomes a challenge to get out of bed in the morning. If you are debilitated by fatigue, this may further slow your metabolism because you aren’t getting much physical activity to keep it high.
  • Slow metabolism: If you are eating the same foods / portion sizes and getting the same amount of exercise during treatment as you were before taking Abilify, but are still gaining weight, it’s likely due to metabolic slowing. Drugs like Abilify have a tendency to slow your metabolism, resulting in weight gain even when your dietary and exercise habits haven’t changed. This can be frustrating, but is generally accepted as part of treatment.
  • Taste improvement: People who were really depressed before taking Abilify may notice that food tastes way better during treatment. Food may start to taste so good, that you may feel as though you can’t get enough. The taste improvement is likely to lead to you consuming bigger portions, more calories, and inevitable weight gain.

Note: The severity to which these factors are experienced is subject to individual variation.

Factors that influence weight gain on Abilify

There are many other factors that may influence the amount of weight you gain on Abilify. It is important to consider the dosage you’re taking, personal lifestyle factors, the duration for which you’ve been medicated, as well as if you are taking other medications.

1. Dosage

Most people taking Abilify for schizophrenia or bipolar disorder end up taking between 10 mg and 15 mg daily, but dosage can be increased all the way up to 30 mg. In general, you are more likely to experience weight gain as you increase the dosage. This is due to the fact that at higher doses, the drug has more influence over your natural physiology.

Certain physiological functions such as the body’s ability to store fat, along with important hormone levels that help prevent weight gain, become drastically altered. At lower doses, a person is less likely to gain weight simply because the drug has less influence over your physiology. For this reason, it is always recommended to use a “minimal effective dose” strategy if you are concerned about weight gain.

2. Individual factors

In some cases, it is necessary to take personal responsibility for some of the weight that you gain throughout treatment. If you have been overworking, not getting enough sleep, are eating a poor diet, or aren’t getting much exercise, those are all factors that can contribute to weight gain. It is often important to consider that there are certain behaviors that you are exhibiting that are directly contributing to weight gain.

There are also other individual factors such as: age, baseline metabolism, and genetics that could influence whether you gain weight while taking this drug. In order to get a better understanding of how your genetics may be reacting to the drug (to cause weight gain), you could look into a test called “GeneSight.” This type of test analyzes some genetic biomarkers and predicts whether you will react favorably vs. unfavorably to a particular psychiatric medication.

3. Time span

The duration over which you have taken the drug may have an impact on the amount of weight you gain. Some people notice significant weight gain in the short-term (i.e. 6 weeks), while others notice more significant weight gain over the long-term (i.e. years). In any regard, it is thought that the longer duration over which you have been treated with this drug, the more likely you will have gained weight.

Short-term: The shorter the term over which you’ve been taking the drug, the less likely you will be to have gained weight. It should be noted that some people experience a major spike in weight during the early stages of treatment, with no further significant weight gain over the long-term. Others experience an initial spike in weight, followed by more gradual increases in weight over the long-term. There are cases of patients gaining 20 lbs. within just 60 days of treatment.

Long-term: Those that have been taking Abilify for a long period of time are more likely to have experienced some sort of weight gain compared to those who only took it for a short duration. Being treated over the long-term generally results in a greater severity of drug-induced physiological alterations. Therefore homeostatic functions and hormone levels will be further from the baseline. It should also be noted that as a person stays medicated over the long-term, they may develop a tolerance. This generally results in a dosage increase, which is known to promote further weight gain.

  • Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000187/

4. Other medications

There are studies suggesting that certain medications are capable of causing increased weight gain while on Abilify. If you are taking a serotonergic antidepressant (SSRI) along with Abilify, there is greater likelihood that you’ll gain more weight than someone taking only Abilify. If you are on multiple medications, it is important to review them with your doctor to determine which may be the primary culprit for your weight gain.

Also understand that if you are taking a stimulatory drug such as Adderall or a non-serotonergic antidepressant, you may remain weight neutral while taking Abilify. Those that remain weight neutral are generally on a medication to stimulate the central nervous system, which helps offset the metabolic slowing that stems from antipsychotic usage.

How much weight will you gain from Abilify?

There’s no predicting exactly how much weight you’re going to gain from taking Abilify. Since there is significant individual variation, you’ll need to first take the medication for awhile and then evaluate whether you’ve gained any weight. Some people have reported that they gained an average of 5 lbs. to 10 lbs. per year of treatment, while other people have gained 40 lbs. within the first 6-months of treatment.

In other cases, people end up not gaining any weight.  Although the average weight gain for adults taking Abilify is unknown, the experienced doctors know that on average, patients are probably going to gain at least 10% of their pre-drug body-weight as a result of the medication.  Assuming you are 200 lbs. starting treatment, you may end up gaining at least 20 lbs.

Will everyone gain weight while taking Abilify?

Despite the fact that an overwhelming majority of people who take Abilify will gain weight, it doesn’t meant that everyone will experience noticeable weight gain. Some individuals may remain weight neutral (and in rare cases lose weight). Those that remain weight neutral generally are able to maintain a healthy diet, physical exercise, and/or are taking a medication that helps offset the weight-gaining effects of Abilify.

It is also important to point out that for people in need of an antipsychotic, this is considered one of the most “weight neutral” options. Nearly all antipsychotics are likely to cause some sort of weight gain, but Abilify is suggested to cause less weight gain than most others. Some people may experience weight loss if they switched to Abilify from another antipsychotic (e.g. Zyprexa) that is known to cause greater weight gain.

“Weighing” the Pros and Cons of Abilify

Throughout your treatment, it is important for you to conduct a cost-benefit analysis of this drug. In other words, “weigh” the side effects (including weight gain) and determine their severity. Next take a look at how well the drug is working to treat or manage your condition. If Abilify is working great to treat your condition, but you experience some minor side effects, it’s probably a good idea to continue treatment.

On the other hand, if you have gained a bunch of weight and the drug just isn’t working very well, you should talk to your doctor. Generally if a drug isn’t working to treat your condition and/or side effects are interfering with your well-being, you may want to consider a medication switch or Abilify withdrawal. No medication is worth staying on if you aren’t getting benefit.

Did you gain weight while taking Abilify?

For those that took Abilify, be sure to share whether you experienced weight gain. Was it consistent with the idea that you’ll gain at least 10% body-weight throughout treatment? If you gained weight, be sure to mention how much weight you gained, whether you noticed you gained more weight when your dosage increased, and how long you’ve been taking Abilify. Also be sure to note any other possible factors that may have caused you to gain weight throughout your treatment.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/23469329

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{ 25 comments… add one }
  • potato January 31, 2016, 9:09 am

    I gained weight before taking Abilify. I am on 20 mg, have been on it for around 7 years. I don’t notice any side effects but can’t seem to lose weight on it dieting, maintaining at a 35 BMI. Is there a prescription weight loss medication I can take with Abilify?

  • Paula February 3, 2016, 4:48 pm

    I’ve been on 1mg of Abilify for 3 years and gained 50 lbs. I am 5’3″ and before this I always was at 105 to 110 maximum. I eat healthier, smaller portions and exercise, but keep gaining. It’s causing me severe depression. When I’ve tried to go off of it, I’m fine for a few weeks then fall into deep depression. Can ANYONE help me? Have been to two doctors and am going to a third next month. I’m ready to starve myself and eat nothing!

    • Robin August 3, 2016, 11:38 pm

      Hi I was always just your same size and with abilify I gained 10Lbs within a month or so. I was on 10 mg and cut the dose in thirds to see if that would help, nope. Now I am on 5 mg and take a third only a day or so when I’m really depressed and have lost 8Lbs so far and am taking synthroid for my thyroid as it was borderline low. I don’t eat much either but this approach helped. Instead of 2 prozac I take one and get off the computer and get busy.

    • Katie September 25, 2016, 6:09 am

      Perhaps alternative medications? Regular therapy? I gained 40 lbs on it. In 8 months. I didn’t realize Abilify was the cause (I didn’t gain weight immediately). When I finally realized, I stopped. I hadn’t seen any benefit from it, though I was still suffering from depression. After 1 month, the lbs started falling off rapidly as they had come, with no effort (I was so discouraged by the gain I’d quite exercising by the end of my use of it cuz it wasn’t making any difference for me either).

      The rest of the weight came off easily with regular exercise and minor diet changes. Lexapro helped me majorly, as well as therapy and daily discipline on my perspective (combating my distorted perspective with truthful steps and reminders and using Christian therapy resources).

  • Shola February 16, 2016, 9:08 am

    I started taking this medication in March and since July, I have gained 3 stone. I’m devastated.

  • Irritated February 23, 2016, 6:37 pm

    I was on 20 MG of Abilify and gained 20 lbs within 3 months. I am trying to lose the weight but it is hard. I’ve put myself on a vegan diet too see if I can lose this weight! I am depressed about this because my clothes don’t fit anymore!!

  • Barry February 29, 2016, 9:28 pm

    I am on Ability 5mg and Prozac 10mg and have put on 30 lbs. in 6 to 8 weeks. This is defeating. If I was not depressed before, I am now as well as embarrassed.

  • Weight Gain March 3, 2016, 3:41 pm

    I’ve been on Abilify 2mg and 5mg for 2 months and gained 6 lbs while dieting, and exercising. I’m drinking water only and watching my calories so I know that this medication is guaranteed to make you GAIN weight. My doctor told me that I can stop taking it and should not have any withdrawals.

  • Doris Martin March 5, 2016, 8:14 pm

    I’ve been taking Abilify for a couple years now, and have put on about 60 pounds. I don’t drink or smoke; food is my one vice, and it’s been a nightmare. I’d stop taking the medication, if I could – but the suicidal thoughts are overwhelming whenever I try. I’ve traded greater mental stability for any semblance of attractiveness. It’s a lousy deal, but better to be “fat and happy,” I suppose. That said: unless you’re truly at the end of your rope, don’t start taking Abilify…it’s hellishly difficult to quit.

  • Robin April 25, 2016, 12:13 pm

    I’ve been taking Abilify for almost 3 months and I have gained almost 30 pounds. I’m a cardiac patient and cannot afford the weight gain. I’ve noticed an increased desire for sugary foods like ice cream. I’ve been living a healthy low-carb lifestyle for many years and was able to manage my weight effectively until beginning to take Abilify.

    As with many psychotropic medications one must weigh the pros and cons of taking them. On a positive note this medication has stabilized my depression in approximately six weeks, which of course has improve my life in many ways. On a not so good note, I feel the weight gain is compromising my heart health and I will be having a discussion with my doctor to discuss other treatment options.

  • Melissa Buechel Andrews May 9, 2016, 7:25 pm

    Somebody have some sympathy or relate. I’ve been on depression meds for the last 29 yrs, and have always weighed 103-105 lbs. I recently went on Abilify 2mg/and I’ve gained 18 lbs in less than 2 months. I suffer from anorexia and decided to take myself off, but the pounds are still there. Does this last forever?

    • Katie September 25, 2016, 6:16 am

      It varies from person to person. I gained 40 lbs on it. In 8 months. When I finally realized Abilify was the cause, I stopped. I hadn’t seen any benefit from it anyway (though I was still suffering from depression at the time). After 1 month, the lbs started falling off rapidly as they had come, with no effort (I was so discouraged by the gain I’d quite exercising by the end of my use of it cuz it wasn’t making any difference for me either).

      The rest of the weight came off easily with regular exercise and minor diet changes. I have heard similar stories…but I have also heard stories where people struggled just as much as if they’d gained the weight naturally. Don’t give up! Try to incorporate small changes over time, baby steps that keep adding.

      It will feel empowering just knowing you are having that discipline in your life, and eventually (it may take time) you WILL see the results! My fave method is a blank monthly calendar. Each day I strive to exercise, even if it’s just a 10-minute walk (easy enough on the busiest of days), though obviously 30-60 minutes of more intense exercise is more my goal. I jot down what I did each day.

      I give myself grace for sick days, travel (I have family far away I occasionally visit, and exercise NOT gonna happen those days), and the rare day where life just happens. It’s beautiful to look back over a month and see what I did. I feel happier and healthier just doing it.

  • Dea May 18, 2016, 7:38 pm

    I’ve been taking abilify for 5 weeks along with 30mg of celexa. (I’ve been on celexa for almost 9 months). Despite eating less, moving more, I’ve gained 12 lbs. While it has helped somewhat with my depression, I’m someone who has struggled with weight my whole life. Summer is upon us and now I’m feeling the depression symptoms worsening because of the weight gain.

  • Joan Cole May 27, 2016, 6:54 pm

    Have been on 5mg and haven’t gained weight! In fact lost, take mirtazapine & lamotrigine 200 mg. Have to increase now after 6 weeks to 10mg so shall see what happens. But yes I am very weight concious.

  • Martymar June 6, 2016, 12:40 pm

    I am on 150mg of Zoloft and 10mg of Abilify. I have been taking them for 9 months now. I had never taken medications like this previously, have dealt with depression my whole life and just started these meds. My depression and Bipolar issues are much better but I have gained 30 pounds. I am athletic, I exercise a lot and eat very healthy.

    I am considering asking my doctor to put me on something else because it is making me more depressed that I now have this belly fat I cannot get rid of. Summer is here and I have been working hard to try and get my stomach trim again. Has anyone taken anything else that is weight neutral? Is there anything out there that they can add to your meds that will help you lose weight?

    • Katie September 25, 2016, 6:21 am

      I have enormous success with Lexapro for a couple of years. I have not seen any side effects at all. It has helped so much and I have had no problems. Abilify was devastating to my health/fitness; I put on 40 lbs, and weight had never before been an issue. That said, I’d do research on it and be cautious…after my experience with Abilify I research the wazoo out of any new medication and carefully monitor my health.

      Before I was on Lexapro and Abilify, I was on Luvox for about a decade. It helped a lot but not nearly to the extent of Lexapro. It did not seem to cause my any side effects either.

  • Bit ok July 1, 2016, 5:08 am

    My Autistic daughter gained over 50lbs in less than a year on Abilify paired with Zoloft. In this case, the benefits do not outweigh the risks.

  • Suzanne July 20, 2016, 9:43 pm

    I have been on 10 mg of Abilify for over 8 months now. I have gained 20 pounds since beginning it. I am trying SO hard to exercise and lose the pounds but they won’t budge. It’s too bad that I’ll probably end up tapering off of it because the weight gain is actually making me more depressed. Abilify is a good drug if weight gain is not a problem for you. I just hope the pounds will come off once I stop taking it.

  • Crystal August 16, 2016, 7:21 am

    I’ve been taking Abiliify for a few years now and I’ve gained over 60 pounds. I started at 136 pounds and now I am at 201 on a good day. I exercise 3 times a week. I’m on a plant based diet and have been for years and I am still over 200 pounds. I wish there was a better drug for me.

  • JULIA August 25, 2016, 6:58 pm

    I have taken 20 mg’s of Abilfy for 3 years and have not gained weight. This has been a life saving drug for me. I suggest if you are gaining a lot of weight talk to your Dr. and have them change your medication. There are many different medications on the market now and your Dr. should be able to switch you to another med. A Dr. should be concerned if you have gained weight from this drug.

  • Skyler August 26, 2016, 2:09 am

    I have been taking Abilify for a year and a half. My dosage has been 2 mg the whole time. I have gained almost 50 pounds. I have cravings all the time, I am constantly hungry, even after eating, etc. Before taking abilify I weighed 115 pounds. I now weigh about 160. and I am 5’2 so you can imagine how drastic of a change in appearance this has caused. I am VERY unhappy, so I am going to see a doctor to switch medicines ASAP. I do not think the medicine is worth it.

  • Hutch September 12, 2016, 1:12 pm

    I took abilify for 6 months as treatment for depression and anxiety. I gained 30 lbs in the first three months and then gained 10 more in the final 3. I was ravenously hungry all the time. I would eat so much my ribs would hurt and no matter how hard I tried I could not stop. I have successfully dieted in past years so I put that knowledge into action.

    That resulted in binge eating daily, even though while dieting I was consuming a healthy amount of calories for a safe weight loss I felt absolutely starved. If I didn’t eat the carbohydrates (unhealthy carbohydrates) I was craving I would being feeling physically sick. I would feel nausea and my mind would tell me some crackers would help. Then I would end up eating the whole box.

    I spoke with my GP about it and he told me it was all in my head and I was looking for an excuse to eat like this. Not only the weight gain, but I also developed a tick of sorts in my face. Randomly I would be talking to someone and I would make the funniest face that was totally out of my control. It was terrible.

    Feeling abandoned by my GP I decided to take myself off abilify, I felt that the depression and anxiety where easier to deal with than the side effects of abilify. That was another experience, and I know we should never try something like that without being under a doctors care, but I felt completely hopeless, and I knew, even if no one else believed me that abilify was the culprit. Since stopping a year ago my appetite has finally tamed down. I’ve regained energy and am able to function more normally.

    I am dieting successfully with no urges to binge, I’m back to running 5k every second day (while on abilify I could hardly manage my day let alone extra activities). However my weight loss has been at next to a snails pace, makes me wonder what’s happened to my metabolism. I will keep trying though, and I warn everyone! Talk to your Doc, make sure you are aware of all the side effects, then decide if your willing to try this drug. Not saying this happens to everyone. But it is what’s happened to me.

  • bad drug October 11, 2016, 1:26 am

    My daughter only took this drug for 3 months it and caused her to feel like she was always staving. She began to compulsively eat and gained 55lbs in 3 month before doctor took her off of this drug. The eating compulsively has improved but even months after stopping the med she’s back to how she used to eat but has not been able to shed the gained weight.

  • Joanna October 26, 2016, 12:07 am

    I take 30 mg of Abilify for Bipolar disorder. I have gained 100 lbs since starting this high dosage. I would say I gained it over a period of three years, but it has been terrible. I constantly crave sweets and chips. My appetite is HUGE, and I eat way more than I have ever eaten. I need it though to prevent terrible mood swings, so I really have no choice about taking it as I am allergic to most other anti-psychotics.

    My psychiatrist put me on a low-carb diet, but it is SO HARD when all I want to eat is junk food. I definitely have a love/hate relationship with this drug. It keeps me “normal” in mood, but I would say it definitely has messed up my metabolism.

  • Maria November 6, 2016, 4:21 pm

    I’ve been on abilify for two years 15 mg. I’ve gained 40 pounds. It causes me to wake up every night at 2am to eat, about a thousand calories worth in anything that contains sugar. Changed to Vraylar last week and love it. I’m not groggy all day, have motivation now and cravings subsided.

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