Zyprexa (Olanzapine) is an atypical antipsychotic medication that is approved by the FDA for the treatment of schizophrenia and bipolar disorder. In relatively rare cases, it is used as an augmentation strategy for the treatment of depression. The drug is manufactured by the company Eli Lilly, and has generated billions of dollars in revenue.
Despite the drug is considered effective, many people struggle tolerating its side effects. In some trials, more than 50% of patients end up quitting the drug before 6-weeks due to tolerability issues. Although it is better tolerated than older medications like Haldol and tends to improve negative symptoms well, older drugs tend to work better on positive symptoms (e.g. hallucinations).
Zyprexa and Weight Gain
Even though this medication may cause less cognitive impairment and extrapyramidal effects than other, typical antipsychotics, there’s no denying that it causes significant weight gain. Many people end up taking this drug and feel as if they are morphing into a blob of cellulite. This is due to the fact that the drug significantly increases appetite, slows metabolism, and alters all kinds of homeostatic physiological functions.
How does Zyprexa cause weight gain?
There are a variety of reasons that taking Zyprexa causes weight gain. For most people, it’s due to a combination of factors including: increased appetite, slowing of metabolism, and lethargy associated with treatment. Understand that there is a significant amount of scientific research supporting the fact that Zyprexa is among the most problematic psychiatric drugs in terms of weight gain.
- Appetite increase: Most people will notice that their appetite increases when they take Zyprexa. Sometimes this increase becomes so extreme, that a person will feel hungry around the clock. There have been cases of people waking up in the middle of the night starving and ready to raid their fridge. If you don’t notice an increase of appetite while on this drug, you are in the minority.
- Blood sugars: Zyprexa is known for elevating levels of blood-glucose and has been suggested as a potential cause of diabetes. If the drug is altering levels of blood glucose, this can affect metabolism and increase likelihood of weight gain. If your blood sugars become difficult to control on this medication, this could be contributing to your weight gain.
- Fat build-up: The way that your body stores fat on this medication is influenced by a number of factors including hormones, blood sugars, etc. It is known that taking this antipsychotic can lead the body to store a large amount of fat in areas that it typically would not (e.g. breasts in men).
- Food cravings: While some people notice that they experience food cravings as a result of their increased hunger, many notice more specific cravings for unhealthy options. If you start to crave refined carbohydrates, sugars, and foods with a lot of artificial sweeteners, it may be a result of the drug. Don’t be surprised if you start to develop cravings for foods that you never craved before.
- Gut bacteria: Your gut microbiome likely becomes severely disrupted when you take Zyprexa. Results have shown that among animals, the disruption of essential gut bacteria contributes to metabolic dysfunction.
- Hormones: Fluctuations in hormone levels is common while taking antipsychotics. However, many of these hormones lead us to gain weight. For example, the drugs significantly elevate levels of prolactin, which also decreases levels of testosterone. By altering just these two hormones, weight gain is likely to occur.
- Increased thirst: Many people notice that they become extremely thirsty while on this medication. Although water will suffice to quench thirst, most people generally prefer something with flavor. If you find yourself drinking large quantities of sodas, juices, etc. to quench your thirst from the medication, understand that this can cause weight gain.
- Metabolism: It’s not difficult to figure out that this drug likely slows the metabolism. Even if you are able to fight the urge to eat foods that you crave or keep your portions the same as you ate before taking the drug, if your metabolism slows, you will gain weight. This is an important contributing element of weight gain from Zyprexa.
- Side effects: There are some obvious side effects such as fatigue, drowsiness, and sleepiness that can cause some people to become less physically active. If you suddenly become a couch potato while on this medication, it’s likely going to contribute to weight gain – you’ll be burning less calories and your metabolism will decrease.
- Social eating: In the event that Zyprexa is working well to help treat your psychiatric condition, you may be more inclined to socialize with friends or work-colleagues. Increased socialization often leads to “going out” for food. Eating out is generally associated with large portions and unhealthier choices. If you go out to eat more while taking Zyprexa, realize that this could also be contributing to your weight gain.
- Taste improvement: You may not only end up with a boosted appetite, and food cravings, but your taste may also improve. When nearly all foods taste incredible, you may eat more than usual and keep going back for more. Many people notice that their taste improves when their negative symptoms are properly managed.
Individual factors that dictate weight gain on Zyprexa
It is important to keep in mind that there are additional factors that will influence weight gain on an individual basis. These factors include things like: dosage, your individual lifestyle and habits, how long you’ve been medicated, as well as whether you take any other medications.
Most people that take Zyprexa will be on a dose between 5 mg and 10 mg when they start out, and stabilize at a dose between 10 mg and 15 mg. The maximum recommended dose is 20 mg. Although you probably are familiar with the dosing, you may not be aware of the fact that dosage often dictates the amount of weight that you gain. At higher doses, you’ll gain more weight than you would at a lower dose.
Therefore, in order to minimize the amount of weight gained on this drug, you’ll want to stay on the “minimal effective dose.” The lower the dose you can take to successfully manage your symptoms, the less weight you’ll stand to gain. Also keep in mind that each time you increase your dose, you also increase the chance that you’ll gain weight.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/9265916
2. Personal: Habits, Genetics, Lifestyle
It is also important to consider your lifestyle on an individual basis. Although Zyprexa is going to cause some weight gain, some people exacerbate the weight gain by making unhealthy lifestyle choices. For example, if you aren’t getting enough sleep, eating a poor diet, pounding sodas, and don’t make any effort to exercise – you are probably contributing to additional weight gain.
Some people claim that despite packing on a significant amount of initial weight with this drug, they ended up minimizing it by making healthy lifestyle changes. There is evidence that your genetics will also determine the degree of weight gain you experience. You may be able to test this with “GeneSight” which assesses various individual biomarkers to predict how you’ll react to Zyprexa.
3. Treatment duration
The length of time that you’ve been treated with Zyprexa will ultimately influence how much weight you gain. When you take this medication for an extended period of time, it is likely that you’ll have developed a bit of a tolerance. This may lead to an increase in dosage – which is already known to increase the likelihood of weight gain.
Even if you don’t develop tolerance to this medication, you may continuously gain weight while taking it. Although the rate at which you gain weight may slow once your body becomes used to the drug, you’re probably still going to pack on more weight the longer you take it. Long-term users of Zyprexa generally gain a significant amount of weight.
4. Other medications
Some medications may help minimize weight gain from Zyprexa, while others may amplify it. If you are taking a stimulatory medication as part of your treatment regimen, it should help decrease appetite and speed up your metabolism. The degree to which this offsets the weight gain from Zyprexa will be subject to individual variation.
On the other hand, if you are taking antidepressants like SSRIs, you may experience an increase in weight gain. Most SSRIs are known to cause weight gain of at least 5 lbs. throughout treatment. The antidepressant Remeron is often a cause of weight gain, and when taken with Zyprexa has been shown to cause 30 lbs. weight gain in a 6 month case study.
How much weight will you gain on Zyprexa?
Since everyone has a unique genetic profile, medication regimen, and lifestyle, it’s impossible to predict exactly how much weight you’ll gain from this drug. For some people that are diligent about keeping their weight low with a healthy diet, controlled portions, and exercise – weight gain may not be as big of an issue as others.
A review of evidence revealed that the average amount of weight gained over the course of 2 years on Zyprexa typically ranges between 6 lbs. and 13 lbs. Understand that this is an “average” and whether you gain more or less weight is largely based on individual factors.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/21348048
Will everyone gain weight while taking Zyprexa?
Although not “everyone” is guaranteed to gain weight on this drug, nearly everyone does. Whether you consider the amount of weight you gain as significant or not is completely subjective. The bottom line is that of all antipsychotics (and psychiatric drugs), this is the most likely to cause significant weight gain. If weight is a major concern, you may be better off pursuing other options and only using this drug as a last resort.
Zyprexa: “Weighing” the Benefits vs. Drawbacks
If you are using Zyprexa, it is important to weigh the pros and cons associated with your treatment. In other words, first determine how well the drug is working to treat your condition, and then determine the severity of the side effects. If the drug is working well, you may be willing to put up with a little bit of weight gain throughout your treatment.
On the other hand, if you are blowing up like a hot air balloon, and feel functionally disabled as a result of the side effects, it may be time to consider other options and/or pursue Zyprexa withdrawal. Obviously you should discuss your feelings about treatment with your doctor before making a decision. Despite the fact that weight gain is a clear drawback associated with Zyprexa, the drug is among the most effective for treating severe psychiatric conditions.
Did you gain weight while taking Zyprexa?
Fortunately, most people that gain a lot of weight while medicated are able to lose it when the switch medications and/or discontinue. If you gained weight while taking Zyprexa, feel free to share your experience. Discuss when you first noticed some weight gain, how long you had been taking the drug, as well as your dosage. For those that gained weight, how much weight did you gain? Also be sure to mention any other possible factors that you believe may have increased the amount of weight that you gained on this drug.