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How Risperdal (Risperidone) Causes Weight Gain

Risperdal (Risperidone) is an atypical antipsychotic medication that has been approved since 1994 for the treatment of schizophrenia, bipolar disorder, as well as certain cases of autism. It functions as an antagonist of the neurotransmitter dopamine. By acting as an antagonist, it reduces overall dopamine activity in the brain and helps eliminate many of the positive symptoms of schizophrenia such as hallucinations and delusions.

It also tends to reduce serotonin, norepinephrine, and histamine activity in the brain. Despite the fact that the drug works well to treat severe psychiatric conditions, most people that take it end up feeling sedated. In addition to feeling sedated, it is typical to experience a variety of side effects while taking this medication, including weight gain.

Risperdal and Weight Gain

There is clear evidence in support of the idea that this drug has potential to cause weight gain. It is believed that carriers of the leptin gene -2548G/A and variants may have different responses to Risperdal, and thus may not gain as much weight. That said, even possessing favorable variants of that particular gene are unlikely to inhibit all weight gain. The reality is that the majority of people are going to gain some weight on Risperdal, and in some cases the amount will be significant.

How Risperdal Causes Weight Gain

Below is a list of ways in which taking Risperdal may cause you to gain weight. Understand that everyone has a different reaction to the drug. Many people notice that their appetite increases and in some cases, they crave foods, but what they may not know is that their hormone levels, metabolism, and fat storage mechanisms may also be playing a pivotal role in weight gain.

  • Appetite increase: If you’ve been taking this drug and notice that your appetite is at an all-time-high, it is important to understand that this is a common side effect. You may feel as if you are starved and need to constantly keep eating to offset the feeling of hunger. Most people have a difficult time keeping their increased appetite under control and begin devouring food like a starving man at a buffet. Up to 44% of users report increased appetite on this medication.
  • Fatigue: Due to the fact that this drug acts as an antagonist for all major stimulatory neurotransmitters (especially dopamine), it tends to cause fatigue and other synonymous effects such as drowsiness, tiredness, sleepiness, and lethargy. If you feel more tired than usual, you’re going to have a tough time getting out of bed to exercise or engaging in as much physical activity as you were pre-Risperdal. This means less calories will be burned and your metabolism will slow.
  • Food cravings: While taking Risperdal, you may start to crave certain foods, especially unhealthy ones like candies and refined carbohydrates. These cravings can become difficult to resist and when coupled with your newly voracious appetite, you may find yourself impulse buying large quantities of “junk food.”
  • Fat storage: The way in which your body stores fat may become altered based on drug-induced hormone and glucose level fluctuations. As you take the drug, it interferes with natural homeostatic processes that work to break down fat and use it as energy. Instead, this drug slows the process and/or may initiate fat-storage processes throughout the body.
  • Hormone levels: Research shows that Risperdal alters levels of various neurohormones, including “leptin” which plays a role in appetite regulation. When leptin levels decrease, weight gain tends to occur because appetite is stimulated. Other hormones like testosterone typically become lowered as well, leading to weight gain in unwanted anatomical areas (e.g. breasts in men).
  • Mechanism of action: It is believed that this drug’s effect on the 5-HT2C receptor and H1 receptor are both capable of causing weight gain. The former tends to influence the amount of leptin (appetite regulating hormone) and the latter influences arousal. While these aren’t the only mechanisms that account for weight gain, they are considered influential.
  • Mood improves: An improvement in mood may not directly contribute to weight gain, but in some cases it does. Some people end up not eating adequate portions due to the fact that they are depressed from their illness. When they get symptoms under control, their mood brightens and this leads to a normalized eating schedule as well as portions; resulting in weight gain.
  • Motivation decline: Although the drug may be helping you manage various symptoms of your illness, some individuals may experience a decline in motivation during treatment. This may be related to the antagonistic effects of the medication on dopamine as well as histamine. If you feel less motivation while taking this drug, it will be tough to keep weight off.
  • Slow metabolism: It’s no secret that atypical antipsychotics can slow the metabolism, and Risperdal is no exception. This means that even if you are able to maintain the same level of physical activity, are eating the same portion sizes, and same foods as you were pre-treatment, you’re going to gain weight. This can be highly frustrating because no matter how strict you are with your personal care, you’ll probably still gain some poundage.
  • Social eating: Now that you’ve got symptoms under control from the medication and are feeling better, you may start to socialize more often. This could be with friends or colleagues at work, and before you know it, you end up making dinner plans. Pretty soon these dinner plans become weekly or in some cases, daily. Eating out with friends is a quick way to gain weight, mostly due to the abundant portions.
  • Taste improvement: For some people, food may start to taste better when taking Risperdal. Although it is restricting dopamine activity, many people are still able to experience pleasure when eating during treatment with this medication. If taste starts to improve, you’ll probably end up consuming more food.

Note: For most people, a combination of the factors listed above play a role in weight gain. Since everyone is different, it is important to realize that the degree to which each factor listed plays a role should be considered on an individual basis.

Factors that influence weight gain on Risperdal

There are several additional factors that influence the amount of weight you’ll gain while taking Risperdal. These are factors that can be highly influential in regards to the amount of weight gain you experience and tend to vary based on the individual.

1. Dosage

The amount of this drug that you take can play a role in determining how much weight you gain. At higher doses, you are more likely to experience weight gain simply due to the fact that the effects of the drug are amplified. At higher doses, the drug has more control and influence over your hormones, neurochemistry, and other physiological processes.

If you are serious about minimizing potential weight gain on this drug (as well as other unwanted side effects), you should always strive to take the “minimal effective dose.” By taking the minimal effective amount, you will still be treating your mental illness, but won’t be giving the drug as much influence over homeostatic processes. The lower the dose you can get away with, the better in terms of weight.

2. Genetic variants

Your genetics play a significant role in determining how much weight you’ll gain from this drug and many others. Although most people will gain weight on Risperdal regardless of their genetics, people with certain genes experience significantly less weight gain. Variants of the leptin gene “-2548G/A” generally have a weight-altering effect.

If you have the right variant of this gene, you may not gain as much weight. Research indicates that people with the GG-genotype carriers experience 2.5x less weight gain than those carrying the A-allele. Fortunately new technology like “GeneSight” may be able to help predict how you’ll react to this drug before you take it.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/19873684

3. Duration of treatment

How long have you been taking this drug? Those that take Risperdal for extended periods tend to experience more weight gain than those on it for a short-term. Although short-term fluctuations are common, and some people do still pack on a lot of weight in the first 6-weeks of treatment, weight gain tends to be more significant over the long-term.

The longer you take a particular medication, the greater the extent to which your physiology will have adapted to its effects. Longer term users are more likely to develop tolerance, which often leads to an increase in dosing (a factor that commonly also increases weight). The longer the term you’re on this drug, the more weight you’re likely to have gained.

4. Other medications

If you are taking other medications, it is important to realize that they may be contributing to weight gain independent of Risperdal. In other cases, the other drugs that you take may be working synergistically with Risperdal to increase your body-weight.

Another scenario could be that the medications you are taking may be helping offset some of the weight gain associated with Risperdal. To get a better understanding of how various medications that you’re taking may be influencing your weight, be sure to talk to your doctor.

5. Lifestyle / habits

It is important to analyze your own life and determine whether your lifestyle and daily habits could be contributing to weight gain. If you make no effort to eat healthy foods, stay conscientious of your dietary intake, and don’t get much physical activity – you may be (partially) to blame for a weight increase. Other factors like your stress level and amount of sleep that you get can have an influence over your weight.

How much weight will you gain from Risperdal?

There’s no exact number that can be stated in response to how much weight you’ll gain. This is because weight gain is largely individualized and based on many factors. For most adults, an increase of 5% body-weight tends to occur as a result of treatment. In other words, if you are 200 lbs. entering treatment, you may gain 10 lbs. while taking Risperdal.

In small-scale studies with children and adolescents, weight gain was roughly 10 lbs. after taking the medication for 6 months and was accompanied by a BMI increase of 1 point. Unfortunately most studies documenting weight gain from Risperdal are relatively indirect. However, it is widely accepted that this drug will cause an increase in weight.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/23519708

Will everyone gain weight while taking Risperdal?

It is estimated that up to 10% of users report weight gain while taking this drug. The reality is that not everyone “reports” this side effect and thus saying that 1/10 users is likely to gain weight may be a skewed statistic. Based on the profile of the drug and the fact that 44% of people “report” increased appetite, it should be assumed that a significant number of users will gain weight.

In fact, some people may consider it to be an oddity if you don’t experience some weight gain from the drug. Whether you consider the amount of weight gained as being “significant” is another story. The reality is that many people taking Risperdal are likely to gain some weight and their BMIs are likely to increase as a result of treatment.

Does Risperdal’s therapeutic effect outweigh the weight gain?

If you are taking this drug, it is important to evaluate the therapeutic effect of the drug in comparison to the side effects that you are experiencing. If you experience an array of unwanted side effects, but the drug is working extremely well, it may be worth continuing treatment.

On the other hand, if the drug is only providing minimal relief, and you’ve packed on a lot of weight, you may want to consider Risperdal withdrawal and/or pursue other treatment options. Individuals that are having a tough time evaluating the efficacy and side effects of their current treatment should discuss these concerns with a medical professional.

Did you gain weight while taking Risperdal?

Perhaps the question shouldn’t be whether you gained weight while taking the drug, it should be, “How much weight did you gain?” If you took the drug for any period of time, feel free to note how long you took it, and whether you gained weight. Be sure to mention the dosage you were taking, whether you were on other medications, and other factors that may have influenced your weight gain.

By sharing your experience, you may give someone else comfort of knowing that they are not the only one who gained weight during treatment. On a positive note, research does indicate that when you discontinue Risperdal, you should lose the weight that you gained. In other words, the weight gain associated with this medication is reversible, but does take time.

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65 thoughts on “How Risperdal (Risperidone) Causes Weight Gain”

  1. I went from 135lbs up to 205 on risperdal. It never worked particularly well for me. I also am a thyroid cancer survivor and it messed with my metabolism so badly I had to check my blood sugar levels and diet carefully. It seemed to raise my blood pressure, too (maybe because of the weight gain?).

    My mother gained 60 or so lbs while she took it. I’m not sure what benefits she got from it… I know that as the lightweight of the family, she was very sedated and on less than I was. When my daughter took it, she, too gained an unhealthy amount of weight, had blood sugar problems, and high blood pressure. Since she was a young child, and it was not helping the hallucinations it was prescribed for, she was taken off of it.

  2. I was on 3mg risperidone for 2 years and I gained 50lbs in the first 6 months. Even though I reduced portion size and amount of food I ate. I have been unable to lose the weight gained. Precaution for everyone about to start this medication. It will make you obese for sure.

  3. I’ve been taking risperidone consta by injection for the last year. My therapist told me that they give the same drug to cancer patients to increase their appetite. I’m pleased to report I have only gained 5 lbs and that’s in the last month. I plan to exercise and diet to take this off. I suffered from delusion disorder but I’m fine now all my symptoms have disappeared. I think this is a good drug – you just need to keep a close eye on your diet that’s all.

  4. Well I have to start by saying it has drastically improved my quality of life in several ways. I have Bipolar Disorder. After I adjusted to Risperidone it’s like I’m not Bipolar at all. I still have mood swings but they’re generally within normal ranges. It’s kind of cool.

    But! BUT! I was put on 1MG (a small dose), April of 2015, it is now October 2016 (18 months) and I’ve gained 100 pounds. Now I know a part of that is I don’t exercise. I am studying working on my Bachelor’s right now and I don’t feel I have time for it. But as soon as I got on this medicine I got an appetite that cannot be fulfilled. I am ALWAYS hungry and no amount of food makes me feel full.

  5. Am I the only one who has put on the weight and not worried about it? So what if I’m round? At least I can sleep at night, no voices, no shivering, no strange sensation… I’d rather be round with a smile than skinny with bags under my eyes. Although I understand everyone I’m just expressing myself too.

  6. I have been taking risperidone for about almost a year and went from 105 to 138 – 139 now I started eating a lot I feel like I am starving all the time and feel anxious and have food cravings all the time just never really feel full… I was an athlete and now I can barely run for about 25mn… But I hope that with trading in and wit a nutritionist I will get better and get back on shape.

  7. I have been taking Risperidone for exactly one month and gained 10 lbs total. Although the drug makes me feel great and seems like the only anti-psychotic that works for me, I cannot continue it because I cannot stand to see my stomach hang over my jeans like it’s doing right now – it makes me even more depressed. I started working out RELIGIOUSLY 2 weeks ago to try and stabilize my weight and the number on the scale continues to rise. What the hell is that all about? I’m through with it!

  8. I went from 120 pounds to 154 pounds on Risperidone and its sister Invega [Paliperidone]. :( I felt starving all the time and couldn’t help constantly scoffing food down 24/7 in the first two weeks of this medication. My usual appetite is scarce, which has now returned after three months on Risperidone. I have started to lose the weight I have gained and am feeling better each day. It can be done :)

  9. I gained 60 pounds in less than 2 months. Went from a nice healthy 116lbs in September 2008 to 175lbs by mid November 2008. My doctor took me off it in November 2008 and I STILL haven’t lost more than 5 total pounds off that in July 2016 and I’ve been trying…it’s not like I’ve sat around and just hoped the weight would disappear.

    Risperdal is POISON and I want it to stop being used. I’m positive it has something in it that makes it impossible to ever lose any weight you gain. NO OTHER MEDICINE has been worse than or equal to this poison.

  10. I am truly terrified to take this drug. When I was diagnosed with bipolar disorder, I was put on seroquel and gained over 40 pounds in a month or two. I have not been able to get rid of this weight for almost a year now. I’ve always had issues with my weight. I feel like I have to choose between being healthy physically or being healthy mentally.

    My medications have not been working well for me so my psychiatrist prescribed this one and I’m supposed to take my first dose tonight but reading all these “horror stories” is scaring me out of taking it. I’m paralyzed by the fear of gaining another pound. I think I’d rather be crazy…it’s pretty much a lose/lose situation cause either way I’ll be miserable.

  11. Was at 5mg for five years. Taking approximately 50 pounds in 6 months. My doctor took me off 4 months ago and lost sixth pounds with no side effects. I guess I am lucky.

  12. I started off with .5 milligrams and had no weight problems for almost two years. Then I started binge drinking and packing on the pounds. Plus I’m on insulin due to Type 2 Diabetes. I’m on 2mg now and dropped the drinking. I guess I’ll see how it goes.

  13. I have been on 2mg for 5 years. My initial weight was 69-70kg now I weigh 98kg. I started dividing the tablet into half, and I take at alternating days. I am very stable now although people say I look fit but I want to go back to my initial weight or even less

  14. I have been on risperdal for 5 months and gained 50lbs. I was on Geodon with good results, but the Dr. wanted to change me due to a bad EKG. I also experienced weight gain from Zyprexa, which I was taking prior to the Geodon. (Ended due to the increased weight gain). I’ve discussed ending treatment with this drug, but the Dr. wants to leave me on it. I’d rather suffer the consequences of bipolar than be grossly fat and miserable. I’m starving all the time too.

  15. I was on Risperdal from about 2007 to 2012 and it to try and address my tics and issues from Tourettes that I have. Which it did so well, and was on low dose so when I was putting on weight I attributed it to the severe depression which kept getting worse I wouldn’t get out of bed and would binge on comfort food like ice cream. In 2010 I was hospitalized and received treatment that changed things quite drastically in the depression area.

    I started exercising and dieting like mad to drop the weight but it was not making much of a difference. It took almost a year and a half to drop from 280 to 225 and I had a pudge belly that would not go away. In 2012 I got a new doctor who wanted to try and change things because I started to have some anxiety issues returning and I changed to Seroquel. This drug had a weird sedative aspect that took a bit to get past and once I got past the part where I was falling down and hurting myself from trying to walk from the couch to my bed I was ok with the drug and my tics remained mostly at bay.

    I seemed to drop soon after about 30 pounds very rapidly. People accused me of being on meth, and I assumed that it just finally kicked in from the gym, I honestly didn’t know until a friend said something to me about Risperdal and I realized that also was something that changed in that time span. I have read this site and it’s not a case of I am not depressed and going out more or that food tastes better. I was eating the same diet before and after switching and while It was one that was intended to help lose weight it was a diet that I had been on for over a year that never dropped that much that quick.

    I urge you to talk to your doctor about switching. I am not qualified to say what to switch to, but for the girl who says that she has to wait 3 months, see if you can find out if there is a way to get you into sooner or if they can write a prescription to something else without seeing you. (If they have been seeing you a while they shouldn’t need to see you, to address this concern. I have OCD and so if I had any idea that Risperdal was the cause I would have demanded that it change immediately or I was stopping it.

    My mind would have otherwise obsessed over it every time I popped the pill. People seem to blow off the idea that it’s no big deal at least you are mentally healthy. It’s more than vanity, there are a lot of irritations that being a bigger person has to deal with. I would find clothes constantly stop fitting, I felt squished into the ones I had.

    It made my face look bigger to a point where I got surgery to clear the fat from my chin. Yet I kept hearing the diet and exercise and was killing myself trying to lose it. Yes there is a problem with this drug and weight and its not the foods intake, I think it is in how the body uses it.

  16. I’ve gained 24 lbs, in 4 months. I know it’s the drug. I just pray that I don’t continue to gain weight. Good luck with your illness!

  17. I went from a size 2 to a size 8. I’ve gained 40lbs in six months. Gained 3lbs just this week. I’m the heaviest I’ve ever been and afraid I’ll gain more. However, my overall wellbeing has improved.

  18. Well this scares me. I struggle with my weight all the time. I’ve been on .25 mg of Risperidone for two months and dieting the whole time I have lost 3 lbs but feel like I should have lost more. My appetite has not increased though and the drug has helped my anxiety immensely.

  19. I’ve been on Risperidone for 15 years I have put on about 250 pounds. I am now 560 pounds food just taste so good and I find myself craving junk. I am trying to sort my life out. I already had a eating problem before taking this med and I think it’s made it worse. I tried to come off it, but went crazy again within a week so can’t come off it.

  20. I’ve been taking 2 mg a day for several months and I have gained about 15 pounds. I exercise regularly but am ravenous, especially at night. I’m going to taper down. I can’t afford new clothes and nothing fits but stretchy fitness pants. The weight gain is very discouraging.

  21. I took this drug for only ten days, didn’t feel any better, in fact it increased my mood swings. I gained 7 pounds in only ten days! I went off it immediately. But I think it changed my metabolism, because my weight is still increasing a month later despite doubling my daily exercise and eating fewer calories! I hate this medicine! It’s still affecting me even though I’ve been off it for over a month!

  22. Ruined my whole body. Gained 10lbs in less than a month. Came off it after 2 months and continued to gain. Gained 30lbs and now im unable to lose the weight. Anything I eat without a strict diet causes weight gain. This drug ruined my body. I have a very small stature, I’m 5′ and I was never overweight until this medication. I’ve been off it for years and my body is still ruined.

  23. I gained 100 pounds in just over a year as a side effect from taking this drug. I am no longer taking it, but the effects have lasted over 5 years. I am working so hard to regain my health but my body has changed drastically and I fear that I will never fully recover.

  24. I have taken 4mg a day for the past 5 years. Two months ago I started on a LCHF diet and have lost about 10 pounds. I have a feeling the weight is going to be very stubborn to come off, but I will keep on plugging…I am a size 10 and am happy with that I just want to feel a bit firmer and get rid of that double chin that has developed. Yuck!

  25. I went from a size 10 to a size 14 on this drug. I was having suicidal tendencies and even attempted suicide. I hate the weight gain, but this drug did save my life.

  26. I’ve taken this drug for about a year and a half to 2 years and I used to be super skinny but I’ve gained over 70 pounds from this drug. I take 1mg a day. I smoke a lot of pot and I every couple of weeks I will skip my daily dosage maybe twice a month, but my mental health has been very good. I think this is a terrible drug and you should be warned before it’s prescribed.

  27. I gained 40 lbs in less than 5 months on this medication. I’m extremely insecure about my body now and desperate to get off of this medication.

  28. I took 2mg daily for a year, gained 65 lbs, and now I’ve been off of it for a year, but still haven’t lost any weight. I used to be in great shape and now I am fat and insecure. On top of making me feel like a zombie, it also completely destroyed my libido. Yea, something they don’t mention at the doctors office.

    I couldn’t even get erections for a year. And when I quit, did it suddenly come back? No it did not. I still struggle to get strong erections, and its been a year. Would not recommend this drug to anyone. Or at least, there should be fair warning from the doctor before you take this drug.

  29. I started risperdal when I was 13 years old. Throughout high school I never gained any weight because I danced 4 hours a day. As soon as I graduated high school and stopped dancing, I went from 110 lbs to 150 over the course of 2 years. Since then, I have gone down to a dose of .25 my and am down to 125. I am working on transitioning to latuda. Risperdal worked wonders for my bipolar, but really hurt my self esteem and confidence.

  30. I gained about 55 lbs on this medicine in a span of three months. I was 110 lbs and fattened to 165. I’ve lost 16.5 lbs since I stopped using this god awful medicine, but I feel like crap all the time. It’s the worst thing ever.

  31. I’ve been on risperdal for about 2 years and have gained 50lbs. No one in my family has ever been overweight, I hardly eat anything, and I get daily cardio in because I have a large dog. I hate that I have to take this medication.

  32. I gained so much weight on this medication that I became a balloon. I am going to try to get off this drug. I was originally prescribed this medication as it helped eliminate the porn urges I would get while taking Adderall. I am taking Vyvanse now so hopefully those urges won’t come back… but this medication has to go! I keep gaining weight!

  33. Was on 2mg of Risperidone and gained 80 pounds on Zyprexa, then stayed at the same weight for awhile. Strong motivation made me drop to 190, then stayed at 220. I’ve been tapering and I’m at my lowest weight in three years! If you can get off the drug do so! I was hospitalized for a psychotic episode and was on Risperidone for six years. No psychotic symptoms since and less anxiety after the taper. I know it’s not the same for everyone but it’s worth noting. I’ll be done with it next week.

  34. I’m almost 50, have been taking risperdal for 20 years now, I gained 68lbs. I was so upset for a lot of years however with lots of prayer and the food lovers fat loss system (which tells you not to count calories but I use it in combination with my fitness pal) I have taken of 20lbs. I am working toward another 20. I take 5 mg of risperdal. All is well. I would just like to say don’t ever give up… all things are possible to those who believe.

  35. My daughter has been on risperdal for a month and gained 25 pounds–from 85 to 108-nearly 30% of her body weight! Needless to say we are switching to a different med.

  36. 3mg a day, appetite is out of this world. Even making myself feeling like I’m starving everyday I can’t lose weight. Weight had been 310.4LB, won’t budge. I am 6’2″. So I’m supposed to take an antidepressant that makes me fat and depressed. I’d rather be skinny and hear voices.

    • This made me laugh, thank you. It’s “funny not funny”. I do not take this drug but am researching for a friend, and I too would rather be skinny and hear voices than be fat and depressed. All these pharmaceuticals just don’t seem to be a good answer.

  37. I gained 60 pounds and I was on it about a year. I have not been able to lose any over 6 years and all I take is Zoloft.

  38. I haven’t gained weight but I do want to lose weight and I’ve been having a really hard time doing so even though my diet is clean and I’ve been very active…has anyone else kept a study weight but is having a hard time losing weight while on risperdal?

    • Yes. I am working out around 1.5 to two hours four days a week. And eating healthy. I am not losing my stomach and gained a few pounds. Been working out since I started the risperidone three months ago. Usually lose my tummy right away when I start working out.

  39. I have gained almost 6 stone – from size 10 to size 18! At its worst point I was gaining 9lbs every ten days. Also fluid retention – is so bad that I have to take high dose fluid tablets.

    • I am on Lamictal 200mg, clonazepam, risperidone & wellbutrin. I have gained 15 pounds in two months – since starting the risperidone two months ago!!! And I’m already overweight.


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