Some make our bodies hold on to more water than usual.
Some amp up the hormones that guide our appetite. A public figure in my country has stated that the medication that was effective for his depression symptoms also made him feel like eating all the time, and even after going to bed, craving for yet another entire warm meal.
We didn’t evolve to fight the feeling of hunger, the feeling of hunger has guided us to survive in times where the problem was not weight gain, but getting enough to eat. When a medication messes up with this survival level instinct, it can end up with excessive eating.
Plus, a considerable part of the population is not really “in control of how many calories we eat”, due to emotional eating, the habit of grazing, etc.
You’re not in control of how many calories your body burns at rest. That’s roughly 2,000 calories per day on average, but lots of things (including medication) can change that significantly.
Your body is an outrageously complex machine with a million william moving parts, and it’s very common for medications to do one thing but accidentally do multiple other things. Sometimes those other things increase one hormone that tells your body to store fat, or slow down some part of some system which then burns less calories, or block a hormone that interacts with your sense of hunger…
Think of it this way: “calories in vs. calories out” is basically the most basic thing your whole body is trying to manage, every day, down to the functioning of every cell. There’s so many ways that this equation can get distorted when you throw something new into your body.
Appetite can be manipulated, have you ever heard of the munchies after people consume marijuana? Medications will change certain things about your makeup that will make eating a tub of ice cream more a necessity than a passing thought.
People tend to eat based on their previous habits and their perceived hunger. People don’t have some magical meter that objectively measures the calories they have eaten and the amount their body burns, it is just feelings and guesswork.
Medications can adjust the amount of energy the body consumes at a base level, just staying alive doing things like breathing, pumping blood, and maintaining body temperature. This “basal metabolic rate” consumes ~60-70% of the body’s total energy consumption, so if a medication increases or decreases the base activity of the body it can greatly impact the amount of calories needed to break even.
Medications can also impact how our brains react to signals and as a result perceived hunger. If someone feels more hungry they are probably going to consume more food regardless of if their body objectively needs the extra calories. Similarly if someone doesn’t feel as hungry as normal they will probably eat a bit less even if their calorie requirements remain essentially unchanged.
Finally keep in mind that a medication’s “side effects” are determined just by observing what happens to people when they take it. It is very much correlation, not necessary causation. For example some antidepressants have listed side effects of suicide! That seems strange and contrary to its intended function until you realize that there might be extremely depressed people who are given the medication and it helps them start to feel better. Now they are still depressed but feel better enough that they can actually muster the energy and will to do some things. Like kill themselves.
Is suicide really an effect of the medication? I would say it is more a side effect of starting to recover from depression, but it happens sometimes when people take the medication so it qualifies as a “side effect”.
You think you’re in control of how many calories you eat. And you are in the short term, and maybe even for months or years. But eventually your body will compel you to eat more. Among people who lose weight through traditional dieting and exercise, for instance, only 2% are able to maintain the weight loss for seven years. And certain medications accelerate that.
Because the other side of calories in is calories out. A person normally burns a certain amount of calories just by living. Some medications and health issues make you burn fewer calories for survival, storing the rest in fat. So you can exercise until you drop from exhaustion and not even touch that fat because you’re body is like “no, we need that for… reasons.”
you think you’re in control. everything around us influences what we eat, how much we eat and when we eat. keep a food diary. track what you eat per day and see if you actually eat what you think you eat. It will definitely surprise you unless you’re a bodybuilder and tracking everything currently. now you’re on medication. you don’t feel good. maybe I’ll have an extra piece of pizza or cake or even just one more cracker. overtime this adds up. plus you’re not feeling good. you’re not going to move as much so you burn less calories. More calories in less calories out. you gain weight. somebody also mentioned water weight. that’s also a huge factor as well. with things like ozempic they make it so you don’t want to have that extra piece. you don’t feel hungry which can be good and bad because you need calories. try to eat the healthy calories first. get full on them then eat The cake, the cookies, the sugar. everything in moderation.
I was on prednisone for a bit, which was one of those weight gain medications.
It was honestly shocking how much it was doing to me. It made me think about food every waking hour. I would wake up thinking about food. I would go to the bathroom thinking about food. I would be thinking about food through every tv shoe I watched, every errand I ran, every conversation I had.
Yes, I was ultimately in control of how much I ate. But it was much, much harder not to eat more living like that. It gave me a lot of empathy for people who for whatever reason struggle to lose or not to gain weight.
In some cases, it’s as simple as either an anti-depressant, or something else that’s intended target is making it harder to access food, so removing that barrier makes us able to have the food when we want it, rather than that constant “can’t be bothered” feeling.
In other cases, the medication directly impacts either something in our GI that increases the potency of something, so we take in more calories/poop or pee less out. Or alternatively messes with something far more complex in our brain/nervous system that makes us want more food.
There’s also the far weirder one, where we can breath out/sweat out less calories, which isn’t necessarily directly related to our GI, but has a similar impact.
Ultimately our actual weight is controlled by a huge number of factors that aren’t always related to how much we actually eat, but how much we eat (or drink) is also controlled by a lot of factors that we don’t necessarily think about.
Lots of ways. Humans are not robots, or rational creatures. We do what our brains and bodies tell us they want, and then we invent excuses for it.
If you’re hungry then you’re going to find something to eat. So medication can have this effect by altering your appetite, making you feel more hungry more often. Or by making you drowsy and less energetic, so you can’t be bothered to work out or even go for a walk.
It can also alter the actual metabolic processes of your body. The number of calories you eat doesn’t mean much in itself. How many of those calories are actually absorbed by your body? And how many of those calories are spent maintaining various parts of your body? Your immune system needs energy, but what if that is inhibited? Then it’ll require less energy, leaving a larger surplus. Your body uses energy to heat itself. What if it turns down the heat? You’ll feel chilly but you can fix that by putting on a sweater, but it also means a bit less energy spent on heating.
And the willingness of your body to store excess energy as fat is also not constant. That’s a biochemical process that can be alterated.
So medication can make you more hungry, less energetic, and make it more likely that the energy you consume is stored as fat instead of being used for other processes. (In addition to a dozen other mechanisms that can lead to weight gain).
Humans are not robots, and our bodies aren’t machines.
I just had an argument with my brother about how it doesn’t actually just come down to ‘just moderate your eating’ and this entire thread is proving just how widespread that mistaken belief is. Yes, calories in vs calories out IS the basis for all weight gain/loss in every human. But some people don’t burn calories the same way others do, and medications can affect that. Yes, some increase appetite and that’s why weight gain happens – but some are notorious for increase weight no matter what you do.
I’ll give a specific example since I’m familiar with it. Zyprexa, aka Olanzapine. It’s an anti-psychotic and one of the most effective out there. It’s crazy good at it’s job, one of the best out there. It also causes people to absolutely balloon at frankly ridiculous rates that defy all logic. A person on Olanzapine can eat 500 calories a day and still gain weight. It’s so bad that even though it’s very, VERY effective a medication, it’s rapidly dying out in actual use simply because the weight gain is so out of control that it kills people, which is pretty contradictory to it’s purpose. It isn’t the only medication that does this by far, though it’s definitely one of if not the worst, and there are also medical conditions that have the same effect.
Metabolism is a real thing and it really does matter. Energy in vs energy out is still the rule, but one person can run for thirty minutes and burn, idk, 400 calories, while another with a f’d up metabolism for whatever various reason might only be able to burn 200 calories in that same time and effort. There are a LOT of conditions that can affect metabolism, and a LOT of medications that can, too. When all’s combined statistically, it covers a pretty significant portion of the population. PCOS is estimated to be present in anywhere between 10-20% of women and it causes weight gain and weight RETENTION, making it much more difficult to lose any. Thyroid disorders affect 10% of the population or more. More than 30% of the population are on anti-depressants, many of which cause the same side effects (and no, I’m not referring to the ones that are known to increase appetite directly. Those are even more prominent, but not the subject of the question here)
And anti-psychotics? Oh boy. Being on an anti-psychotic drops your life expectancy by up to 20 years just due to the medications alone, simply because it completely wrecks your metabolic system directly.
It’s easy to be dismissive of people for not ‘just exercising’ and accomplishing the calories in vs calories out idea, but the reality is some people can only get that by exercising for hours a day. Do you have the time and energy for that?
It varies depending on the medication and its mechanism of action but for me, it altered my metabolic processes.
I have always been an active person that monitors everything I eat. I ended up gaining almost 100 pounds no matter what I did. I had sounded the alarm at 5 pounds and at 10 pound increments but all the doctors I saw either dismissed me, said I need to stop overeating, or I needed gastric bypass surgery. Took 3 years for one of them to realize it was a medication interaction that is actually an off label treatment to help those with anorexia gain weight. I quit cold turkey and lost all of the weight within a year.
Even if your metabolism normally burns off a few extra calories without gaining weight.. suddenly, it doesn’t, and any extra calories become fat.
Other medications make you hungry all the time or increase cravings for sugar.
In diabetic medications, you weren’t processing the carbs before and releasing large amounts in your urine. With the medicine, your body processes the carbs now, and you start gaining weight.
There are many different medications that cause weight gain and many different reasons they cause it.
It would be much easier to answer this question if you asked it about a specific medication.
You know how you get full after you’ve eaten a big, succulent (Chinese) meal?
Your stomach is telling your brain: “Yo, I’m full. Thanks for feeding me, mate.”
I have to take a medication that, as a side effect, prevents me from feeling full.
So my stomach is telling my brain the same thing as above, but the medication hijacks and changes the context of the message to: “Yo, wtf, why didn’t you feed me, mate?”
As a result, I’m feeling hungry nearly all the time. It sucks.
While you can count every calorie that goes in your mouth and just eat the amount you want every day, most people don’t. So how come some people tend to gain weight, some stay the same weight for years on end, and some stay skinny?
Most people’s weight is determined by their basic biological drive to eat when they’re hungry and stop when they’re full. This is determined by biological factors, food habits, etc. Medicine can basically reduce your body’s ability to signal that you are full, so you eat more than necessary.
Lots of people out there gain weight because their food choices and other habits cause them to consume more calories than needed to maintain their current weight. This weight gain could of course be stopped by counting calories, but the root cause of the problem is being hungry inappropriately. Not so different an issue than what the medicine causes.
This whole post is a stellar example of why in America, watching drug commercials, the listing of side effects is done in a lower volume, and made to be as passively non-memorable as possible.
Are we really in control? Or do we mostly get by on moment to moment impulses, hunger cues, and habit?
Medicine can alter those cues and impulses, and can also impact the other side of the equation by slowing down our metabolism or making us feel less like being active.
Metabolic changes are one effect. People have touched on other effects (water retention, massive appetite changes) but your metabolic rate can drop and become prone to store fat so you gain fat on the amount of food you wouldn’t have gained on before.
I was on seroquel which is known for weight gain. One reason it can contribute to it is because it changes taste perception in people. It made sweets taste freaking AWESOME. I had never been a sweets person but all of a sudden they tasted incredible and I was hammering down sweets all day
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Typically by reducing mood and consequently activity level. Less activity with the same amount of food intake means more weight.
Some make our bodies hold on to more water than usual.
Some amp up the hormones that guide our appetite. A public figure in my country has stated that the medication that was effective for his depression symptoms also made him feel like eating all the time, and even after going to bed, craving for yet another entire warm meal.
We didn’t evolve to fight the feeling of hunger, the feeling of hunger has guided us to survive in times where the problem was not weight gain, but getting enough to eat. When a medication messes up with this survival level instinct, it can end up with excessive eating.
Plus, a considerable part of the population is not really “in control of how many calories we eat”, due to emotional eating, the habit of grazing, etc.
You’re not in control of how many calories your body burns at rest. That’s roughly 2,000 calories per day on average, but lots of things (including medication) can change that significantly.
Your body is an outrageously complex machine with a million william moving parts, and it’s very common for medications to do one thing but accidentally do multiple other things. Sometimes those other things increase one hormone that tells your body to store fat, or slow down some part of some system which then burns less calories, or block a hormone that interacts with your sense of hunger…
Think of it this way: “calories in vs. calories out” is basically the most basic thing your whole body is trying to manage, every day, down to the functioning of every cell. There’s so many ways that this equation can get distorted when you throw something new into your body.
Appetite can be manipulated, have you ever heard of the munchies after people consume marijuana? Medications will change certain things about your makeup that will make eating a tub of ice cream more a necessity than a passing thought.
People tend to eat based on their previous habits and their perceived hunger. People don’t have some magical meter that objectively measures the calories they have eaten and the amount their body burns, it is just feelings and guesswork.
Medications can adjust the amount of energy the body consumes at a base level, just staying alive doing things like breathing, pumping blood, and maintaining body temperature. This “basal metabolic rate” consumes ~60-70% of the body’s total energy consumption, so if a medication increases or decreases the base activity of the body it can greatly impact the amount of calories needed to break even.
Medications can also impact how our brains react to signals and as a result perceived hunger. If someone feels more hungry they are probably going to consume more food regardless of if their body objectively needs the extra calories. Similarly if someone doesn’t feel as hungry as normal they will probably eat a bit less even if their calorie requirements remain essentially unchanged.
Finally keep in mind that a medication’s “side effects” are determined just by observing what happens to people when they take it. It is very much correlation, not necessary causation. For example some antidepressants have listed side effects of suicide! That seems strange and contrary to its intended function until you realize that there might be extremely depressed people who are given the medication and it helps them start to feel better. Now they are still depressed but feel better enough that they can actually muster the energy and will to do some things. Like kill themselves.
Is suicide really an effect of the medication? I would say it is more a side effect of starting to recover from depression, but it happens sometimes when people take the medication so it qualifies as a “side effect”.
You think you’re in control of how many calories you eat. And you are in the short term, and maybe even for months or years. But eventually your body will compel you to eat more. Among people who lose weight through traditional dieting and exercise, for instance, only 2% are able to maintain the weight loss for seven years. And certain medications accelerate that.
Because the other side of calories in is calories out. A person normally burns a certain amount of calories just by living. Some medications and health issues make you burn fewer calories for survival, storing the rest in fat. So you can exercise until you drop from exhaustion and not even touch that fat because you’re body is like “no, we need that for… reasons.”
you think you’re in control. everything around us influences what we eat, how much we eat and when we eat. keep a food diary. track what you eat per day and see if you actually eat what you think you eat. It will definitely surprise you unless you’re a bodybuilder and tracking everything currently. now you’re on medication. you don’t feel good. maybe I’ll have an extra piece of pizza or cake or even just one more cracker. overtime this adds up. plus you’re not feeling good. you’re not going to move as much so you burn less calories. More calories in less calories out. you gain weight. somebody also mentioned water weight. that’s also a huge factor as well. with things like ozempic they make it so you don’t want to have that extra piece. you don’t feel hungry which can be good and bad because you need calories. try to eat the healthy calories first. get full on them then eat The cake, the cookies, the sugar. everything in moderation.
I was on prednisone for a bit, which was one of those weight gain medications.
It was honestly shocking how much it was doing to me. It made me think about food every waking hour. I would wake up thinking about food. I would go to the bathroom thinking about food. I would be thinking about food through every tv shoe I watched, every errand I ran, every conversation I had.
Yes, I was ultimately in control of how much I ate. But it was much, much harder not to eat more living like that. It gave me a lot of empathy for people who for whatever reason struggle to lose or not to gain weight.
Some antipsychotics just stop you moving around as much.
In some cases, it’s as simple as either an anti-depressant, or something else that’s intended target is making it harder to access food, so removing that barrier makes us able to have the food when we want it, rather than that constant “can’t be bothered” feeling.
In other cases, the medication directly impacts either something in our GI that increases the potency of something, so we take in more calories/poop or pee less out. Or alternatively messes with something far more complex in our brain/nervous system that makes us want more food.
There’s also the far weirder one, where we can breath out/sweat out less calories, which isn’t necessarily directly related to our GI, but has a similar impact.
Ultimately our actual weight is controlled by a huge number of factors that aren’t always related to how much we actually eat, but how much we eat (or drink) is also controlled by a lot of factors that we don’t necessarily think about.
Lots of ways. Humans are not robots, or rational creatures. We do what our brains and bodies tell us they want, and then we invent excuses for it.
If you’re hungry then you’re going to find something to eat. So medication can have this effect by altering your appetite, making you feel more hungry more often. Or by making you drowsy and less energetic, so you can’t be bothered to work out or even go for a walk.
It can also alter the actual metabolic processes of your body. The number of calories you eat doesn’t mean much in itself. How many of those calories are actually absorbed by your body? And how many of those calories are spent maintaining various parts of your body? Your immune system needs energy, but what if that is inhibited? Then it’ll require less energy, leaving a larger surplus. Your body uses energy to heat itself. What if it turns down the heat? You’ll feel chilly but you can fix that by putting on a sweater, but it also means a bit less energy spent on heating.
And the willingness of your body to store excess energy as fat is also not constant. That’s a biochemical process that can be alterated.
So medication can make you more hungry, less energetic, and make it more likely that the energy you consume is stored as fat instead of being used for other processes. (In addition to a dozen other mechanisms that can lead to weight gain).
Humans are not robots, and our bodies aren’t machines.
I just had an argument with my brother about how it doesn’t actually just come down to ‘just moderate your eating’ and this entire thread is proving just how widespread that mistaken belief is. Yes, calories in vs calories out IS the basis for all weight gain/loss in every human. But some people don’t burn calories the same way others do, and medications can affect that. Yes, some increase appetite and that’s why weight gain happens – but some are notorious for increase weight no matter what you do.
I’ll give a specific example since I’m familiar with it. Zyprexa, aka Olanzapine. It’s an anti-psychotic and one of the most effective out there. It’s crazy good at it’s job, one of the best out there. It also causes people to absolutely balloon at frankly ridiculous rates that defy all logic. A person on Olanzapine can eat 500 calories a day and still gain weight. It’s so bad that even though it’s very, VERY effective a medication, it’s rapidly dying out in actual use simply because the weight gain is so out of control that it kills people, which is pretty contradictory to it’s purpose. It isn’t the only medication that does this by far, though it’s definitely one of if not the worst, and there are also medical conditions that have the same effect.
Metabolism is a real thing and it really does matter. Energy in vs energy out is still the rule, but one person can run for thirty minutes and burn, idk, 400 calories, while another with a f’d up metabolism for whatever various reason might only be able to burn 200 calories in that same time and effort. There are a LOT of conditions that can affect metabolism, and a LOT of medications that can, too. When all’s combined statistically, it covers a pretty significant portion of the population. PCOS is estimated to be present in anywhere between 10-20% of women and it causes weight gain and weight RETENTION, making it much more difficult to lose any. Thyroid disorders affect 10% of the population or more. More than 30% of the population are on anti-depressants, many of which cause the same side effects (and no, I’m not referring to the ones that are known to increase appetite directly. Those are even more prominent, but not the subject of the question here)
And anti-psychotics? Oh boy. Being on an anti-psychotic drops your life expectancy by up to 20 years just due to the medications alone, simply because it completely wrecks your metabolic system directly.
It’s easy to be dismissive of people for not ‘just exercising’ and accomplishing the calories in vs calories out idea, but the reality is some people can only get that by exercising for hours a day. Do you have the time and energy for that?
I know I don’t.
It varies depending on the medication and its mechanism of action but for me, it altered my metabolic processes.
I have always been an active person that monitors everything I eat. I ended up gaining almost 100 pounds no matter what I did. I had sounded the alarm at 5 pounds and at 10 pound increments but all the doctors I saw either dismissed me, said I need to stop overeating, or I needed gastric bypass surgery. Took 3 years for one of them to realize it was a medication interaction that is actually an off label treatment to help those with anorexia gain weight. I quit cold turkey and lost all of the weight within a year.
Some medications change how you process calories.
Even if your metabolism normally burns off a few extra calories without gaining weight.. suddenly, it doesn’t, and any extra calories become fat.
Other medications make you hungry all the time or increase cravings for sugar.
In diabetic medications, you weren’t processing the carbs before and releasing large amounts in your urine. With the medicine, your body processes the carbs now, and you start gaining weight.
There are many different medications that cause weight gain and many different reasons they cause it.
It would be much easier to answer this question if you asked it about a specific medication.
Weight loss is technically a side effect of Ozempic
You know how you get full after you’ve eaten a big, succulent (Chinese) meal?
Your stomach is telling your brain: “Yo, I’m full. Thanks for feeding me, mate.”
I have to take a medication that, as a side effect, prevents me from feeling full.
So my stomach is telling my brain the same thing as above, but the medication hijacks and changes the context of the message to: “Yo, wtf, why didn’t you feed me, mate?”
As a result, I’m feeling hungry nearly all the time. It sucks.
“We’re in control of what we eat?” Who is “we”? It’s hormones and other neurochemical signals that determine when and how much we eat.
While you can count every calorie that goes in your mouth and just eat the amount you want every day, most people don’t. So how come some people tend to gain weight, some stay the same weight for years on end, and some stay skinny?
Most people’s weight is determined by their basic biological drive to eat when they’re hungry and stop when they’re full. This is determined by biological factors, food habits, etc. Medicine can basically reduce your body’s ability to signal that you are full, so you eat more than necessary.
Lots of people out there gain weight because their food choices and other habits cause them to consume more calories than needed to maintain their current weight. This weight gain could of course be stopped by counting calories, but the root cause of the problem is being hungry inappropriately. Not so different an issue than what the medicine causes.
Can weight loss medication counteract the meds that make you hungrier/gain more?
This whole post is a stellar example of why in America, watching drug commercials, the listing of side effects is done in a lower volume, and made to be as passively non-memorable as possible.
Are we really in control? Or do we mostly get by on moment to moment impulses, hunger cues, and habit?
Medicine can alter those cues and impulses, and can also impact the other side of the equation by slowing down our metabolism or making us feel less like being active.
Metabolic changes are one effect. People have touched on other effects (water retention, massive appetite changes) but your metabolic rate can drop and become prone to store fat so you gain fat on the amount of food you wouldn’t have gained on before.
I was on seroquel which is known for weight gain. One reason it can contribute to it is because it changes taste perception in people. It made sweets taste freaking AWESOME. I had never been a sweets person but all of a sudden they tasted incredible and I was hammering down sweets all day
You can control how many calories you eat? I’m jealous.
They can affect your metabolism or your hunger or both.
So while we control what we eat, if suddenly your body isn’t burning as many calories as before and you don’t change your eating, you’ll gain weight
If your body is telling you are hungry due to the medication and you eat but aren’t burning any more calories than before, you’ll gain weight
Lots of great detailed answers here BUT the ELI5 answer is that some can medications increase hunger.