Dealing with Weight Gain Caused by Medications

By Margaret Walsh, M.A., BCBA

One of the most common reasons people stop taking psychotropic medications prescribed for mental health disorders such as depression, bipolar disorder, anxiety, and various psychotic disorders is because they experience weight gain, a common side effect of these medications.

Adults with intellectual disabilities (ID) and/or autism spectrum disorder (ASD) who also have co-occurring mental health disorders such as those listed above are likely to be taking psychotropic medications to treat these conditions. And, just like the rest of us, they may want to stop taking their medications if these meds cause them to gain weight.

However, when psychotropic medications are appropriately prescribed and the person is compliant in taking them, they can significantly improve that individual’s quality of life. This is the desired outcome. How can we increase the likelihood this will be the case for a person with ID or ASD?

The medical professional who prescribes psychotropic medications for an individual with special needs should help him or her understand why he or she is taking these medications, how they will help, and the potential side effects they may have. It is also important that the individual taking the medications be closely monitored so any side effects can be observed and evaluated.

Significant weight gain can be avoided by ensuring that the person is routinely engaging in basic healthy behaviors like eating well and exercising. It will be difficult for an individual with ID or ASD to begin or maintain a new, healthy diet and exercise plan without the appropriate support. Changing behaviors is hard work for all of us. And if a person with ID and/or ASD has a co-occurring mental health disorder, it is a lot harder for him or her to access the necessary supports to make living a healthy lifestyle a reality. Family members and caregivers can provide needed assistance.

One of the best ways to help increase the likelihood that a person will maintain a healthy weight while taking medication is to ensure that they are not overmedicated. Identifying when a person is overmedicated can be difficult. The individual and his or her caregivers need to determine when they are experiencing side effects from a medication. For example, some anti-psychotics can cause dry mouth and increase a person’s appetite. If a person is consistently eating and drinking significantly more than what is typical for them, it is imperative that these new behaviors are brought to the prescriber’s attention. With this information, the prescriber can adjust or change medications to help relieve unwanted side effects.

To help ensure that weight gain does not become an issue, or to help a person lose weight, it is helpful to consult a nutritionist. The nutritionist will understand the side effects of these medications and can help the person develop a plan that meets his or her individual needs. Initially, the nutritionist may ask the person to write down (or get assistance writing down) what they are eating to better understand his or her behavior around food. With this information, the nutritionist can help the person develop strategies to increase better behavior around food. For example, the nutritionist may have suggestions about how the individual can eat more consciously and develop a schedule to ensure that he or she eats regularly. Changing eating habits is difficult for all of us. The best way to make sure that healthy eating becomes a natural part of everyday life is to start small and build on incremental successes.

Any medication may potentially have unwanted side effects. Without psychotropic medications, however, the life of a person with ID or ASD and co-occurring mental health disorders could be much more challenging. With support from caregivers and the right behavioral and medical support, people with special needs can better address side effects like weight gain, learn to advocate for themselves, and enjoy improved health and a sense of wellbeing.

Margaret Walsh, M.A., BCBA, is the Clinical Director for the May Center for Adults Services in Western Massachusetts. She can be contacted in West Springfield, Mass., at 413-734-0300 (ext. 262) or at mwalsh@mayinstitute.org

About May Institute
May Institute is a nonprofit organization that is a national leader in the field of applied behavior analysis and evidence-based interventions, serving autistic individuals and individuals with other developmental disabilities, brain injury, neurobehavioral disorders, and other special needs. Founded nearly 70 years ago, we provide a wide range of exceptional educational and rehabilitative services across the lifespan. For more information, call 800.778.7601 or visit www.mayinstitute.org.