One of the issues with medication for bipolar is that so few of them are what is euphemistically described as being “weight neutral”. After a recent relapse I was prescribed a medication that, along with other side effects can lead to up to 50 pounds of weight gain. That is alarming.
I treat my brain health holistically. Health is not just “healthcare”, after all. We are more than a combination of maladies and medicines. Diet, exercise, regular sleep, stress reduction and other non-pharmaceutical factors influence brain health. I take them seriously.
Looking at overall health and bipolar, 50 pounds of weight gain is a serious issue. Weight gain contributes to an increased risk for obesity, diabetes, heart disease, and other health concerns. This is not to be taken lightly.
Does the medication itself directly lead to weight gain, or is something else at play here? I don’t know. I do know that my experience with it can be summed up in two words:
I am hungry all the time. I’m hungry when I wake up. I’m hungry when I get out of bed. I’m hungry when I shower, when I tie my shoes, when I go to baseball games, when I go to the movies, when I go to bed. I am hungry when I do anything. I am hungry when I do nothing.
This isn’t a stomach-constantly-growling-holy-crap-when-can-I-eat-I-would-even-be-willing-to-gnaw-my-own-arm-off kind of hunger. But it is present. It is pervasive. It is almost like I am a teenage boy all over again, minus the zits, the awkwardness with the opposite sex, and the metabolism to handle eating an entire pizza.
Bipolar doesn’t come conveniently pre-packaged with herculean quantities of self-control. Bipolar comes with impulsivity instead. I have never been a model for self-control. This is true when it comes to my eating habits, too, which have been described as being “based on a dare”.
I have always like to eat. There is nothing wrong with that. But I have been disciplined of late. I have been mindful. I have, with some strategic exceptions, been adherent to a rather strict diet. I am doing fine.
How long can I keep this up? I don’t know. I also don’t know at what point this constant hunger will be too big a quality of life issue to remain on this medication. With meds there is always a trade-off between therapeutic benefit and side effects.
So far this medication has produced no weight gain. In fact I’ve lost a little bit of weight despite my psychiatrist and my general practitioner both telling me that weight loss isn’t realistic and that the best I could hope for would be to maintain my weight.
Psychologically I feel good today. I have felt good for the last couple of weeks. I have felt content, functional, and productive. I might even feel, dare I say, happy. The medication is doing its job and it is helping me achieve better quality of life.
Felling hungry may negatively impact quality of life, but for now the good far outweighs the bad.
Fat and happy isn’t such a bad thing, either.