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What actually causes Abilify weight gain?

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I'm on a diet and a exercise 3x a week but I want to know what causes abilify weight gain? Is it just because it increases your appetite and you eat more? I'm scared if I take it I'll gain like 5 pounds out of nowhere or I wont be able to lose weight anymore.

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I don't think anyone knows for sure.  You will have to just roll the dice and see what happens.  I have gained 30 lbs at least while on it but I have several other factors that can lead to weight gain working against me (like drinking too much and smoking pot, etc.)  By getting enough exercise and cutting down on my drinking, though, I have stopped the weight gain.

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2 hours ago, cryinginmoscow said:

I'm on a diet and a exercise 3x a week but I want to know what causes abilify weight gain? Is it just because it increases your appetite and you eat more? I'm scared if I take it I'll gain like 5 pounds out of nowhere or I wont be able to lose weight anymore.

I think it works sort of the opposite way as stimulants. So, it both increases your appetite and decreases your metabolism.

Even if you ate the same amount you'd probably still gain... I think.

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Weight gain with antipsychotics is multifactorial - they do increase appetite, the sedation can lead to physical inactivity, but there are also metabolic changes that make weight gain more likely independent of changes in diet and exercise.

However, Abilify is one of the more weight neutral ones.  The worst offenders (in order) are clozapine, olanzapine, and quetiapine.  The better ones in that sense (in no particular order) are aripiprazole/Abilify, ziprasidone, and, newly, lurasidone.

The evidence shows that diet and exercise are the best ways to prevent antipsychotic induced weight gain so you're doing all the right things.  And Abilify isn't nearly the worst offender.

The best way to avoid AAP weight gain according to the literature is to do those things and monitor your weight.  If by some chance you do gain an unmanageable amount of weight, you talk to your doctor about changing medications.  You may not gain any, though - like I said, Abilify isn't known for it as far as I am aware.

Edited by tryp
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2 minutes ago, tryp said:

Weight gain with antipsychotics is multifactorial - they do increase appetite, the sedation can lead to physical inactivity, but there are also metabolic changes that make weight gain more likely independent of changes in diet and exercise.

However, Abilify is one of the more weight neutral ones.  The worst offenders (in order) are clozapine, olanzapine, and quetiapine.  The better ones in that sense (in no particular order) are aripiprazole/Abilify, ziprasidone, and, newly, lurasidone.

The evidence shows that diet and exercise are the best ways to prevent antipsychotic induced weight gain so you're doing all the right things.  And Abilify isn't nearly the worst offender.

The best way to avoid AAP weight gain according to the literature is to do those things and monitor your weight.  If by some chance you do gain an unmanageable amount of weight, you talk to your doctor about changing medications.  You may not gain any, though - like I said, Abilify isn't known for it as far as I am aware.

From what I read recently, a study actually found that in the long term, all antipsychotics produce about the same weight gain, but some put on the weight more slowly than others.

I don't know how that works, but it's worth looking into/confirming/disconfirming, I think.

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I'm not sure what study you're referencing - if so, that's certainly good to know and I'd be interested to read the paper.

This one: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3998960/ addresses this issue and does find that even in the long term, Abilify and Zeldox cause less weight gain than the others.  And amisulpride but I haven't seen many people using that.

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Just now, tryp said:

I'm not sure what study you're referencing - if so, that's certainly good to know and I'd be interested to read the paper.

This one: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3998960/ addresses this issue and does find that even in the long term, Abilify and Zeldox cause less weight gain than the others.

Oh, thanks. I was sort of surprised when I read that, and it's good to know it may not be totally accurate.

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Abilify did not cause weight gain with me.  Could it be a combination of meds you are on?

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7 hours ago, melissaw72 said:

Abilify did not cause weight gain with me.  Could it be a combination of meds you are on?

I am not taking Abilify yet, but I want to start taking it except there is a fear of weight gain. I see you have recovered from anorexia/bulimia and I want to let you know that I do suffer with eating disorders and that is why the weight gain is such a scary factor for me. I really don't want to gain weight on the med and I don't want the med to make it impossible for me to lose weight.

I'm currently on Vyvanse 50mg and Cymbalta 90mg so far I have not noticed any increase in weight 

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25 minutes ago, cryinginmoscow said:

I am not taking Abilify yet, but I want to start taking it except there is a fear of weight gain. I see you have recovered from anorexia/bulimia and I want to let you know that I do suffer with eating disorders and that is why the weight gain is such a scary factor for me. I really don't want to gain weight on the med and I don't want the med to make it impossible for me to lose weight.

I'm currently on Vyvanse 50mg and Cymbalta 90mg so far I have not noticed any increase in weight 

I understand where you are coming from.  I had the same fear about that, and the only med I have ever had to come off of because of weight gain was clozaril.  The rest I didnt' really have any problem with weight gain.  Actually zyprexa slightly caused me to gain weight, but it wasn't more than 5 pounds.  And I didn't stop taking it because of that.

The thing is, is that unfortunately you wont know how it reacts with you and weight gain until you try it.  Everyone metabolizes the med differently.  And some need a high dose of it while someone else might do well on a lower dose.

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18 minutes ago, melissaw72 said:

I understand where you are coming from.  I had the same fear about that, and the only med I have ever had to come off of because of weight gain was clozaril.  The rest I didnt' really have any problem with weight gain.  Actually zyprexa slightly caused me to gain weight, but it wasn't more than 5 pounds.  And I didn't stop taking it because of that.

The thing is, is that unfortunately you wont know how it reacts with you and weight gain until you try it.  Everyone metabolizes the med differently.  And some need a high dose of it while someone else might do well on a lower dose.

Do you have any more knowledge about the way it changes the metabolic rate? A lot of people tell me it slows the metabolism but by what mechanism? It is like a lot of people who think that coffee speeds their metabolism but it's only by 1 point.

Also someone told me you're less likely to experience side effects on a higher dose of Abilify than on a lower dose is that true?

Edited by cryinginmoscow

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6 hours ago, cryinginmoscow said:

Do you have any more knowledge about the way it changes the metabolic rate? A lot of people tell me it slows the metabolism but by what mechanism? It is like a lot of people who think that coffee speeds their metabolism but it's only by 1 point.

Also someone told me you're less likely to experience side effects on a higher dose of Abilify than on a lower dose is that true?

All I have is this article:

http://thelastpsychiatrist.com/2010/10/zyprexa_and_fat.html

That is the best I can give you.

With side effects and Abilify, everyone is different.  I do not think the statement in bold (above) is true.  Anyone, please correct me if I am wrong.

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In my experience, the only side effect that I became less likely to experience at higher doses was anxiety. Anxiety at lower doses was really bad for me.

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I'm a health writer, and I interviewed a weight loss doc at NYU Langone a few months ago about medication-induced weight gain. She said that while the causes vary, in most cases it has to do with a drug's effects on carbohydrate metabolism. You end up with too much insulin in your blood, and insulin is a fat storage hormone--hence the weight gain, as well as the increased risk of insulin resistance and diabetes. I took Abilify and gained 15 pounds, despite the fact that I have excellent health habits. I've been off it for a couple of years and the weight refuses to budge, so I now have to get tested for insulin resistance. It's incredibly frustrating.

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19 minutes ago, J718 said:

I'm a health writer, and I interviewed a weight loss doc at NYU Langone a few months ago about medication-induced weight gain. She said that while the causes vary, in most cases it has to do with a drug's effects on carbohydrate metabolism. You end up with too much insulin in your blood, and insulin is a fat storage hormone--hence the weight gain, as well as the increased risk of insulin resistance and diabetes. I took Abilify and gained 15 pounds, despite the fact that I have excellent health habits. I've been off it for a couple of years and the weight refuses to budge, so I now have to get tested for insulin resistance. It's incredibly frustrating.

I'm not sure the science is so settled on what causes the weight gain. But in any case, many people do not gain weight on Abilify and some people even lose weight on it. I have both gained and lost weight on Abilify.

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8 minutes ago, jt07 said:

I'm not sure the science is so settled on what causes the weight gain. But in any case, many people do not gain weight on Abilify and some people even lose weight on it. I have both gained and lost weight on Abilify.

Agreed--she stressed that the causes can vary. I just got very frustrated because when I complained about the weight gain to my psychiatrist and my primary care doctor, they both quizzed me about my eating habits. I explained that they hadn't changed at all (I keep a food diary, so I'd have evidence if they did) but neither one of them believed me. I had to learn about the metabolic effects on my own. I don't know if this is true for other people with depression, but I feel like the minute I tell any doctor I have depression they seem less likely to believe anything I say. It's like they don't trust a depressed person to have any self-awareness.

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Nothing out of the many drugs I took actually changed my appetite...I am positive it has all been metabolism for me and ability was by far the worst offender...it made me gain 60 pounds... and I complained after the first 15 but I believed my docs when they told me it would stop and that if I just dieted and exercised it would be ok... LIES straight up lies. I cut calories to a pretty big degree... I never ate more than 1100 NEVER and I exercised a minimum of 4 days a week for 1 hr each time... and I still keep gaining weight but I kept listening to them and trying and became more and more uncomfortable and miserable because I hated myself and actually believed it was my fault that I wasn't trying hard enough. And then I finally said enough eff this and I slowly reduced it until I was off of it and very quickly I stopped gaining... but I didn't start losing...another medication I was taking wasn't making me gain but was preventing me from losing it so I slowly got off that too ....and within 3 months I was down 24 lbs. tbh I'm gonna need to add in something but I will literally wait until I absolutely cannot live one more minute or go completely off the rails manic because I am so tired of being in such distress and discomfort from the massive weight gain I experienced..,as soon as those first 15 went on I shoulda said eff you I'm not doing this anymore but I tried to be patient and reasonable etc but I should have taken control sooner so I wouldn't be in this shitty position.

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On 6/25/2016 at 1:43 PM, J718 said:

I'm a health writer, and I interviewed a weight loss doc at NYU Langone a few months ago about medication-induced weight gain. She said that while the causes vary, in most cases it has to do with a drug's effects on carbohydrate metabolism. You end up with too much insulin in your blood, and insulin is a fat storage hormone--hence the weight gain, as well as the increased risk of insulin resistance and diabetes. I took Abilify and gained 15 pounds, despite the fact that I have excellent health habits. I've been off it for a couple of years and the weight refuses to budge, so I now have to get tested for insulin resistance. It's incredibly frustrating.

I know latuda and geodon don't do what the zyprexas and clozarils do as far as changing carbohydrate metabolism so its clearly not the dopamine pathway causing the weight gain. I think i read somewhere its the m1 pathway that causes the change in carbohydrate tolerance. Either way i always put abilify closer to latuda than zyprexa so im always shocked when people say they gained a ton of weight on it. I'd definitely stick to latuda if it worked but it left me with daily panic attacks and constant voices so it had no effect on my symptoms. Abilify weight gain has been neutralized by treating the cause of weight gain which is my inability to tolerate carbohydrates. Unfortunately once you stop growing vertically you start growing horizontally cause all those carbs you ate as a kid get stored as fat leading to insulin resistance diabetes high blood pressure cholesterol issues etc. Its horrible what carbohydrates do to peoples body and that modern medicine created drugs to ruin that sensitivity even more yet hand them out like candy. And prescribe calorie restriction diets that leave people starving when all you have to do is limit the carbohydrates to a level where weight gain is neutralized and the person has perfect blood work and bmi.

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