Medications that cause weight gain and alternatives in Canada: a narrative review

Abstract

Background

The cause of the obesity epidemic is multifactorial, but may, in part, be related to medication-induced weight gain. While clinicians may strive to do their best to select pharmacotherapy(ies) that has the least negative impact on weight, the literature regarding the weight effects of medication is often limited and devoid of alternative therapies.

Results

Antipsychotics, antidepressants, antihyperglycemics, antihypertensives and corticosteroids all contain medications that were associated with significant weight gain. However, there are several medication alternatives within the majority of these classes associated with weight neutral or even weight loss effects. Further, while not all of the classes of medication examined in this review have weight-favorable alternatives, there exist many other tools to mitigate weight gain associated with medication use, such as changes in dosing, medication delivery or the use of adjunctive therapies.

Conclusion

Medication-induced weight gain can be frustrating for both the patient and the clinician. As the use of pharmaceuticals continues to increase, it is pertinent for clinicians to consider the weight effects of medications prior to prescribing or in the course of treatment. In the case where it is not feasible to make changes to medication, adjunctive therapies should be considered.

Keywords:

• weight gain
• weight loss
• weight neutral
• adverse effects of medications
• obesity
• adjunctive therapy

Disclosure

SW is the Medical Director of the Wharton Medical Clinic and maintains privileges at Toronto East General Hospital and Hamilton Health Sciences. SW has previously received grants from CIHR and Mitacs, and has payment from Novo Nordisk, Eli Lilly, Janssen and Astra Zeneca for advisory work. SW and RAGC are currently working with Novo Nordisk for the completion of pharmaceutical manuscript(s). RAGC is also the Research Coordinator at the Wharton Medical Clinic. The authors report no other conflicts of interest in this work.