4. Oral contraceptives
What are these? Our old friend "the pill," these medications are pills combining two hormones - progestin and estrogen - and together they prevent ovulation with an almost 99 per cent effectiveness rate (when taken correctly). While they're generally used to prevent pregnancies, they are also prescribed for conditions such as severe acne or to regulate heavy or irregular periods that come with conditions such as endometriosis.
The gain explained: "There's a mild weight gain associated with contraceptives. It's not any real mystery," says Dr. Michael Rieder, a professor in the physiology and pharmacology department at the University of Western Ontario in London, Ont. "Most of the medications causing weight gain do so because they're appetite stimulants. They make the brain think we're not actually full and that we need to eat more." But Rieder says only about 20 per cent of women on the pill gain weight (and it's fairly unpredictable as to who will and who won't gain).
What now: While many think the answer to the gain is to switch the pill you're on, Rieder says think again. "People are too laissez-faire with hormonal birth control. They don't think of them as medications with side-effects," he says. "Switching pills is rarely the answer. It's my personal observation that if people gained weight on one medication, they'll do so on another." He does note you could try a nonhormonal form of birth control, such as a diaphragm or sponge, if you suspect the pill is the problem. But note: Generally these methods don't work as reliably as the pill for contraception.
5. Steroids
What are these? Not to be confused with anabolic steroids (the kind weight lifters and athletes take), corticosteroids, the kind you inject or swallow, are used for conditions such as rheumatoid arthritis and generally lessen any painful inflammation.
The gain explained: "Steroids make you ravenously hungry; I've seen patients on steroids pack on 20, 30,
40 pounds. Steroids, such as prednisone, are catabolic so it gives the impression the body is burning itself up and wants to get more food to replace it," says Rieder. "You can really put on pounds."
The weight gain also tends to be fairly localized. "It's mostly around the abdomen, and less so the arms or legs. It's called centripetal obesity, and a person's face looks rounder. You can almost tell, especially with kids, when they are on steroids because they look very similar," says Dornan.
What now: "Steroids often are prescribed for diseases for which weight gain isn't such a great thing. And it's hard because people get really hungry," says Rieder. He recommends focusing on the health problem that you're taking the steroids for first by following the course of medication; once that's relatively under control, focus on losing the weight through diet and especially exercise.
6. Antidepressants
What are these? Antidepressants, which are prescribed, alter the chemicals in our brain to relieve symptoms of depression (which include feeling sad all the time, decreased energy, insomnia, irritability and loss of interest in hobbies). There are different generations of antidepressants, and the newest - selective serotonin reuptake inhibitors (SSRIs) - reportedly are more effective at treating depression, but they come with side-effects such as weight gain.
The gain explained: "One theory is that people on antidepressants are in better moods, so they move more and eat more. But, like many of the drugs, they seem to also be appetite stimulants," says Rieder. "It's really quite variable who gains weight and who doesn't. But the people who gain weight can gain 20 pounds without a lot of trouble."
What now: If you're about to start taking them, Rieder says education up front is needed about possible weight gain. "Especially with chronic therapy such as this. Depression can go on two, three, four years or maybe the rest of your life," he says. Knowing weight gain is possible, you can plan for it by starting to eat less and move more.
And, unlike the pill, switching drugs is an option. "Prozac seems to be the antidepressant that, on average, creates less weight gain than other antidepressants for some people," says Dr. Denis Prud'homme, the dean of health sciences at the University of Ottawa. The effectiveness of one antidepressant to the next can really vary, adds Rieder. "The risk is that the alternates don't work as well." Talk to a physician about finding the best balance for you or investigating nondrug therapies for mild depression.
7. Estrogen
What is it? As women reach menopause, levels of the hormone estrogen dip dramatically. While the health risks and benefits of estrogen replacement therapy are still controversial, many women suffering from hot flashes and night sweats are still prescribed this option.
The gain explained: Hormones used to replace estrogen can trigger fluid retention, or water weight. "The weight gain could depend on the dose," says Watson. "Plus, as a woman ages, her metabolic rate slows, so she is more inclined to gain weight. Unfortunately, that's usually the population taking that hormonal replacement."
What now: "A lot of people are trying to encourage non-estrogen approaches," says Rieder. Be sure to talk to your physician about what might work for you. And for much more on these options, check out our Summer issue: we'll investigate natural ways to reduce hot flashes and other symptoms.
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