You Don’t Have to Gain Weight on Abilify, Lithium, Risperidone, and Other Psychiatric Medications

As a personal trainer, I get to know many of my clients’ on a deeper level during our personal training sessions in my Carlsbad gym. Several of them have shared their struggles with weight gain while taking psychiatric medications like Abilify, lithium, risperidone, and even common antidepressants like Prozac.

These psychiatric medications are prescribed to stabilize mood, reduce irritability, and manage other symptoms associated with conditions like bipolar and depression. They can literally save lives, but they can also cause significant weight gain--one of my personal training clients gained 50 pounds in six months on Abilify!

I’m not sharing this to scare you into refusing a prescription you may need in order to live a healthy, fulfilling life. In fact, I’m here to say that the weight gain on medications like Abilify and lithium is not inevitable. You can prevent it if you’re willing to do the work to live a healthy lifestyle!

Why Psychiatric Medications Like Abilify Cause Weight Gain

It’s unclear why some psychiatric medications cause weight gain. Lithium, for example, causes weight gain in about 25% of the people who take it. However, the exact mechanism is unknown. Lithium does cause thirst, so it’s possible that people are quenching that thirst with high-calorie drinks like soda. It’s also possible that lithium affects the thyroid.

Things are more clear for mood stabilizers/atypical antipsychotics like Abilify and risperidone. These medications can stimulate appetite, which leads to eating more calories than you need to maintain your normal weight. Even an excess of 100 calories per day--the equivalent of less than half a bag of M&Ms--can lead to a 10 pound weight gain in just under a year.

Many people who take them also have high blood levels of lipids and glucose, which can be a sign of metabolic syndrome. It’s unclear whether this is caused by overeating or by the medication itself. Either way, metabolic syndrome is not something you want in your life. It not only makes it harder to lose weight, but it also increases your risk of heart disease, stroke, and Type 2 diabetes.

How to Prevent Weight Gain on Abilify and Other Medications

The good news is that you can take the medications your doctor recommends and still maintain a normal weight. It just takes some work.

First of all, remember that everyone responds to medications differently. If one medication causes weight gain for you, another in the same category may be equally effective yet weight neutral. For example, Latuda (another mood stabilizer/atypical antipsychotic) is known to cause less weight gain than Abilify, and Abilify may cause less weight gain than risperidone.

If changing medications doesn’t help or isn’t an option, lifestyle changes can be a powerful tool for preventing weight gain on medications--this approach just takes more work on your part.

Like I said, I’ve had several personal training clients at my gym in Carlsbad who have taken mood stabilizers like Abilify and successfully lost or maintained their weight. Here’s what worked for them:

High Intensity Interval Training (HIIT)

If you’re not familiar with HIIT, it’s when you exercise for a short period of time (usually about 20 minutes) and alternate between low effort activity and high effort activity. One of my favorite HIIT exercises is doing sprints on a stationary bike in my Carlsbad personal training gym. Alternate between 30 seconds of easy pedaling with 20 seconds as fast as you can do. Do this for anywhere from 5 to 20 minutes for an intense exercise that burns a ton of calories and revs up your metabolism.

Endurance Sports

While HIIT burns lots of calories in a matter of minutes, endurance sports like running or swimming laps can be equally effective if you’re willing to put in the time. Some of my personal training clients prefer steady endurance activities over the bursts of energy required in HIIT. It’s up to you what you prefer, although I would recommend a fitness program that combines the two for maximum benefit.

Calorie Counting

Even a small increase in calories can cause significant weight gain. It’s very hard not to eat more when your medication hijacks your appetite and makes you crave sugary, fatty foods. If you just go off how you feel, you will very likely eat more food than you need when taking medications like Abilify.

To counter this, I recommend tracking your calories in a fitness app like MyFitnessPal. This will make you more mindful of how many calories you’ve eaten and help you balance your intake with what you’re burning through exercise.

Yes, calorie counting is a pain when you do it day-after-day. But it’s such an effective way of seeing your trends in your diet and keeping your eating in check. It’s also helpful if you end up seeing a dietician or other nutritional specialist as they can see at a glance what you are eating.

My recommended calorie and macronutrient goals vary by person. For me personally, I shoot for less than 22 grams of sugar per day (almost always in the form of fruit). I also try to keep my healthy fat intake at 25% of my calories.

If you’re actively losing weight, you want to prevent muscle loss, so it’s important to increase your protein intake as well. Specifically, aim for .7 to 1 gram of protein per pound of bodyweight per day. This may seem like a lot, but a higher level of protein will help you maintain muscle mass and also makes you feel more full in between meals.

Paleo Diet

I’ve personally gone back and forth on the Paleo diet over the years. Whole grains (which are not Paleo) are a great source of fiber and healthy carbohydrates, but I go through phases where it seems like my body doesn’t tolerate them well.

However, if you’re dealing with weight gain (or trying to prevent it), I would say that Paleo is almost non-negotiable. There are lots of studies showing that Paleo is effective for weight loss, probably because Paleo encourages eating fewer carbs, healthy fats, and more protein.

(I know the ketogenic diet is very popular right now, but I personally haven’t had success with it. As someone who trains intensely every day, I can’t seem to become “fat adapted” and need the glucose from carbohydrates to fuel my workouts.)

The Results Speak for Themselves

I’ve had several clients go on mood stabilizers while training, and they have actually lost weight and become more muscular as a result of a healthy diet (calorie counting and Paleo) combined with regular strength training and cardio. I know for a fact that weight gain on medications is not inevitable because I’ve seen it!

The hardest part is always getting started. If you’re like many of my personal training clients, you’re feeling overwhelmed right now thinking that you need to clean up your diet and start exercising regularly.

The good news is that I’m here to help! I’d love to meet in my Carlsbad personal training gym for a free 30-minute assessment. You can tell me about your current situation, and I’ll run you through some exercises to assess where you are at physically. If you find it helpful, my personal training sessions include text support throughout the week so you can stay on track with your fitness goals.

Contact me today at (760) 658-4708 to get started!