Is your medicine giving you a muffin top?

We live in a pill-popping society, where drugs are used like chemical fairy godmothers. Some, such as antibiotics, which are often over-used, may be employed temporarily to ward off infection. However, there’s an increasing array of tablets designed to be taken every day for a multitude of conditions — and weight gain can be a silent, serious and permanent side-effect. This is often not picked up until the problem has caused great distress and led to excess kilos that won’t budge despite a healthy lifestyle.

Some medications that cause this kilo-creep are used for conditions such as heart disease, epilepsy and breast cancer, where there may be no other options that work as effectively. However, it’s always worth asking your health practitioner about different drugs that have equal benefit, minus the muffin top. Alternatively, self-help strategies can sometimes be used to reduce the dosage of a regular drug you are taking. If these bring benefits, further reduction of meds may be possible. Before altering the dose or coming off any medication, however, you should consult your GP and make any changes slowly and under medical supervision, as sudden cessation of some drugs can be dangerous.

Meanwhile, make sure you are well informed about the potential for weight gain if you are using drugs for any of the following health issues.

Depression

Antidepressants (and, increasingly, antipsychotic medications for conditions like bipolar) have become so accepted that people now swap notes about the brands they have tried and which ones were easier to tolerate. Though the older tricyclic antidepressants were known to cause weight gain, time has also now shown that the newer-generation antidepressant pills also stack on the kilos in many people.

These SSRIs (selective serotonin reuptake inhibitors) are thought to work by increasing the amount of serotonin (a “feel-good” brain chemical) circulating and available in the brain. For reasons not well understood, many people initially lose weight on them but then, after three to six months, gain weight. This rise on the scales, along with other metabolic changes, is thought to be why people taking SSRI antidepressants are at higher risk of type 2 diabetes, according to research from the University of Southampton in the UK.

Another sobering study, at Kirklareli State Hospital in Turkey, tracked patients just as they started to take antidepressants. Those in the study used different types of medication. At the end of only 16 weeks on antidepressants, most of the study subjects had experienced a significant and concerning increase in waist circumference, fasting glucose levels and both bad LDL and triglyceride cholesterol levels.

The take-home message? If you are on antidepressants and can manage to lower the dose a little, and take the medication for a shorter duration of several months rather than several years, this is worth doing to reduce the well-documented weight-gain risks caused by the medication. Antidepressants should never be stopped cold turkey. They take a long time to taper off and this should only be done under the supervision of a supportive GP.

Drug-free self-help

• Exercise daily. Studies have repeatedly shown that daily exercise is just as effective for mild-to-moderate depression as antidepressants. So schedule exercise every day, such as a brisk walk or yoga or a high-intensity workout where you get breathless over 10–15 minutes.
• Live in the now. Whether you are savouring a cup of tea or walking home from the bus stop, aim to live every moment through your five senses. When you live in the present you cannot be caught up worrying about the past or the future.
• Write a journal. Note concerns and debrief about feelings. This process can be cathartic and help you to offload issues weighing on your mind.
• Be still. Revel in daily practices like meditation, qi gong, tai chi and yoga. Enjoy the serenity boost. Studies show that yoga can reduce anxiety and stress, even after just a few sessions.

Anxiety

With the unending busyness of our lives, combined with growing economic uncertainty and social disconnection, it’s hardly surprising that anxiety is on the rise, now affecting over 2 million Australians, according to beyondblue. Pills such as benzodiazepine are often used to help people cope with the symptoms, but they can be addictive and, with regular use, they can widen your waistline and cause fluid retention.

Drug-free self-help

• Eat regularly, particularly breakfast. Ensuring your blood glucose levels don’t drop can help to stabilise your mood and promote feelings of calm.
• Cut caffeine, alcohol and sugar. These all stimulate your body to pump out the stress hormones, adrenalin and cortisol. Side-effects can include shakiness, heart palpitations, difficulty sleeping and a general sense of anxiety.
• Lighten your fears. Sing worries to a well-known nursery rhyme to help reduce their impact on you and make them seem less daunting.
• Try tapping. When you feel stressed, use your fingertips to tap on specific points, including the top of your head, collarbone, under the arm, on the chin, on the eyebrow and on the part of your hand you would use in a karate chop. Many people find this technique very calming; it’s sometimes referred to as “emotional acupuncture”.

Contraception

The hormones in the contraceptive pill prevent monthly ovulation so you don’t release any eggs to be fertilised. Many women complain that when they take the contraceptive pill they gain weight or suffer fluid issues or both, which is not surprising given that the pill causes a constant shift in natural hormone levels. High-oestrogen pills appear to cause more fluid retention. Research at the Oulu University Hospital in Finland also found the contraceptive pill may affect insulin sensitivity and increase inflammation — both known contributors to weight gain.

Drug-free self-help

• Rethink your contraception. Consider coming off the pill and using a diaphragm or condoms or both.
• Change your brand of pill. Talk to your GP about changing to a pill with a different combination of hormones, to see if your body better tolerates this without the weight issues.

Migraines

These intense headaches can cause symptoms such as nausea and vomiting, flashing lights and changes in smell and perception. People who suffer constant migraines often go on preventative medications or take these meds over high-risk periods — for example women who suffer migraines in the two weeks before menstruation. However, some migraine meds have been known to cause metabolic changes that lead to weight gain or changes to hunger hormones that increase the appetite, causing a tendency to overeat.

Drug-free self-help

• Use preventative herbs and flowers. Feverfew and butterbur are both herbs known to help prevent migraines and reduce the number of attacks. In addition, it can be helpful to take a sedating and antispasmodic herb formula that includes valerian, skullcap, lemon balm and passionflower to relax muscles.
• Take a tea break. Steep chamomile tea for 10 minutes and drink — this promotes relaxation.
• Seek head-friendly supplements. Magnesium has been found to be low in people suffering migraines, so stock up on foods like dark, leafy greens, fish, pumpkin seeds, figs and wholegrain rice, as they are rich in this important mineral. Vitamin B₂ (also called riboflavin) has also been shown in studies to help reduce migraine frequency. It’s found in cheese, almonds, beef, lamb and eggs.
• Employ fragrant oils. When you feel a headache coming on, apply a few drops of rosemary and thyme oil to your forehead. These contain carvacrol, which inhibits inflammation. Peppermint and lavender oils added to a warm footbath may also help reduce the bloodflow from your head by increasing circulation to your feet.
• Identify food triggers. It’s well known that foods like cheese, chocolate and red wine can trigger migraines, however research also shows that foods containing MSG and nitrates may be a problem. Keep a “symptoms diary” and note down foods you ate in the days leading up to a migraine to help identify any food triggers so you can avoid them.
• Address lifestyle triggers. If you know you tend to get migraines when you don’t exercise enough, get stressed out, skimp on sleep, miss meals, feel hung-over or drink too much coffee, address these issues through lifestyle changes. If you are also affected by triggers you can’t control, such as weather changes, try to be flexible on those kinds of days — for example, by postponing an important meeting or getting a friend to pick up your kids to lighten your load.

High blood pressure

Your blood pressure measures the force your blood puts on the vessel walls as it is pumped around your body. If this is high you are at risk of stroke, so your doctor will suggest blood pressure medications. However, once the drugs are being taken, simple DIY measures are often overlooked, even though they might make it possible to reduce your blood pressure meds. Unfortunately, tablets used for high blood pressure can interfere with your body’s ability to efficiently burn kilojoules. As some also slow the heart rate, they may reduce the energy needed for regular exercise.

Drug-free self-help

• Slash salt intake. Excess salt increases your blood pressure. So cut back to 6g or less of salt (about one-and-a-half teaspoons) per day by reducing your intake of pre-packaged foods (or choosing low-salt varieties), avoiding salty snacks and adding spices, not salt, to food for taste.
• Breathe slowly. Studies, including one at the National Institute on Ageing in the US, show that slowing your breathing to under 10 breaths per minute can help lower blood pressure when carried out for as little as 15 minutes a day.
• Cuddle someone you love. Cuddles can lower blood pressure and boost levels of an uplifting hormone called oxytocin, shows US research at the University of North Carolina. In women, if hugs were repeated, they were as effective as drugs in reducing high blood pressure.

Asthma & arthritis

Oral steroids, used to treat conditions such as asthma and rheumatoid arthritis, can contribute to weight changes, mostly through altering hunger signals and increasing appetite.

Drug-free self-help

For asthma:

• Learn Buteyko breathing. This method involves breathing exercises and techniques that change unhealthy breathing habits, such as hyperventilation. This restores the balance of carbon dioxide and oxygen in the body and bloodstream, which helps reduce spasm in the bronchial tubes.
• Go on an elimination diet. Cut out allergenic foods or foods you suspect trigger your asthma attacks. Unlike an allergy, which causes a response in the immune system, a food intolerance seems to work by irritating nerve endings in different parts of the body. Natural chemicals called amines and salicylates in foods such as oranges and broccoli can be as problematic as other allergenic food groups, such as wheat, soy and dairy.
• Keep a clean house. Regularly dusting (with a damp cloth and mask to reduce dust inhalation), sweeping and vacuuming your home are important natural ways to reduce dust mite, which can trigger asthma attacks.

For arthritis:

• Try ginger to reduce pain. Studies show that gingerol, the active component of the thick, knotted stem of the Zingiber plant, can alleviate pain and inflammation caused by arthritis.
• Supplement with glucosamine. This can help rebuild cartilage, reducing arthritic pain.
• Eat more curries. Studies suggest that curcumin in turmeric may reduce arthritis onset and symptoms of arthritis due to its anti-inflammatory actions.
• Minimise intake of certain fats. Though omega-3 fats from fish can help reduce arthritis symptoms, excess vegetable oil or saturated fat may encourage the production of inflammatory chemicals called prostaglandins, which exacerbate joint pain.

Fluid retention

Diuretic drugs are prescribed for all manner of conditions, including unexplained fluid retention and ear problems such as ringing and dizziness or more potentially life-threatening issues such as heart and kidney disease, so they should never be stopped without GP supervision.

Unfortunately, constant use of diuretics can lead to a rebound effect, where you retain more fluid the longer you keep taking the drug. Trying to come off the diuretics can also increase this rebound effect, making fluid problems worse. Meanwhile, this can feel and look like weight gain because the oedema (swelling) can make it more difficult to fit into clothes and shoes.

Drug-free self-help

• Minimise fluid-retention triggers. These may include stress, long hot showers, use of medications such as sleeping pills and overindulgence in salty foods.
• Drink water regularly. The body’s first response to dehydration is to retain fluid just in case. So sip on water all day to keep your body well hydrated, which may help reduce swelling in places like your feet, lower legs, hands and face.
• Take natural diuretics. These include cranberry juice, celery and fresh parsley; supplements of magnesium and potassium to stabilise body fluids; and supplements of vitamin C and horse chestnut to support vein strength and combat leakage, which can contribute to fluid retention.

Stephanie Osfield is an award-winning freelance health journalist, published in Australia and overseas. She is an advocate of nutritional medicine and specialises in all aspects of health from exercise and disease prevention to stress, depression and women’s health issues. W: savvysteph.com