psychiatric medication and weight gain: purple prose vs. intelligent talk

a few days ago, big fat blog referred to a story in prospect magazine about a young woman who underwent psychiatric treatment and “tragically” lost her beauty by gaining weight. if you like purple prose,sexism, sizeism, an outdated concept of beauty and other such nonsense, this prospect article is for you!

far more intelligent and interesting are some of the responses to the article, like this one, posted by sjbrodwall:

From experience I can tell you that most patients’ and parents’ concerns about medication-induced weight gain are far from cosmetic. For most patients, particularly the chronically mentally ill ones, the first med is not going to be the med that turns them back into “themselves”. Maybe not even the second or third. The problem is that while the first, second, and third might not help with the depression (or whatever), they still cause weight gain–weight gain that often doesn’t go away. And we’re not talking a few pounds here, we’re talking about turning average-weight people into fat people.

As evolved as most of us fat people here are about the relationship between weight and self esteem, it would behoove everyone to recall that we had to work to accept ourselves, and work hard. When you’re just a teenager and first put on meds for your illness, you’ve got one helluva lot of issues to deal with. First you have the typical issues of self-esteem, peer pressure, etc. that all teenagers deal with. Then your self esteem takes a couple of non-typical, nasty hits–first that you’re crazy enough to have to be medicated, second that the meds make you fat. I think that most of us here can remember how standards were different for us when we were teenagers–just think about the last time you looked back at a picture of yourself when you were young. Think about how fat you felt then, and how thin you look to yourself now. So while 30 pounds might seem like a drop in the bucket to some of us now, this is a major, major weight gain for a teenager, and will have serious and real consequences with regard to how she is treated by her peers and how she feels about herself. On top of the physical appearance problem, there’s also the issue medicated teenagers face about “If I need a medication to be normal, then doesn’t the medication turn me into some who isn’t me? Is normal for me fat, then?”

Teenagers are for many reasons likely to be non-med compliant, and the weight gain really doesn’t help. Being a teenager is hard in and of itself; being a fat one is even harder. Now imagine being a fat teenager who has such serious mental problems that she has to be medicated.If we were talking about a tradeoff between being fat and being happy, that would be one thing. But that’s far from the reality of the situation. It is rarely the case that a person can just start popping pills and be happy, be “cured”, be back to their old selves. Often the pills that cause the weight gain only work partially, and then in addition you have these other problems added to your mental load.

I’ve tried upwards of 15 meds in the course of my depression. The last one I tried got me up to 300 pounds. Despite the fact that it was marginally effective, I decided to stop taking it because the weight gain was too much for me. Yes, cosmetic issues played a part in my decision. I did not like the way I looked. But I also didn’t like the way I felt. I had a harder time getting around. My knees hurt more. I started having fit issues when it came to movie theaters and public transportation. These problems were making my depression worse. Despite the fact that I’ve been involved in the SA movement for over five years, I could not accept this weight gain. It outweighed (cough) any benefits the medication might have had.

I’ve grown angrier and angrier as I’ve seen this issue trivialized here and other places around the web. Many psychiatric patients allow the possibility of weight gain as a side effect to affect our choice of medication. To assume that we are superficial in doing so is to grossly underestimate the complexity of the problem. I am frankly insulted by comments such as these. IMO, they’re not terribly dissimilar from “losing weight is simple–just eat less and exercise more”. I’m not arguing against medication. What I’m trying to do is point out that this issue is far from as simple as many posters here and elsewhere would like for it to be.

isabella mori
moritherapy
counselling in vancouver
www.moritherapy.com

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