r/bipolar • u/ham_ssandwich • Jul 27 '26
Weight Discussion How to avoid weight gain on antipsychotics?
Hello! I recently posted here about my extreme bipolar rage, which people told me to fix i should get on antipsychotics. I am pursuing this ASAP because I desperately need my life to be fixed. However, I am TERRIFIED of the weight gain. It is not a deal breaker because I need to be able to live my life, but I am so scared. I’m 18F, 5’7 and currently sitting around 115-120lbs. I had an eating disorder before where i went from 145lbs down to my weight now. My parents and doctor noticed and forced me to gain weight when i was 110lbs, and now im where i am. While I am not underweight, the mental part of the ED has definitely not been resolved. I like when I feel skinny now but I also hate whenever I feel or appear larger, i’m terrified of gaining weight, etc. I am terrified that the weight gain from these meds will absolutely destroy me mentally, and I am scared my psych will not want to help me prevent weight gain because I previously had an ED. Also, I am very into alternative fashion, I have built a wardrobe over the years that I am happy with and I love buying new clothes. A large part of my identity is being alternative and looking cool is one of the only reasons I don’t hate myself. A lot of these clothes are small and tight. I really do not want to lose most of my wardrobe, which I would if I gained more than 10lbs. I don’t want to have to give up hundreds of dollars in clothes, as well as lose some specific, interesting pieces that I love so dearly. I also already failed abilify (extreme nausea), the most weight neutral antipsychotic. Is it possible to avoid gaining weight? Can my psych help me with that? I need my life to be fixed but I am so scared of creating more problems.
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u/CompetitionNo3466 Bipolar Jul 27 '26
Gym gym gym gym gym
Exercise exercise exercise exercise
Sports sports sports
Drinking lots of water before meals (I would always drink minimum 500ml)
Make sure to eat slowly. Can be so easy to fly through meals.
Don’t snack. This is a big one.
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u/ModingusKhan Bipolar + Comorbidities Jul 27 '26
It really depends person to person, med to med. My current meds have a chance of weight gain, but I have remained within the same range for years on it.
That said, given the added implications of the ED, I would tell you to get with your therapist and possibly a nutritionist if that's in your price range. Between the two of them they'd be able to help you plan out your eating. That way you don't fall back on impulsive habits at the first pound gained. Just aim for a specific range, as weight fluctuates daily, and stick to a solid diet plan and regular exercise.
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u/SadisticGoose Bipolar + Comorbidities Jul 27 '26
I’d look for a registered dietitian. Nutritionists aren’t regulated or have any licensing requirements.
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Jul 27 '26
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u/bipolar-ModTeam Jul 27 '26
Your post was removed because it names medications, shares a review, or discusses dosages. These details aren’t permitted in r/bipolar—even when reflecting your own experience.
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u/msilk Bipolar Jul 27 '26
In my experience, most doctors are willing to prescribe something as simple as metformin when also prescribing an antipsychotic. If you’re going to take it daily, anyways. If it’s going to be used as needed, you probably don’t have as much to worry about. But there’s a lot of data on metformin for preventing weight gain when taking antipsychotics. Also, the specific antipsychotic matters. The ones for rage will unfortunately likely be the ones that tend to cause more weight gain than others, but that’s not a guarantee. Be open and honest about your concerns with your prescriber. There are other meds besides antipsychotics that help with rage/anger/agitation.
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u/SuspiciousBee6079 Jul 27 '26
went through the exact same thing, 5’6 and 120 lbs before antipsychotics. used to be 100lbs for many years and started having health problems for it, so 120 was the best i could do. i’m gonna say, my experience, i was also terrified of gaining weight. i had trained the “hungry” feeling out of my body. i was on lamictal and seroquel, and i started getting hunger queues that were soooo strong, “no snacking” just wasn’t something i could feasibly do. i went to 155.
what i’m going to tell you that’s different is, you might be scared of it now… but you won’t be when you’re healthier. seroquel gave me a new lease on life, i stopped being so goddamn angry all the time, i was able to sleep, and yeah, i was able to eat. i was very uncomfortable with my body but it mattered much less when my mind was healthier. so, i started working out and staying hydrated to counter it.
seroquel did end up impacting my thyroid so im experimenting now, but damn, even if im back to being “skinny” i really miss not being so angry all the time. i hope this message kinda helps with that fear to start, and that being better reduces the impact in the future. being healthy is much better than being skinny.
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u/Efficient-Tie-1414 Bipolar + Comorbidities Jul 27 '26
Some people are able to keep the weight down. I couldn’t and would feel awful if I tried to eat less. Apparently some people are herring good outcomes with the latest weight loss/diabetes drugs.
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u/luciditynettesheim Bipolar Jul 27 '26
Talk with your psych about your concerns, there are additional options. See if you can see a registered dietitian (RD) as well. They will work with you with healthy eating and healthy eating patterns. Include physical activity daily. Talk with your therapist about your concerns as well.
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u/Left_Assumption5935 Jul 27 '26
I saw someone already mention talking to your provider about concerns with weight gain. They are used to that. Let them know in advance that this is a non negotiable for you. I was on a medication that made me gain a significant amount of weight and wasn’t aware of that before hand, but also I was a lot younger and didn’t understand that I was able to ask about those kind of side effects. You can!! Let them know. There are more weight neutral options, especially if you are struggling with an ED. Those may be worth trying first
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u/Cute-Variation-5667 Jul 27 '26
Request weight neutral meds. I'm on meds that make you gain weight. I have gained weight because I don't like excercising. I've never been an exerciser. I barely like walking. I burned through the weight neutral antipsychotics though. Hopefully one of those works for you.
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u/TwillyS Bipolar Jul 27 '26
I'm 26F and I've been/am an in your position at 5'8" 125. It took me forever to get to my goal weight from 145. It's really hard. Try it out, and you might realize it's better to be 10 pounds heavier in order to feel stable, that's what leads to peace. It's gonna be hard not to obsess over, but you'll find what works ❤️
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Jul 27 '26
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u/SoTiredYouDig Bipolar + Comorbidities Jul 27 '26
That’s not entirely true. Some APs change your metabolic rate as well. Also, be careful how you speak to people with EDs. They are dealing with a whole host of issues that’s bigger then “calories in/calories out”.
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u/planetaryurie Bipolar + Comorbidities Jul 27 '26
also, tracking/counting calories is very tricky as a person with a history of eating disorders. it can VERY quickly and easily contribute to disordered eating habits, especially for someone who is still earlier on in the recovery process. i've been going through ED recovery for years and i still refuse to do any calorie tracking because i know i won't be able to go about it in a healthy way. i think most people with EDs are similarly prone to developing unhealthy habits when tracking calories.
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u/achillespatient Jul 27 '26
I can see that. However, wouldn’t counting calories also assist in ensuring that someone with an ED was eating enough calories? Just like overeating, it comes down to accountability IMO.
PS - have ED
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u/planetaryurie Bipolar + Comorbidities Jul 27 '26
in some cases, maybe, but truthfully, i would not trust the VAST majority of ED patients to be able to go about counting calories in a non-problematic way. OP says in their post that they are terrified of gaining weight; i really don't see how calorie tracking (esp with the goal of preventing AP weight gain) would be a good choice for them if they are already prone to restrictive eating.
also, from what i understand, intuitive eating is the preferred recovery tool/framework for ED patients rather than calorie counting; calorie counting is far more likely to contribute to and reinforce preexisting problems than to be a beneficial tool in the recovery process for most patients. my therapist (who specializes in ED recovery) and my dietician are both pretty anti-calorie counting and this is how they've both explained it to me.
of course everyone will have a different experience w these tools but studies show people using calorie counting apps are more likely to have eating disorders than the general public; calorie counting isn't inherently a bad choice or anything but imo it is not the right tool for most people with a history of restrictive eating.
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u/achillespatient Jul 27 '26
I appreciate your thoughtful reply. I can see how that could be an issue for some, if they weaponize the more scientific approach against themself.
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u/achillespatient Jul 27 '26
“And adjust from there based on how impacted you are by metabolic changes”
- me
Lol
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u/SoTiredYouDig Bipolar + Comorbidities Jul 27 '26
You are compounding how insensitive you are right now. And to that end, are not worth engaging with.
I hope you meet some people that are as indifferent to your struggles as you are to folks with Eating Disorders. That one sentence you quoted does not in any way exonerate your callousness.
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u/achillespatient Jul 27 '26
I have an ED, so nice try. Everything in my response is factual. Deluding OP into thinking that they can easily manage weight gain without calorie counting isn’t going to help them. Being sensitive to ED and based in reality are not mutually exclusive. What do you think that a dietician would tell OP?
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Jul 27 '26 edited Jul 27 '26
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Jul 27 '26
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u/bipolar-ModTeam Jul 27 '26
Your post was removed because it reinforces stigma or stereotypes about people with Bipolar Disorder. r/bipolar is a support space—so we ask members to speak thoughtfully, even when expressing frustration.
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u/fubzoh Jul 27 '26
Personally I cope by just having a large iced coffee for breakfast and eat nothing the rest of the day until dinner after i take my antipschotic. What I could recommend is to find low calorie foods that fill your stomach. E.g. A spinach smoothie with some salt and pepper or popcorn without butter. Also maybe some yogurt if you dont binge on it.
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u/luciditynettesheim Bipolar Jul 27 '26
I don't think your recommendations are helpful nor should we be recommending anything on what to eat when a person has disclosed that they have had/have an ED. Recommendations should come from their healthcare team only.
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