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Gained weight
Unexplained weight gain
Inability to sleep
Lack of motivation
Consuming excessive calories
Rashes
Facial roundness
Not seeing your symptoms? No worries!
Drug-induced weight gain is a side effect of many commonly used drugs, such as long-term steroid medication. This often leads to obesity-related health problems. Due to the weight gain, some patients discontinue the medication.
Your doctor may ask these questions to check for this disease:
Medication causing weight gain should not be discontinued without consulting the doctor. Management of weight gain includes dietary changes and exercise. Medications to manage drug-induced weight gain may be prescribed.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Hidetaka Hamasaki, MD (Endocrinology)
Dr. Hamasaki graduated from the Hiroshima University School of Medicine and the Graduate School of Medicine, Jichi Medical University. He completed his residency at the Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Hospital and the Department of Internal Medicine, Kohnodai Hospital, National Center for Global Health and Medicine. He has served in the National Center for Global Health and Medicine Hospital and Kohnodai Hospital and joined Hamasaki Clinic in April 2017. Dr. Hamasaki specializes in diabetes and treats a wide range of internal medicine and endocrine disorders.
Content updated on Dec 5, 2025
Following the Medical Content Editorial Policy
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Q.
Gaining Weight on Meds? Why Your Metabolism Needs New Depression Drugs
A.
Many antidepressants can lead to weight gain by increasing appetite, slowing metabolism, or causing fatigue, but newer depression drugs that don't cause weight gain, such as bupropion, vortioxetine, vilazodone, and esketamine, may better protect metabolic health. Do not stop medication on your own; track changes and speak with your doctor about switching, dose adjustments, and metabolic labs. There are several factors to consider, including other medical causes and practical offset strategies; see below for details that could affect your next steps.
References:
* Blumenthal SR, Smith MR, Williamson D, O'Day JB, Albeja N, Flamenbaum C, Flament C, Lytle M, Nunez V, Reiff D, Scaglione K, Shah D, Taylor E, Vangala T, Waldeck R, Weinberger L, Weiss L, Weiss T, Weiss E. Antidepressants and weight gain: a narrative review. Obes Rev. 2023 Feb;24(2):e13526. doi: 10.1111/obr.13526. Epub 2022 Nov 25. PMID: 36437759.
* Ma C, Yan S, Pan Y, Tan Y, Wang C, Wang Y, Xu H. Antidepressants and Metabolic Health: Current Perspectives. Compr Psychiatry. 2023 Apr;121:152368. doi: 10.1016/j.comppsych.2023.152368. Epub 2023 Feb 15. PMID: 36796338.
* Fava M, Alpert JE, Carmin CN, Friedman MG, Nierenberg AA, Papp LA, Petitto F, Rohan KJ, Zajecka JM. Newer Antidepressants and Weight: A Comprehensive Review. J Clin Psychiatry. 2020 Jan 21;81(1):19nr12869. doi: 10.4088/JCP.19nr12869. PMID: 31968037.
* Upadhyaya C, Sharma V, Garg M, Kumar R. Mechanisms and clinical management of antidepressant-induced weight gain. Psychopharmacology (Berl). 2017 Apr;234(8):1233-1249. doi: 10.1007/s00213-017-4560-6. Epub 2017 Feb 16. PMID: 28205096.
* Davies L, Ferner J, Taylor V, Ferrier N, Blenkinsopp A, Young A. A systematic review of metabolic outcomes in clinical trials of newer antidepressant medications. Psychoneuroendocrinology. 2017 Jan;75:204-211. doi: 10.1016/j.psyneuen.2016.10.015. Epub 2016 Oct 20. PMID: 27837775.
Q.
Zyprexa Side Effects? Why Your Body is Reacting & Medical Next Steps
A.
Zyprexa can cause weight gain, higher blood sugar and cholesterol, drowsiness, dry mouth or constipation, and less often movement symptoms, with rare emergencies like severe muscle stiffness with fever, allergic reactions, chest pain, or confusion from very high blood sugar. There are several factors to consider, including dose, genetics, age, and baseline metabolic risk; see below for what’s normal, what needs monitoring, and key red flags. Do not stop it suddenly; instead, contact your prescriber to review labs, adjust timing or dose, consider alternatives, and add supportive lifestyle steps, and seek urgent care for severe symptoms. Complete next steps, monitoring checklists, and special risks for older adults are outlined below.
References:
* Duggan, L., & Duggan, J. (2017). Olanzapine: a review of its use in the treatment of schizophrenia, bipolar I disorder, and depression. *CNS Drugs, 31*(9), 779-804. pubmed.ncbi.nlm.nih.gov/28836173/
* De Hert, M., Detraux, J., & van Winkel, R. (2012). Antipsychotic-induced metabolic syndrome: mechanisms, clinical implications, and management. *CNS Drugs, 26*(11), 949-972. pubmed.ncbi.nlm.nih.gov/22754716/
* Kroeze, Y., Correll, C. U., & de Haan, L. (2011). The metabolic side effects of olanzapine: a systematic review of the underlying mechanisms and potential solutions. *Pharmacology, Biochemistry and Behavior, 99*(2), 207-220. pubmed.ncbi.nlm.nih.gov/21855653/
* Mazza, L., Maellaro, N., Corponi, F., De Vecchis, L., Palumbo, F., Panaccione, I., ... & Sani, G. (2021). Pharmacological strategies for the treatment of olanzapine-induced weight gain. *Expert Opinion on Drug Safety, 20*(4), 389-405. pubmed.ncbi.nlm.nih.gov/33501744/
* Correll, C. U., Bobes, J., Kane, J. M., Tanaka, Y., & Schulze-Lentzen, D. (2008). Long-term safety of olanzapine in bipolar disorder: a meta-analysis and systematic review. *Journal of Clinical Psychiatry, 69*(9), 1321-1340. pubmed.ncbi.nlm.nih.gov/18767936/
Q.
Zyprexa Side Effects? Why Your Body Reacts & Medically Approved Next Steps
A.
Zyprexa side effects include weight gain, sedation, and metabolic changes like high blood sugar and cholesterol, plus possible movement or sexual effects, and rarely emergencies such as fever with rigidity, severe confusion, fainting, or seizures; these occur because it changes dopamine and serotonin pathways that also influence appetite, metabolism, sleep, and movement. Do not stop the medicine suddenly; see below for medically approved next steps, including a medication review, regular weight and lab monitoring, dose or timing adjustments, supportive lifestyle steps, discussing alternatives when needed, and exactly when to seek urgent care.
References:
* Schoretsanitis G, Gassenmaier L, Stegmayer K, Rössler W, Schimmelmann BG, Messer T. Adverse effects of olanzapine: A critical review. J Clin Psychopharmacol. 2017 Mar/Apr;37(2):203-211. PMID: 28248881.
* Zhu H, Li P, Hu G. Mechanisms of Olanzapine-Induced Metabolic Side Effects: New Insights and Potential Targets for Prevention. Front Endocrinol (Lausanne). 2021 Mar 1;12:656331. PMID: 33737968.
* Pinto-Figueroa DA, Sánchez-Algarra D, García-Marín LM, García-Domínguez JM, Gutiérrez-Rojas L. Olanzapine-induced weight gain: Mechanisms and therapeutic strategies. J Psychiatr Res. 2019 Jun;113:149-158. PMID: 31035048.
* Chintoh A, Mansur RB, Brietzke E, Soczynska JK, Goldstein BI, Blumberger DM, Miranda L, Kennedy SH, McIntyre RS. Extrapyramidal Side Effects of Second-Generation Antipsychotics: A Review of the Literature. J Clin Psychopharmacol. 2015 Oct;35(5):548-59. PMID: 26352936.
* Guo R, Zhang Y, Tan Y, Wu Y, Yang J, Cai D, Yang X, Shi R, Wang X, Zhang C, Cui K, Yu Y. Pharmacological strategies for managing olanzapine-induced weight gain and metabolic syndrome. Expert Opin Drug Saf. 2021 Mar;20(3):283-294. PMID: 33261546.
Q.
Weight Gain on Olanzapine? Why Your Body Reacts & Medically Approved Next Steps
A.
Weight gain with olanzapine is common because the medication can increase appetite, slow metabolism, and reduce insulin sensitivity, which may raise risks like metabolic syndrome. There are several factors to consider, and safe, medically approved steps include not stopping suddenly, working with your prescriber on dose or alternatives, considering metformin, starting early lifestyle changes, and getting regular lab checks. See below for important details that can shape the best next steps in your care.
References:
* Xu, H., Huang, R., Xu, Y., Zhu, T., Tang, R., Wang, X., ... & Shi, S. (2019). Mechanisms of Olanzapine-Induced Weight Gain and Metabolic Dysfunction. *Frontiers in Endocrinology*, *10*, 144. doi: 10.3389/fendo.2019.00144
* Hasnain, M., Vieweg, W. V., & Hollett, S. B. (2021). Management of Antipsychotic-Induced Weight Gain: An Update. *Innovations in Clinical Neuroscience*, *18*(7-9), 17–23. PMCID: PMC8465355.
* Mossa, A. K., Shahzad, M. R., Aftab, M. T., Kasi, A., Rehman, Z. U., Khan, M. F., ... & Moin, K. (2021). Pharmacological strategies to manage antipsychotic-induced weight gain: a systematic review and meta-analysis. *International Clinical Psychopharmacology*, *36*(3), 115–124. doi: 10.1097/YIC.0000000000000350.
* Patel, R. A., & Rihani, R. (2021). Olanzapine: a review of safety and tolerability in the treatment of schizophrenia. *Therapeutic Advances in Psychopharmacology*, *11*, 20451253211048680. doi: 10.1177/20451253211048680.
* Mamo, D. C., & Mamo, M. M. (2022). Clinical guidelines for the prevention and treatment of antipsychotic-induced weight gain: an update. *Journal of Clinical Psychopharmacology*, *42*(4), 305–311. doi: 10.1097/JCP.0000000000001550.
Q.
Do steroids cause weight gain?
A.
Yes, taking steroids can cause weight gain. See below to understand more.
References:
Fardet L, Nazareth I, & Petersen I. (2021). Long-term systemic glucocorticoid therapy and weight gain. Rheumatology (Oxford, England), 32864693.
https://pubmed.ncbi.nlm.nih.gov/32864693/
Merritt RJ, Hack SL, Kalsch M, & Olson D. (1986). Corticosteroid therapy-induced obesity in children. Clinical pediatrics, 3948457.
https://pubmed.ncbi.nlm.nih.gov/3948457/
Uddén J, Björntorp P, Arner P, Barkeling B, Meurling L, & Rössner S. (2003). Effects of glucocorticoids on leptin levels and eating .... Journal of internal medicine, 12542564.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Ness-Abramof R, Apovian CM. Drug-induced weight gain. Drugs Today (Barc). 2005 Aug;41(8):547-55. doi: 10.1358/dot.2005.41.8.893630. PMID: 16234878.
https://pubmed.ncbi.nlm.nih.gov/16234878/Singh S, Ricardo-Silgado ML, Bielinski SJ, Acosta A. Pharmacogenomics of Medication-Induced Weight Gain and Antiobesity Medications. Obesity (Silver Spring). 2021 Feb;29(2):265-273. doi: 10.1002/oby.23068. PMID: 33491309; PMCID: PMC8215694.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215694/