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What causes weight gain inspite of suffering from depression, diabetes and under-active thyroid?

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Posted on Sat, 29 Mar 2014
Question: Hi Doc, I am a 46 year old, white male. I am 6'3" and weigh 295. In the last few months, I have gained 20+ pounds. I take Seroquel 200mg @ night to control my bipolar. I am also on Resperidone 2mg @ night. No surprise, I have metabolic syndrome from inactivity. Two days ago, I was diagnosed with diabetes. My fasting sugar is 280-290. During the day between meals my glucose is 325-350. Yesterday, I started on metformin 500mg twice a day. I have not notice any significant reduction in my glucose. Tomorrow, I see my primary care doctor. I want my numbers to go down as soon as possible. Any advice or specific questions I should ask her when we meet tomorrow? XXXXXXX
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Answered by Dr. Rakesh Karanwal (2 hours later)
Brief Answer: Dietary restriction, weight reduction and exercise Detailed Answer: Hi XXXXXXX Thanks for your query. Apart from most of the anti-depressants, diabetes and under-active thyroid also cause weight increase. Hence, Thyroid Profile should be done to rule out/detect underlying undiagnosed hypothyroidism. Incidentally, mood disorders is also a feature of hypothyroidism. Further, I agree that your sugar levels are grossly elevated. You will therefore need much more medicines than the present drug/dose. Addition of an effective anti-diabetic drug, such as Glimepiride, apart from increasing the dose of metformin would certainly control the sugar levels to within the desirable range. Also, in the presence of obesity, there is a possibility of insulin resistance (a component of Metabolic Syndrome). Therefore, blood insulin levels should also be evaluated. Please bear in mind that ideal control of blood sugar is a slow process, as it is done by trial and error method. The dose requires titration, depending on the blood sugar levels. Once the sugar level is under fair control, the regime is finally modified to maintain 24-hours' control. Dietary restriction, lifestyle modification, regular physical exercises and, above all, weight reduction to a BMI of 25 would go a long way in controlling your sugar levels. Consult your doctor and apprise him of my opinion. I am certain that he will agree with me and will prescribe the advised drugs in appropriate doses. Hope I have addressed your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Take care Dr. Rakesh Karanwal
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Rakesh Karanwal

Internal Medicine Specialist

Practicing since :1980

Answered : 1357 Questions

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What causes weight gain inspite of suffering from depression, diabetes and under-active thyroid?

Brief Answer: Dietary restriction, weight reduction and exercise Detailed Answer: Hi XXXXXXX Thanks for your query. Apart from most of the anti-depressants, diabetes and under-active thyroid also cause weight increase. Hence, Thyroid Profile should be done to rule out/detect underlying undiagnosed hypothyroidism. Incidentally, mood disorders is also a feature of hypothyroidism. Further, I agree that your sugar levels are grossly elevated. You will therefore need much more medicines than the present drug/dose. Addition of an effective anti-diabetic drug, such as Glimepiride, apart from increasing the dose of metformin would certainly control the sugar levels to within the desirable range. Also, in the presence of obesity, there is a possibility of insulin resistance (a component of Metabolic Syndrome). Therefore, blood insulin levels should also be evaluated. Please bear in mind that ideal control of blood sugar is a slow process, as it is done by trial and error method. The dose requires titration, depending on the blood sugar levels. Once the sugar level is under fair control, the regime is finally modified to maintain 24-hours' control. Dietary restriction, lifestyle modification, regular physical exercises and, above all, weight reduction to a BMI of 25 would go a long way in controlling your sugar levels. Consult your doctor and apprise him of my opinion. I am certain that he will agree with me and will prescribe the advised drugs in appropriate doses. Hope I have addressed your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Take care Dr. Rakesh Karanwal