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Singing About Antidepressant Weight Gain in a Broadway Musical

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“Next to Normal” is a Broadway musical dealing with the common, but rarely sung about, problems of mental illness and the impact this has on the family. Despite its theme, the musical is often very funny while being uncannily accurate in depicting the symptoms of bipolar disorder and how current therapies affect the patient. In one very long musical sequence, the patient, the mother of the family, is put on a variety of medications to stabilize her out-of-control mania. In scene after scene she comes back to tell her psychopharmacologist about the side effects of the various medications he is trying and their lack of efficacy. To my amazement, she sings that one medication took away her appetite and then made her gain ten pounds. “Did you hear that?” I whispered to my husband as people around us laughed. “They sing about weight gain from antidepressants on stage but psychiatrists still won’t talk about it.”


As we left the theater, I felt hopeful that this hidden cause of obesity might finally become mainstream. If it could make its way into the lyrics of a popular play, then maybe weight gain due to antidepressants and drugs used for bipolar disorder might be recognized as contributing to the epidemic of obesity In fact, the only part of the song that did was not entirely accurate was the weight gain of ten pounds. Of course, this was supposedly after only a few weeks of treatment. Many drugs, especially those used for bipolar disorder, can produce weight gains upwards of seventy pounds over six months or so.


One of the saddest aspects of medication-induced weight gain is that people who experience it were often a normal size before drug use and without any history of eating problems or obesity. In our weight-loss center at a Harvard University hospital, we saw many clients who not only had been thin but also had led physically active lives. They would tell us that they did not recognize their own bodies after several months on their medication. Not only were they unable to control their eating, they no longer could exercise as their extreme weight gain left them fatigued and often with back or leg pain. Their family and friends did not understand what was happening and these formerly thin people were subjected to unkind and sometimes abusive statements about their new size. A few became recluses because they could not bear people looking at them. One of our clients, in high school at the time, refused to go to school because of the way she looked. Her mother had to home-school her.


And yet, as we point out in our book, The Serotonin Power Diet, this does not have to occur. The side effect of chronic hunger produced by the medications can be aborted by getting the brain to make more serotonin. No one is sure how the weight-gaining medications affect food intake but serotonin’s role in turning off hunger has been known for at least thirty-five years. It would be ideal if a drug existed that turned serotonin into an appetite terminator but there isn’t any. The only safe and effective way to get serotonin to function more potently as an appetite suppressant is to make the brain manufacture more of this chemical. This is easy to do and it is too bad the Broadway show didn’t mention it. Serotonin is made when non-fruit, starchy or sweet carbohydrates are eaten. As long as the food is eaten without protein and with very little fat, serotonin is made within twenty minutes or so. And as soon as it is made, it acts to shut off further eating.


Clients in our hospital weight-loss center and our private practice were given a diet we have reproduced in our book. They were told to consume a carbohydrate drunk, which we had developed for the clinic. It allowed the brain to make serotonin very quickly. They were also allowed to substitute a carbohydrate food for the beverage, if they wished.


Weight loss was immediate and easy because the additional amount of serotonin seemed to diminish or remove entirely the need to eat all the time. Some of the clients had to stay on the weight-loss plan for many weeks because they had gained so much w eight from their medication. They all told us they wished their psychopharmacologist had told them about our diet when they first started gaining weight and not after their weight gain became a major side effect.


But who knows? Now that weight gain from antidepressants and mood stabilizers is put to music, maybe some songwriter will tell the audience about eating carbohydrates to lose weight.

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