An honest conversation about weight gain

Finding the right treatment is essential for managing our mental health, but one factor that can damage our self-esteem and potentially dissuade people from sticking to their plans can be changes in weight. Here, we explore how to navigate mental health medications when weight changes can be triggering, and how to ensure you find a healthy, suitable solution for you

Weight gain is a common side-effect of many mental health medications, but it isn’t often talked about. It’s absolutely vital that people receive the right treatment to help manage their mental illness, but the potential fear, or triggering nature, of weight changes could be something that puts people off seeking much-needed support. And the stigma surrounding both medication and weight gain can prevent people from talking about this connection, too –making it a challenge that many feel they are facing alone.

As someone who takes medication for bipolar disorder, I’ve experienced weight gain. As much as the medication helped stabilise my moods, the weight I put on had a huge impact on my self-esteem. On a personal level, I felt miserable and it impacted my confidence. My sex life was affected too, and it put a huge strain on my relationship.

Having a history of bulimia, (I’m now in recovery), it was vital I was told about the possible implications. This experience taught me how important it is to communicate with GPs, therapists, and psychiatrists. When we were discussing treatment options, I didn’t think about the side-effects I might go through, or the possible impact it would have on my body image and overall mental health. The side-effects are so important to talk through to ensure individuals have proper understanding of what to expect, and can express any concerns or needs.

Counsellor Kathryn Taylor explains: “Eating disorders are often caused by low self-esteem, and having a negative self-image or feelings of having no control over various areas of an individuals’ life. Individuals presenting with eating disorders often see taking control of what they put into their body as a way of taking back some of that sense of control, and improving their self-image.”

Personally, gaining weight caused me to relapse temporarily. Eating disorders are often accompanied by other mental health conditions, so it can make finding the right treatment and medication a little more complicated.

“When an individual who has an eating disorder seeks treatment and finds ways to manage their thoughts, emotions, and feelings, this can greatly aid them in managing their condition,” counsellor Kathryn says. “However, when they go through periods of stress, this will possibly impact their mental health and ability to see positives about themselves, which negatively impacts their self-esteem and body image, and this may then may result in a relapse.”

With all this considered, it’s so important to be clear and honest with your GP or psychiatrist about any history of disordered eating you may have, and/or your fears of relapsing into unhealthy habits. When I was initially diagnosed with bipolar disorder, I wasn’t honest, and ultimately it put back my journey to finding long-term stability. Sometimes when we’re at our lowest, or struggling the most we ever have, we will take the first option put in front of us, which isn’t always the right fit.

“Talk to your GP about your concerns and the fact that the possible side-effects worry you,” says Kathryn. “Then work with your GP to look at alternative medication, to ensure you have the appropriate mental health support structure in place to enable you to manage your mental wellbeing at this time – as well as working towards resolving the underlying causes.”

Finding the right medication can sometimes be trial and error – so it’s your right to choose a different medication if you’re worried about weight gain, but you must do this safely. One important thing to remember is that you should only stop taking medication when you’ve been instructed to do so by your doctor, which usually involves a slow taper off the medication.

Now, I’m on medication that works for me, and have more of a handle on bipolar and its symptoms. Although I have gained weight, I’m more focused on maintaining a healthy lifestyle – eating well with regular exercise. Ultimately, when it comes to your overall health it’s about finding what is healthiest and happiest for you. It might be embracing a healthy lifestyle that helps counteract some side-effects, or it could be seeking out therapy to help you understand why you have a negative self-image or self-esteem issues. Those initial conversations with your doctor should be a two-way conversation, where they make sure you know what to expect from side-effects, and you express your worries and anxieties.

Positive lifestyle changes, such as eating healthily and getting regular exercise, can help to boost your self-esteem, but there is more to lifestyle changes than just food and exercise. Focusing on your mind, and how you approach each day, to making sure you’re doing something every day that brings you joy, can be just as beneficial.

To help you on your journey to a healthier you, counsellor Kathryn Taylor shares some top tips:

1. Identify positive things in your life. Keep a journal and note down at least three positive things each day to have a regular reminder. If this is difficult at first, start with small things and build from there.

2. Ensure that you drink plenty of water – dehydration can impact your mental state.

3. Try to get outside in the fresh air and nature each day. If this is challenging for you, start by standing near an open window or door for five minutes, and gradually build on this.

4. Try to avoid situations or people in your life that don’t support you, or negatively impact you. Setting boundaries is healthy.

5. Ensure you get enough rest – listen to your body and what it needs.

6. Be kind to yourself and do things you enjoy – reading a book, taking a bath, calling a friend, gardening, making time for a hobby.

7. Set yourself small challenges, and take small steps towards achieving your desired goals.

8. Practise breathing exercises for two to three minutes, several times a day (or whenever you feel you need to take some time out), as these help to calm the nervous system and reduce anxiety. Try the following two options...

Belly breathing: Ensure you breathe properly, opening up your chest and shoulders, placing a hand on your chest and one on your stomach as you breathe in. You should feel the hand on your stomach lift up as you breathe in, and deflate as you breathe out. Follow the path of your breath in through the nostrils noticing how it feels, imagine the breath going down through your chest and into your lungs, down to your stomach, then rising back up and coming out of your nose – noticing it’s slightly warmer than at the start.

Box Breathing: Breathe in for five seconds, and hold this for five seconds. Breathe out for five seconds, then hold for five seconds. Repeat this for two to three minutes.

To connect with a counsellor to discuss ways to manage your thoughts and feelings, visit counselling-directory.org.uk