Prescription medications: A modifiable contributor to obesity

Background. While usually not the only factor in obese patients, prescription medications, which may increase appetite or body weight, can be important in some individuals. The cause of weight gain in such cases may go unrecognized or lead to cessation of medication with or without the practitioner's knowledge or approval. Methods. We found illustrative cases among patients treated at the Johns Hopkins Weight Management Center, searched MEDLINE and the Micromedex Drug Information database, and organized this information by drug mechanism and indications for use. Results. Most reports of medication-induced weight gain are anecdotal or gleaned from clinical trials. Notable offenders include hormones (especially corticosteroids and insulinotropic agents), and psychoactive medications (especially tricyclic antidepressants, lithium, and some antipsychotics). Conclusions. Medication-related increases in appetite and body weight are under-recognized and cause noncompliance with pharmacotherapy. A high index of awareness of the known mechanisms by which medications can lead to weight gain has the potential to prevent most medication-related contributions to weight gain and obesity.