“Weight gain” is on the list of possible side effects of many treatments. “For some molecules, the meta-analyses show an average weight gain of 1.2 to 3 kilos” specifies Dr. Patricia Nury, a doctor specializing in drug development. This is indeed an average: some patients will gain less weight, others more, in particular according to their lifestyle and related risk factors, such as pre-existing excess weight.
In play depending on the molecules concerned, different mechanisms. “Some are well documented scientifically, such as a direct effect on satiety centers in the brain or metabolic effects that will, for example, alter glycemic control due to their effect on insulin secretion” adds the specialist.
Others are of more recent discovery, such as the role of the intestinal flora, and are the subject of a new field of research. “What is certain is that these are multiple and complex mechanisms that often combine with each other,” she adds.
What if you want to lose weight?
It is obviously not a question of stopping his treatment, at the risk of putting his health at risk. “As the different molecules are known, it is up to the doctor to choose the most suitable for his patient, in particular according to his basic BMI, but also the drug interactions that may play in the balance” explains Dr. Nury.
But in many cases, no alternative is possible, because it is often entire therapeutic classes that are concerned. “It is then up to the doctor to clearly inform the patient of the risk of weight gain, and to provide him with lifestyle and dietary advice in order to control it.” Thus, to limit this irrepressible desire to eat that certain psychotics in particular cause, care should be taken to favor satiating foods: foods with a low GI and high in fiber (whole cereals, legumes, vegetables), quality proteins (egg, ham white, poultry, oilseeds, etc.) at all meals.
Our expert: Dr Jean-Michel Lecerf, medical director of the longevity health prevention center, head of the nutrition and physical activity department of the Institut Pasteur de Lille
