Hormonal treatment, cortisone, antidepressants… how to avoid gaining weight when you take them?

2024-01-03 20:09:11

Thanks to Dr Jean-Michel Lecerf, nutritionist, specialist in endocrinology and metabolic diseases, author of 40 misconceptions regarding diets (Editions Quae).

Benzodiazepine type anxiolytics do not have any particular effects on weight, just like Prozac®, Celexa®, Zoloft®… On the other hand, be wary of tricyclic antidepressants (Laroxyl®, Tofranil®…) as well as lithium which can stimulate the appetite.

The parade for avoid succumbing to the urge to snack : organize your menus around foods that are slow: start each meal with fiber (plate of grated carrots, soup, crunchy raw vegetables, etc.), include a portion of starchy foods with a low glycemic index (pasta or brown rice, legumes, quinoa…) at lunch and dinner, and fill half the plate with vegetables that provide volume but few calories. And above all, we move: it’s good for regulating weight and it helps (a lot) to improve mood.

Several weeks of cortisone? This anti-inflammatory promotes water retention, and tends to modify the distribution of fats (we get stuffiness in the stomach, face or neck, etc.). Fortunately, these effects only appear if treatment lasts several months, at high doses (more than 10/20 mg of cortisone/day).

The parade for avoid swelling under cortisone ? We reduce salt and sugar! We hunt for salt (no more than 4 g per day) to limit swelling. Also pay attention to sugars which promote storage: avoid all sweetened drinks (including fruit juices), as well as cakes and sweets (replace with almonds, nuts, sugar-free dairy products, etc.).

Synthetic progestins prescribed for endometriosis can make you hungry and promote fat storage. The same goes for hormone therapy during or following cancer. The latest generation pills and hormonal treatment for menopause do not pose these problems.

The solution to resist cravings? 30 minutes of physical activity per day (brisk walking or equivalent) helps burn more calories, make treatments easier to tolerate, and even make them more effective. We adapt the pace to our state of fitness, and if necessary we call on a coach trained in adapted physical activity. In case of water retention, be very gentle on the salt.

Beware of sulfonylureas and insulin prescribed for type 2 diabetes: they facilitate the passage of glucose into the liver, muscles, etc. and its storage in adipose tissue.

What solution to avoid storing fat when taking antidiabetic drugs? Adopt a low GI diet which causes little variation in blood sugar levels and prevents hypoglycemia. The right balance: fiber which slows the absorption of carbohydrates (raw or cooked vegetables at all meals, whole or semi-complete cereals, etc.), less saturated fat (cheese, cold meats, red meat, etc.) and more physical activity. This is not enough ? We talk to the doctor to adjust the dosage.
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