Medication Associated with Weight Gain May Influence Outcome in a Weight Management Program

BACKGROUND Weight gain is a commonly overlooked adverse effect of some medications that potentially confounds weight loss efforts in individuals who are overweight and obese. OBJECTIVE To determine the frequency of use of drugs associated with weight gain by participants and the effect on outcome in a weight management program. METHODS Adult patients >18 years of age were recruited from an outpatient, university-based setting to participate in a 20-week structured weight management program. RESULTS Ninety patients (74 women) were recruited (mean [± SD] age 48 ± 10 y, mean body mass index 37 ± 6 kg/m 2 ). Patients had multiple diseases including type 2 diabetes mellitus (n = 23), hypertension (n = 48), depression (n = 18), and dyslipidemia (n = 9). The median number of drugs per patient was 4.0 (range 0–15). The median number of drugs associated with weight gain was zero (range 0–3). Forty-three (48%) patients were taking at least one of these agents, including β-blockers (n = 18), selective serotonin-reuptake inhibitors (n = 18), sulfonylureas (n = 7), insulin (n = 9), and thiazolidinediones (n = 6). Seven patients completed ≤6 weeks of the program and were excluded from further analysis, and 83 patients completed 10 weeks. Of these 83 patients, 39 had lost ≤2% of their initial weight; 23 (59%) of those 39 were taking drugs associated with weight gain. Fifty-nine patients completed the full 20 weeks. The mean overall weight loss of completers was 4.8 ± 5.0% (range −5.9 [gain] to 17.1% [loss]) at 20 weeks. CONCLUSIONS Patients taking WGDs weighed more at baseline and were less likely to lose weight in this program. Attention should be given when prescribing such medications to obese patients, as this may negatively influence their weight management.