Bipolar Disorder And Oreo Cravings
By Judith J. Wurtman, PhD, and Nina Frusztajer Marquis, MD
Authors of The Serotonin Power Diet

"My daughter gained 70 pounds after she was treated for bipolar disorder," a friend told me recently. The young woman, now in her late twenties was a size 4 before her illness caused her weight to shoot up to a size 16. "The medication did it," the mother went on to say. "She would get up in the middle of the night and eat two bags of Oreos because she had such a craving for sweets."

Weight gain associated with the drugs used to treat bipolar disorder may cause substantial weight gain and 70 pounds is not unusual. The disorder, which used to be known as manic-depressive disease, can be treated with a variety of medications but all of them have the potential to increase food intake. And because the weight gain may be so great, the patient is unable to cope with a strange, new heavy body.

Formerly thin patients find themselves laboring to walk quickly and unable to climb stairs. They bend down with difficulty and even experience sleep disturbances caused by excess weight. Any woman who has gone through pregnancy knows how difficult it is to move when the weight of the fetus and assorted tissues adds 40 or 50 pounds to her frame. This weight is gained over 9 months but much of it is lost in the early months after the baby is born.

Imagine gaining 70 pounds over the same period and not losing it but perhaps even gaining more. "I felt as if something has taken over my body," said a client who had gained nearly 90 pounds. "I have to introduce myself to friends who have not seen me in a while and sometimes I don’t recognize myself in the mirror."

The initial weight seems to be gained because the control over appetite appears to be switched off by the medication. There is a need to eat often, and the foods chosen tend to be high-fat snack foods like cheese, ice cream, cookies, chips, French fries, and chocolate. Often a second supper follows the first because the drugs take away the feeling of being full. A person may eat a full meal at 6 PM but by 8 PM is ready to eat again. Food may also be consumed during the night—sometimes when the eater is half asleep.
Added to this obvious cause of weight gain is difficulty in exercising. Some of the drugs make the patient feel very tired, so it is easier to sit or take naps than to walk or do anything requiring physical activity. Back, knee and other orthopedic problems are triggered by excessive weight and diminish even further the possibility of using exercise to stop the weight gain or to lose weight.

Then there are the psychological factors: Going to a gym or attempting to jog in your neighborhood when feeling unfit and heavy is difficult under any circumstance. It’s even more so if you always thought of yourself as thin and athletic and now look the opposite. Social activities also tend to be restricted when individuals are ashamed of how they look. A teen who gained about 100 pounds on the medications she was taking for bi-polar disorder insisted on home schooling because she refused to let her classmates see what she looked like after her weight gain. And given the well-documented bias against hiring obese people, some patients who are now able to work due to their medications find it difficult to get jobs.

If lack of work, social opportunities and tiredness result in being alone most of the day, eating may increase just as a way of filling up time. So more weight may be gained, not because of the medication per se, but because of the consequences of the initial medication-induced weight gain.

Yet it is possible to lose weight, even though the medications are still being taken. Shutting off the persistent feeling of wanting to eat is the first step. Will power alone is not sufficient. It is necessary to make the brain turn off the appetite, which has been turned on by the medication. Boosting serotonin levels in the brain seems to be the most effective way of bringing this about.

Serotonin controls appetite. In our clinical practice we found that when serotonin was increased, our clients were able to stop their excessive eating. Serotonin is made when sweet or starchy carbohydrates are eaten without any protein. All carbohydrates with the exception of fruit will cause the brain to make new serotonin. Many snack foods such as graham crackers, rice cakes, rice crackers, breakfast cereals, pretzels, popcorn and other very low-fat carb snacks are capable of boosting serotonin levels. Serotrim, a carbohydrate drink we developed, has the same effect, except somewhat faster.

Following a calorie and portion controlled snacking or Serotrim schedule will take away the need to eat large amounts of food at meals or follow one meal with another. A snack before lunch, another in the late afternoon and an optional third late in the evening bring a halt to overeating within hours. Eating moderate-sized meals should become much easier because there will already be a sense of being full before the meal begins.

Physical activity will, of course, speed up weight loss. Any is better than none. Just walking for ten minutes is better than not moving at all and eventually, as stamina increases, this can be expanded to more strenuous exercise. As everyone who works out while feeling exhausted knows, exercise seems to renew energy, not deplete it.

Weight won’t be lost quickly but it will be decrease following these suggestions. And what will be gained is a sense of physical and mental well-being.

Copyright © 2007 Judith J. Wurtman, PhD, and Nina Frusztajer Marquis, MD

Authors
Judith J. Wurtman, PhD, has been recognized worldwide for decades of pioneering research into the relationship of food, mood, brain, and appetite. Dr. Wurtman received her PhD in cell biology from MIT and took additional training as an NIH Postdoctoral Fellow in nutrition/obesity. The author of five books for the general public, she has written more than 40 peer-reviewed articles for professional publications. She splits her time between Boston and Miami.

Nina Frusztajer Marquis, MD, received her master's degree in nutrition from Columbia University and her medical degree from George Washington University. Her articles on weight, stress, and lifestyle have appeared in numerous publications. With Judith Wurtman, she founded the Adara Weight Loss Centers in the Boston, Miami and San Francisco Bay Area, where she lives.

They are the authors of The Serotonin Power Diet: Use Your Brain’s Natural Chemistry to Cut Cravings, Curb Emotional Overeating, and Lose Weight. Published by Rodale. January 2007; $24.95US/$31.00CAN; 1-59486-346-6.

For more information, please visit www.serotoninpowerdiet.com