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Hot Flushes, Antidepressants, and Weight Monday, March 17, 2008, 04:39 PM - AntidepressantsThe woman sitting next to me in the concert hall was fanning herself vigorously with her program. It was not hot in the hall; indeed most people had on sweaters or jackets as the hall was drafty and it was very cold outside.
"Hot flushes?" I asked knowingly. "Yes," she replied, "and they never seem to end. Plus I never get a good night's sleep. I must wake up every hour hot and sweaty. And then the next day I am so tired, I eat all the time just to stay awake. My doctor suggested I go on antidepressants. He said they might help." At this point the lights dimmed so I said nothing. I wondered if she realized that the therapy for her hot flushes might bring with it another set of problems: weight gain.
Just about all the antidepressants available today have the potential to make people gain weight. The amounts range from 10 to upwards of 30 pounds or more. The reason for the weight gain is that these drugs seem to take away a sense of satisfaction after food is consumed. Patients report food cravings, needing to eat larger portions than before they went on the medications, and a loss of satisfaction and satiety. Added to this drug- induced overeating is the effect of menopause itself. Many women start to struggle with their weight as they go into menopause and complain that it is harder for them to lose pounds than when they were younger. As my seatmate was already overweight, the addition of even 10 more pounds would be unwelcome and might even have an impact on her health. So how could going on antidepressants to relieve her hot flushes be a good idea?
On the other hand, awakening at night due to frequent hot flushes is unpleasant and leads to daytime fatigue. Disrupted sleep is a well-known trigger for overeating and weight gain. So it was possible that my seatmate was gaining weight because she slept so badly. Was her choice between taking an antidepressant so her hot flushes would go away, she would be able to sleep but might gain weight or not take anything, have her sleep disrupted, and then eat too much because she was so tired?
Fortunately, antidepressant-associated weight gain does not have to be inevitable. Although research studies have not yet identified why these drugs cause overeating, studies that my colleagues and I conducted have shown that there is an easy and natural way to stop it. The same brain chemical on which the antidepressants work, serotonin, is involved in appetite control. Unfortunately, the antidepressants do not make serotonin work harder at controlling eating. If they did, everyone on these drugs would never have to worry about eating too much. That is the bad news. The good news is that everyone can make serotonin work harder at preventing overeating simply by choosing the right foods to eat.
Serotonin is produced only when carbohydrates are eaten. Complex carbohydrates such as rice, potatoes, pasta, bread, cereal, crackers, tortillas, cornbread and simple sugar all activate a process in the body that leads to more serotonin in the brain. (Fructose, the sugar in fruit is the only exception.) When protein is eaten either by itself or with carbohydrate (a chicken sandwich for example) the protein part of the meal prevents serotonin from production. When new serotonin is made, it functions to put a brake on eating.
Even though the antidepressants would give my seatmate feel a persistent need to eat, regardless of how much food she consumed, she can prevent this from happening by eating a small amount of carbohydrate before starting a meal. A cup of low-fat cereal, 4 or 5 small graham cracker squares, a low-fat granola bar or two fat-free meringue cookies will boost serotonin levels and spoil her appetite. And if she finds herself nibbling all evening, she ought to eat a dinner of only carbohydrate and vegetables. That way the increased serotonin in her brain will prevent her from snacking until she goes to sleep.
Intermission came and we both stayed seated. After a few minutes, I reached into my bag and offered her some cherry Twizzlers, my all-time favorite carbohydrate snack. "Before you start on your antidepressants," I said to her, "there is something you ought to know."
"Well," she said, after I gave her my carbohydrate 'serotonin boosting suggestions,' if getting rid of hot flushes means snacking on carbohydrates, menopause may not be so bad after all."
The Serotonin Power DietThe easiest way to lose weight is to use your brain.Here's why: The brain contains the switch that turns your appetite on and off.Serotonin, called the satiety or satisfaction chemical, is the brain chemical that turns off your eating. To lose weight you have to know how to activate the "off button'" before you either overeat or chose foods that are not on your diet. Our book will show you how to boost serotonin to stop overeating, to quiet food cravings, and to experience feelings of satisfaction and comfort.You don't need to take medication or herbs or special supplements to boost serotonin. All you need to do is follow the simple meal and snack plan in The Serotonin Power Diet and your brain will produce more serotonin. And within hours of following the food plan, you will find yourself feeling full, even after eating diet-size portions of meals. Your cravings will disappear. And for an added bonus, your mood will be better. You'll get this extra benefit because serotonin is also the "good mood" brain chemical.Nature gave us a simple way to control our eating and balance our mood just by eating the right foods. During our years of research at the Massachusetts Institute of Technology, we discovered the connection between eating, emotions and serotonin. By using your brain's natural chemistry, you can:
- Turn off appetite by triggering more serotonin before meals
- Stop the universal carbohydrate craving in the late afternoon by triggering more serotonin before the cravings begin
- Prevent emotional overeating by triggering serotonin during those stressful times
- End the overeating that comes with the use of antidepressants by making the brain produce more serotonin
See what our readers have to say!Read excerpts from the book!Here are a couple of corrections to the first edition (hardcover).
Opposing view?:::
Your noontime meal can also lead you into an afternoon tailspin. Bonnie J. Spring, Ph.D., professor of psychology at the University of Health Sciences/Chicago Medical School, has shown in studies that a high-carbohydrate/low-protein lunch can produce an afternoon drop in energy and alertness by elevating the brain's levels of serotonin, a substance that makes us sleepy.
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