How much postmenopause weight gain can be blamed on weight-promoting medications?

CLEVELAND, Ohio (July 15, 2020)--Abdominal weight gain, which is common during the postmenopause period, is associated with an array of health problems, including diabetes and heart disease. A new study suggests that the use of antidepressants, beta-blockers, and insulin during the menopause transition is partially to blame for such unhealthy weight gain. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

Many medications prescribed for hypertension, diabetes, depression, and/or other mental health problems are associated with unintentional weight gain. Unfortunately, postmenopausal women, who already have a high prevalence of being overweight or obese, are more likely to be treated with weight-promoting medications for these various health problems at the time of the menopause transition. In this new study based on data collected from women who participated in the Women's Health Initiative, researchers sought to quantify the magnitude of the association between weight-promoting medications and a 3-year weight change in postmenopausal women.

The study measured body mass index (BMI) and waist circumference at baseline and at 3 years and cross-checked the results with an inventory of prescribed medicines, including antidepressants, beta-blockers, insulin, and/or glucocorticosteroids. On the basis of these results, the researchers concluded that taking at least one weight-promoting medication was associated with a greater increase in BMI and waist circumference compared with women not on these medications. Both of these measurements increased with the number of weight-promoting drugs prescribed. Those who took either antidepressants or insulin, or a combination of antidepressants and beta-blockers, were most likely to have a significant increase in BMI compared with nonusers. Racial and ethnic minority women--groups with a higher weight at baseline--also were more susceptible to weight gain associated with the use of prescription medications.

In response to the study's results, the researchers suggest a need for healthcare providers to be more vigilant when prescribing various medications to postmenopausal women. Specifically, healthcare providers need to determine whether various medications are absolutely necessary, whether alternative options are available, and whether the lowest dose is being prescribed to provide the desired results.

Study results appear in the article "The association between weight-promoting medication use and weight gain in postmenopausal women: findings from the Women's Health Initiative."

"This study highlights the significant adverse health effects of obesity and the association between use of weight-promoting medications such as antidepressants, antihypertensives, and insulin and weight gain in midlife women. In addition to ensuring that these weight-promoting medications are used judiciously and in the lowest doses needed to achieve the desired outcomes, lifestyle strategies to mitigate these adverse effects, such as diet quality, physical activity level, and sleep quality and duration, should be emphasized," says Dr. Stephanie Faubion, NAMS medical director.

Credit: 
The Menopause Society