I've worked in mental health for 25+ years and have observed many
individuals fight weight gain on these meds, fail to comply with the meds
because of the weight gain, and actually become more depressed because of
the weight gain.  In all the cases of which I had good information on their
eating habits [I was working in a residential treatment center at that time]
I can attest to the fact that they were not bingeing nor did their caloric
intake increase.  There were several who decreased their caloric intake
and/or increased their physical activity in an attempt to control or
diminish the weight gain, often with little success.  It is unfair and
potentially harmful to their treatment progress to blame them for their
weight gains.  Some meds have side effects that can be somewhat mitigated
but not always effectively controlled.  It would appear that the known
effect of SSRI's on a person's weight  is one of those.

-Aula

It's debateable whether they cause obesity on their own or whether
it's simply a matter of the person over eating as an effect of the
depression.

There is a significant number of folks taking anti-depressants, but perhaps
they may need them.  Either side of that question - yes, I'm talking about
those meds.

-Aula

Are you talking about SSRI's that it seems half the population takes?

DrG

Perhaps you are unfamiliar with several psychotropic meds that are known to
have that side effect, even with close controls placed on caloric intake.

-aula

Sounds like an excuse to me.  Drugs don't make you fat.  Steroids,
often given for asthma, usually increase the appetite leading to
overeating.

Ann

Correct, but usually its due to excess intake of calories and lack of
exercise. Less often it can be due to some medicines, thyrod or
metabolism problems. I had a teacher who was quite obese, short and 220
pounds(my guess/estimate) and she once explained that it was due to her
asthma and other problems and the medicines she takes. She does not
overeat.

It depends on the cause of the obesity.

Maybe refer them to a diet tech? Obesisty is an epidemic just like
myopia is, but at least you can lose weight much easier than lose
diopters.

<http://tinyurl.com/mx6m3>

I'd like to add to the following to that list of devices:

o  Slit-lamps

I've had quite a few patients I've had to refer out for direct
gonioscopy because they couldn't fit behind the slit-lamp.  Or you
don't get the testing done.  Bringing a patient down to the OR to
perform Koeppe gonioscopy with a counterbalanced gonioscope costs big
bucks.  Most hospitals don't have one -- you have to typically go to a
University ophthalmology residency clinic.

And optic nerve/retinal nerve fiber layer evaluation with a +14D or
MaculaPlus using a head-mounted BIO is not nearly as nice as using a
contact fundus lens or Super66 non-contact fundus lens at a slit-lamp
because patients can't get their forehead close enough to the front of
the slit-lamp for me to obtain or sustain clear focus.

Same thing for Goldmann tonometry.  I can't count the number of times
having a TonoPen has alllowed me to check IOPs when I couldn't do it
with a slit-lamp Goldmann.

Good luck to ophthalmologists trying to perform ALT/SLTs on these
pateints.  Well, they can bill more for trabeculectomies anyways :(.

Hand-held slit-lamps are a poor substitute.

If this trend keeps up, I expect to start having problems at the
perimeter.

And I thought this was only me noticing this alarming trend.