For many of us, we are expected to be fat and happy on bipolar medication. This is because many people gain weight as a bipolar medication side effect – sometimes a lot of weight. You can easily go from a size 8 to a size 18 because of bipolar medication. This is not what happens to everyone, but for those for whom it does happen, the question is, can we be fat and happy on bipolar medication?

Being Fat on Bipolar Medication

As I said, some bipolar medications make some people gain weight. This is a major problem with antipsychotics (although it can happen with other medications as well). According to one study:

Almost all AP [antipsychotics] showed a degree of weight gain after prolonged use, except for amisulpride [Solian, not approved in the United States), aripiprazole [Abilify] and ziprasidone [Geodon], for which prolonged exposure resulted in negligible weight change. The level of weight gain per AP varied from discrete to severe. Contrary to expectations, switch of AP did not result in weight loss for amisulpride, aripiprazole or ziprasidone. In AP-naive patients, weight gain was much more pronounced for all AP.

Believe me, being fat on bipolar medications is a real problem. (And to make matters worse, doctors often don’t mention how severe this side effect is and they don’t seem to care much about it.)

Additionally, being on medication that makes you gain weight also tends to make losing weight almost impossible.

Being Happy on Bipolar Medication

However, that being said, bipolar medication saves lives and makes lives worth living every day. Without antipsychotics, for example, people with schizophrenia or bipolar may be in extremely prolonged and recurring psychosis. This can easily destroy families, careers and relationships. Bipolar medications may be the only thing to make you feel happiness again. I have had this experience. I have had an antipsychotic change my life. I know it happens.

Being Fat and Unhappy on Bipolar Medication

Nevertheless, dealing with weight gain can be difficult. Some people say that medication for depression that makes them gain weight just makes them depressed because of how they look. I understand this. And worse yet, sometimes bipolar medication makes you fat and it doesn’t even have positive effects. Then you have to try something new and see if it makes you gain more weight. It’s a painful cycle.

People flippantly say “sanity before vanity” and seem to think this will change everyone’s perspective. It can help, and it’s certainly a valid point, but that doesn’t mean that being fat on bipolar medication is easy.

Is It Possible to Be Fat and Happy on Bipolar Medication?

Sometimes we're faced with being fat or happy on bipolar medication. Do we have to try to be both? Do we have to try to be fat and happy on bipolar medication?In short, being fat and happy on bipolar medication may be your only option to reach the “happy” point. There may simply be no way to treat your bipolar disorder, gain stability and regain happiness outside of a bipolar medication that makes you gain weight. This is incredibly sucky but true.

There are three things you need to know about being fat and happy on bipolar medication:

  1. Most people have a limit to how much weight they can stand to gain. This means if you’re taking bipolar medication you need to be watching your weight carefully – believe me when I tell you weight gain can creep up on you without you noticing if you’re not purposefully paying attention. And while your psychiatrist should be ensuring that your weight is monitored, in my experience, they rarely do. If you do reach a limit when you feel like you just can’t live with any more weight, be open with your doctor about it. There are many bipolar medications out there and it may be worth you switching and trying something else.
  2. It also may not be worth it. It’s a very individual decision. Sometimes it’s not worth the possible relapse. Truly consider your options and take control of your treatment, but understand that switching just isn’t always smart (or effective).
  3. Sometimes you just have to accept the fat in order to be happy. Yes, I know this isn’t what anyone wants, but sometimes it’s your only choice. Sometimes you just have to accept weight gain in bipolar disorder. I’m sorry, but it’s true.

I’m also not saying that losing weight on bipolar medication is impossible. People have done it but it tends to be very, very hard – much harder than for the average person. Nevertheless, if that is your goal, work with your doctor to find a weight loss program that is best for you.

For most people, I would say that you have to work on the being “happy” part if you have no choice about the “fat” part. But this is possible, too. Try therapy, for example, to help. Try changing your perspective. Try being grateful for what the medication does give you. Yes, I know it gives you gifts with purchase that no one wants, but it can also give you a life – and that’s worth it.