ON MENTAL ILLNESS: Using Diet to Compensate for Metabolic Medication Side Effects

By Jack Bragen
Friday February 07, 2014 - 10:17:00 AM

Bulimia and anorexia are awful diseases that are not the fault of the person who suffers with them. The suggestions in this week's column do not apply to people with any eating disorder, and these suggestions should not be considered medical advice. If you are having a problem, please seek professional help.  

Hunger is one of the most basic of human instincts. It is a sensation that is hard to ignore. Hunger disappears when a person perceives imminent threat. It can also be lessened through heavy physical exercise.  

Atypical antipsychotic medications, which are the newer class of medications used to treat psychosis, appear to be more effective at treating psychotic symptoms; however they have problems. Atypical antipsychotic medications, such as Olanzapine, accentuate hunger. They also directly affect metabolism, making a person more prone to weight gain.  

Another side effect of Olanzapine and other atypical antipsychotic medications is that they raise blood sugar, causing Type II Diabetes. Also, these meds make it a lot harder to exercise due to their sedating effects. Thus, many who have taken Olanzapine or similar medications have had their weight double in a relatively short time period.  

Mental health caregivers, when in a position of providing food for indigent persons with mental illness, usually opt for sugar and fat laden rich foods which are inexpensive and easy to prepare, and which have a calming effect.  

Mental health consumers are also more likely to smoke tobacco compared to people in the general public. Thus, we see a deadly combination of medications which create obesity and diabetes, smoking, lack of exercise, and bad diet choices being foisted on us.  

I take Olanzapine and it has caused me to become overweight and borderline diabetic. If there existed another medication that would do the job of keeping me stable, one without metabolic side-effects, I would be taking that.  

I have made an effort to compensate with diet, and have lost thirty pounds. My hemoglobin A1C, an indicator for the severity of diabetes, has also gone down considerably.  

For psychiatric consumers who play an active role in their dietary choices, I have some suggestions.  

First of all, do not try to go hungry. Lack of food for someone with a mental health diagnosis is a risk factor for a relapse of symptoms of mental illness. Some amount of hunger, however, can and should be tolerated. If you can become accustomed to a mild level of hunger and can learn to tune it out, this will allow you to generally consume less food. Yet, when this is taken to extremes, it leads to destabilization and also can lead to binging.  

Secondly, avoid desserts, candy, cookies and ice cream. When mental health caregivers would like to give you cake and ice cream, refuse it. Also avoid pizza and food from the drive thru. If you must eat junk food, fast food or desserts, do so only on occasion.  

Increase intake of fresh fruits, fresh vegetables, and cooked frozen vegetables. Use them to displace higher calorie, high fat or high carbohydrate foods. If you fill up on vegetables, it can reduce hunger for higher calorie foods. Avoid excessive fruit juice, since it is high in calories, and since drinking it is equivalent to eating five or ten pieces of fruit all at once.  

Make it a gradual change, and make changes that are sustainable. Attempting changes that are abrupt and extreme will almost certainly backfire. It is important that you know yourself and gauge changes that are realistic and that can be ongoing. In order to be metabolically healthy, permanent changes in eating habits are necessary.  

It starts with just eating one vegetable, and goes from there.