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Topiramate and Weight Loss

Wed, 12/29/2010 - 01:23
I had this discussion with my doctor and he was not too concerned, as I have always been a little overweight; but I am a little worried because of the quickness of my weight loss since I have been on Topiramate. I was 165 pounds when I started taking this drug. Now I am sitting at just below 140. I started the medication less than two months ago, and I am on a dose of 100 mg. twice a day. I have fought with my weight for most of my life and have never had this type of weight loss in this time frame. Usually for me to lose this amount of weight, it takes me at least five months of hard dieting and exercise because of my bad gene-pool. My diet has not changed (aside from me eliminating more meat and adding more fruits and veggies, and incorporating more juice), and I am not taking any other medications that might have caused this weight loss. Is this weight loss going to continue or is this just a temporary side effect until I fully adjust to the medication? Should I be worried? How much weight loss is too much with this drug? Any advice is appreciated and happy new year :-) Regards, Kat

Comments

Re: Topiramate and Weight Loss

Submitted by MinKels on Wed, 2010-12-29 - 18:46

The amount of weight lost and how long it goes on tends to vary by the individual from what I've read about the drug and from what I have read on other boards about others' experiences on Topiramate.

Before I developed epilepsy in June of this year (no family history, no explanation as to why), I was a healthy 115 pounds. I stand 5' 3" tall and am very small-framed. Since I had two seizures intially and the EEG was not normal, the neurologist started me on Keppra (supposed to cause weight gain!) which caused me to drop to 110 pounds.

I continued to have seizures (tonic-clonic) and had terrible headaches from the Keppra, so the neurologist decided to take care of both issues by adding Topiramate at 100 mg a day, which ended up having to be upped to 200 mg a day.

The first month I was on it, I dropped another 5 pounds--I didn't really see the major weight loss until month 4 when I dropped 11 more pounds. I've lost about 4 more pounds this month, though I attribute that to the stress of being laid off at work since I am the sole breadwinner and so on. I've leveled off in my weight loss through eating 5 small meals per day, drinking Ensure 3 times a day (expensive but worth it), and doing weight training (so I don't look so thin). It doesn't look too bad since I am small framed to begin with, but I probably would look too thin in something that was revealing.

If you do go on a regimen to gain weight, stick with high protein foods and a balanced diet instead of fatty foods.

I don't like weighing 96 pounds, but it's worth it to me to have the tonic clonics under control since I need to be able to drive and this drug has made it able for me to get my license back. I have done a great deal of training to get my legs and lower body toned so I don't look too thin; now I am working on my upper body ( a bit harder) to build some muscle so I don't look so thin. I generally wear fitted pants with a heavy sweater (luckily it's winter) with a vest to add some bulk up top.

Consult with a nutritionist if you don't think your doctor is listening; most doctors do not get much training in nutrition. I was told that my amount of weight loss was pretty extreme based on the relatively low dose that I am on, but I tend to be very active and have a high metabolism. Monitor your weight regularly, and definitely let the doctor know if you think you are losing too much weight on the medicine.

In my case it's a hard call. I know I've probably lost too much weight, but I am in the middle of a job hunt and am doing lots of driving to various interviews since the job market is not very good in my area and I do not want to mess with my medications at this point and end up possibly having another tonic-clonic seizure at this point. I've discussed it with my neurologist and he is also reluctant to drop the dosage of the Topiramate right now...I'll wait until things are more settled in my life to work on the dosage reduction.

Good luck to you.

The amount of weight lost and how long it goes on tends to vary by the individual from what I've read about the drug and from what I have read on other boards about others' experiences on Topiramate.

Before I developed epilepsy in June of this year (no family history, no explanation as to why), I was a healthy 115 pounds. I stand 5' 3" tall and am very small-framed. Since I had two seizures intially and the EEG was not normal, the neurologist started me on Keppra (supposed to cause weight gain!) which caused me to drop to 110 pounds.

I continued to have seizures (tonic-clonic) and had terrible headaches from the Keppra, so the neurologist decided to take care of both issues by adding Topiramate at 100 mg a day, which ended up having to be upped to 200 mg a day.

The first month I was on it, I dropped another 5 pounds--I didn't really see the major weight loss until month 4 when I dropped 11 more pounds. I've lost about 4 more pounds this month, though I attribute that to the stress of being laid off at work since I am the sole breadwinner and so on. I've leveled off in my weight loss through eating 5 small meals per day, drinking Ensure 3 times a day (expensive but worth it), and doing weight training (so I don't look so thin). It doesn't look too bad since I am small framed to begin with, but I probably would look too thin in something that was revealing.

If you do go on a regimen to gain weight, stick with high protein foods and a balanced diet instead of fatty foods.

I don't like weighing 96 pounds, but it's worth it to me to have the tonic clonics under control since I need to be able to drive and this drug has made it able for me to get my license back. I have done a great deal of training to get my legs and lower body toned so I don't look too thin; now I am working on my upper body ( a bit harder) to build some muscle so I don't look so thin. I generally wear fitted pants with a heavy sweater (luckily it's winter) with a vest to add some bulk up top.

Consult with a nutritionist if you don't think your doctor is listening; most doctors do not get much training in nutrition. I was told that my amount of weight loss was pretty extreme based on the relatively low dose that I am on, but I tend to be very active and have a high metabolism. Monitor your weight regularly, and definitely let the doctor know if you think you are losing too much weight on the medicine.

In my case it's a hard call. I know I've probably lost too much weight, but I am in the middle of a job hunt and am doing lots of driving to various interviews since the job market is not very good in my area and I do not want to mess with my medications at this point and end up possibly having another tonic-clonic seizure at this point. I've discussed it with my neurologist and he is also reluctant to drop the dosage of the Topiramate right now...I'll wait until things are more settled in my life to work on the dosage reduction.

Good luck to you.

Re: Topiramate and Weight Loss

Submitted by Katianna on Thu, 2010-12-30 - 16:10
Right now, I have gotten resistance from my neuro regarding my concerns about my weight. Apparently he does not think it's an issue if I become a super skinny. But for me to be under-weight, it is. I have set my bottom weight number at 120 and if I hit that number, I am going to make him see me and address this because it will put me under what my weight should be. So I went ahead and spoke to my GP today... and even she was a little shocked about my loss. I go get weighed in on their fancy digital scales tomorrow and find out how much I've lost to the tenth of a pound in about 8 hours.. (yes it's 3:37am and I am having a bout of insomnia.) I have an appointment to meet with a nutritionist from my GP's office at GNC tomorrow and I have undergone a diet change with more veggies and fruits, including slushies and smoothies. The nutritionist actually thinks I should go on a weight gainer shake once a day (breakfast) to see if that makes any difference in balancing out the effects of the medication. From that point if that does not work, they will up the gainer shakes to more than once a day. I guess the weight loss would be ok with me, if I felt that it was healthy for me to be this size. My friend told me that I should be happy that I am this weight but I am not because I know that it is unhealthy for me. Does that make any sense? I look in the mirror and I can see my ribs. I can see a lot of my collar bone. One friend told me I was making a mountain out of a molehill. Am I? I really don't think I am. My goal is just to be healthy. I don't want to be in bikini shape, or appealing to the eye. I just want to be healthy and happy. In your case, I can understand why you would let yourself be ok with being that small. I can sympathize. Any dose reduction definitely needs a bit more stability. When they were upping my dose I took it very easy and didn't do much because I knew that adjusting to the medication was going to be a trick. How did you manage to lose weight on Keppra? Any time I have heard people talk about that drug, it's always been about how it's made them blow up. Thank you for your advice and input :-) Happy New Year and Regards Kat UPDATE: Here we go.... the scale don't lie. I am at 136. And they told me that my bottom weight number should be no lower than 125. They said that I should be drinking this stuff called Pro-Complex Gainer once a day for two weeks if my weight hits 130. So I went ahead and picked some up at GNC. Also they put me on a prenatal vitamin to make sure that my vitamin levels stayed within a good range. That kind of confused me. I thought that a good multi-vitamin did the same thing?

Re: Topiramate and Weight Loss

Submitted by MinKels on Fri, 2010-12-31 - 20:20

It actually makes a lot of sense to me...I think that your concerns are valid, and that we all have a weight range we are comfortable with and feel best at. Not everyone wants to be stick thin, and personally, I would prefer to be bit more robustly built with more curves than I have naturally!

The weight gainer shakes sound like a good idea; they have helped me maintain my weight, and from what I have read of others' experiences, have actually helped them gain back some of the weight they have lost while on Topamax. If one a day doesn't do it, the nutritionist will probably up it to two per day.

I don't think you are making a mountain out of a molehill...if you are not happy with how you look/feel, it's your body and you are the one who knows it best. I can also see some collar bone and ribs (though it's usually this way) and it can be kind of disconcerting if you aren't used to it.

LOL...I have also heard many stories of how Keppra is supposed to make one gain a LOT of weight but it didn't do that to me...the neurologist was kind of suprised that I had actually lost weight on it and did say that a very small number of people lost weight on the drug and mentioned something about me having an unusal reaction to it. I must have a strange body chemistry or something because I generally don't get the side effects most people do, but instead get the odd ones...Topamax has been the only one that I have gotten the normal side effects (weight loss) from.

Interesting you mention the small weight losses during the day...my weight will fluctuate during the day, and I will actually lose a pound during the night but gain it back during the day...go figure how one loses weight while sleeping???

I hope that your nutritionist and you can work together to help you get back to a weight that you are comfortable with. I've basically been told by the doctor to not let my weight drop below 92 pounds, but I certainly don't want to get THAT skinny! The pre-natal vitamin is actually a better choice since it has much more nutrients in it, and some of the nutrients in it are said to be able to help counteract some of the side effects of the Topamax...so stick with the pre-natal vitamin, even if you aren't pregnant or planning on it.

Good luck with everything...I am glad you are working with a nutritionist and your doctor. Happy New Year!

It actually makes a lot of sense to me...I think that your concerns are valid, and that we all have a weight range we are comfortable with and feel best at. Not everyone wants to be stick thin, and personally, I would prefer to be bit more robustly built with more curves than I have naturally!

The weight gainer shakes sound like a good idea; they have helped me maintain my weight, and from what I have read of others' experiences, have actually helped them gain back some of the weight they have lost while on Topamax. If one a day doesn't do it, the nutritionist will probably up it to two per day.

I don't think you are making a mountain out of a molehill...if you are not happy with how you look/feel, it's your body and you are the one who knows it best. I can also see some collar bone and ribs (though it's usually this way) and it can be kind of disconcerting if you aren't used to it.

LOL...I have also heard many stories of how Keppra is supposed to make one gain a LOT of weight but it didn't do that to me...the neurologist was kind of suprised that I had actually lost weight on it and did say that a very small number of people lost weight on the drug and mentioned something about me having an unusal reaction to it. I must have a strange body chemistry or something because I generally don't get the side effects most people do, but instead get the odd ones...Topamax has been the only one that I have gotten the normal side effects (weight loss) from.

Interesting you mention the small weight losses during the day...my weight will fluctuate during the day, and I will actually lose a pound during the night but gain it back during the day...go figure how one loses weight while sleeping???

I hope that your nutritionist and you can work together to help you get back to a weight that you are comfortable with. I've basically been told by the doctor to not let my weight drop below 92 pounds, but I certainly don't want to get THAT skinny! The pre-natal vitamin is actually a better choice since it has much more nutrients in it, and some of the nutrients in it are said to be able to help counteract some of the side effects of the Topamax...so stick with the pre-natal vitamin, even if you aren't pregnant or planning on it.

Good luck with everything...I am glad you are working with a nutritionist and your doctor. Happy New Year!

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