Sources: loss weight
“We saw a significant increase in body mass index (BMI) over two years for the surgical group, but not the control group,” says Zeni, a research assistant professor at UD. “Sixty-six percent of the people in the surgical group gained weight over the two years — the average weight gain was 14 pounds.”
Those who had the knee replacement surgery started out heavier and ended heavier than the control group. The weaker the surgery patients were, as measured by the strength of the quadriceps, the more weight they gained, Zeni notes.
“These findings are making us re-think the component after total knee surgery and of patients not being in a routine of moving around,” says Snyder-Mackler, Alumni Distinguished Professor of Physical Therapy at UD.
She notes that it's critical that people not wait too long to have a knee replaced because their functional level going into surgery typically dictates their functional level after surgery.
Gaining weight after one knee replacement is worrisome because it could jeopardize the patient's other knee. Between 35-50 percent will have surgery on the other side within 10 years, Snyder-Mackler says.
The researchers note that weight gain after a knee replacement needs to be treated as a separate concern and integrated into post-operative care through a combination of approaches, including nutritional counseling to help patients with portion control, and more emphasis on retraining patients with new knees to walk normally.
“For physical therapists and surgeons, the common thinking is that after a patient's knee has been replaced, that patient will be more active,” says Snyder-Mackler. “But the practices and habits these patients developed to get around in the years prior to surgery are hard to break, and often they don't take advantage of the functional gain once they get a new knee,” she notes.
“We need to re-train patients with new knees to walk more normally and more systematically. And we need to encourage more community participation,” Snyder-Mackler adds. “If you're not getting out of the house, you won't gain the benefit. We need people with new knees to get out there — with the help of their family, their friends, and the community at large.”
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Taking medication for depression sounds like it would be a cure. End the depression and the person feels better. Unfortunately one of the side effects of these medications can cause a patient to gain 10 or more pounds. If the person was overweight to start with this can endanger their health and cause a person to fall back into being depressed.
The drugs that are known to cause weight gain are: SSRI's (selective serotonin reuptake inhibitor like Prozac, Paxil, Zoloft and Lexapro), tricylics (for example Elavil and Tofranil) and MAO inhibitors (monoamine inhibitors such as Parnate and Nardil).
Dr. Norman Sussman Associate Dean for Postgraduate Programs at The New York University School of Medicine and a Psychiatrist believes that in at least some patients a metabolic and appetite affect may be taking place. “I have had patients who swear that they are not eating any more, but still gaining weight, so that tells us there is some kind of metabolic influence going on; I have also had patients tell me that they are not only more hungry and eating more, but that the medicines are encouraging a carbohydrate craving that is hard to control, so we know appetite also plays a role.”
There is a suggestion by Dr. Jack E. Fincham, PhD, RPh, Professor of Pharmacy Practice at the School of Pharmacy at the University of Missouri at Kansas City that the patient starts to feel better and hit comfort food because it's associated with feeling better, thus creating weight gain.
Switching medications may help with weight gain but not with the patient's depression. Only a licensed physician should make that decision, and patients should discuss their concerns over weight gain with their doctor and the possibility of changing their medication.
The leading suggestion by medical experts in the field of treating depression is a healthy well-balanced diet and exercise. It has long been known that people who exercise regularly have less stress, anger and depression.
Still, there does seem to be a small group of people who have changed their medications, eat a healthy diet and exercise without any change to their weight. In that case, Dr. Sussman suggests making the treatment for the depression a priority. The patient has to realize that they aren't responsible for the weight gain. Once the depression is over the patient's diet and exercise will help stabilize their weight at a healthy level.
Source: Colette Bouchez, “Fat Pharms: Antidepressants and Weight Gain.” Web MD