Drug-induced obesity

• the potential for iatrogenic weight gain is more common than is generally appreciated
• Drug-induced obesity may result from therapeutic use of:
  • corticosteroids
    • have potent weight-promoting actions, particularly at higher doses
    • the characteristic alteration of body composition is accompanied by insulin resistance
  • psychotropic drugs
    • many psychotropic drugs are associated with weight gain - has more recently been highlighted as a concern with atypical antipsychotics such as olanzapine and clozapine
    • risks of excessive weight gain and the development of the metabolic syndrome call for careful monitoring
  • anti-retroviral agents
    • nucleoside reverse transcriptase inhibitors, e.g stavudine and zidovudine promote central adiposity, as well as subcutaneous lipoatrophy
  • thiazolidinediones
    • agonists for peroxisome proliferator-activated receptor-gamma e.g. pioglitazone
      • reduce insulin resistance and can improve a range of cardiovascular risk factors in people with type 2 diabetes
      • weight gain averaging 3-4 kg is common during the first few months of thiazolidinedione therapy, tending to stabilise thereafter

Reference:

1. Van Gaal L. Drug-induced obesity and its metabolic consequences: a review with a focus on mechanisms and possible therapeutic options. J Endocrinol Invest. 2017 Nov;40(11):1165-1174.