How Lithium Impacts Body Weight
Lithium is an effective medication prescribed to stabilize mood and reduce symptoms of bipolar disorder. However, like all drugs, it can cause certain side effects. Weight gain is a common concern among people taking lithium.
Research shows that lithium may influence weight in several ways. But results vary across studies regarding the severity and likelihood of clinically significant weight changes.
Here we review lithiums therapeutic effects and discuss what research reveals about its complex weight-related side effects.
Lithium for Bipolar Disorder Treatment
Lithium salts have been used to treat bipolar disorder for over 50 years. This mineral acts on the central nervous system, but its exact mechanism of mood stabilization is unknown.
By controlling mood highs and lows, lithium reduces recurrences of manic and depressive episodes in people with bipolar disorder. It may also help prevent suicide.
Regular blood tests are required during lithium treatment to ensure safe drug levels since high amounts can cause serious toxicity.
Short-Term Effects on Appetite and Weight
Appetite changes are among lithiums early side effects observed within the first few weeks of starting treatment. Both increased and decreased hunger and eating have been reported.
Some people temporarily gain or lose a few pounds during this initial adjustment period. Your body generally adapts over a month or two, resolving these short-term appetite effects in most cases.
Risk of Longer-Term Weight Gain
While sometimes transitory at first, research indicates that lithium also poses a risk of gradual weight gain over months to years of use. Multiple studies have aimed to quantify lithium-related weight changes compared to placebo and other mood-stabilizing drugs.
In a 2018 meta-analysis combining results from 17 qualifying trials with at least a year follow up, researchers found that nearly 55% of lithium-treated adults gained weight long-term. The average increase was approximately 9 pounds compared to placebo.
Proposed Causes of Weight Gain
Scientists are still working to understand the mechanisms behind lithiums delayed effects on body weight. Proposed explanations include:
- Altered thyroid hormone balance - Lithium may disrupt thyroid function in some individuals. Since thyroid hormones regulate metabolism, this effect could reduce energy expenditure causing weight gain over time.
- Kidney changes Long-term lithium treatment negatively impacts kidney function for some people. This may contribute to fluid retention or salt imbalance, potentially increasing body weight.
- Shifted metabolism Research shows lithium can significantly lower basal metabolic rate compared to other psychiatric medications and normal controls without disorder. A slowed metabolism means fewer daily calories are burned at rest.
Comparison with Other Mood Stabilizers
Studies comparing lithium to anticonvulsant medications also used to stabilize bipolar mood such as lamotrigine, valproate, or carbamazepine show varied results. Some indicate lithium has higher weight gain risks. Others suggest comparable effects across these maintenance treatments.
Notably, while lamotrigine may initially cause weight loss when treatment starts, ongoing use seems less likely to increase body weight over time based on current evidence.
Mitigating Lithium-Related Weight Gain
Despite its weight gain potential, lithium remains among first-line treatments for bipolar disorder. However, side effects can reduce medication adherence. Monitoring and managing weight is key for both mental and physical health.
If lithium-associated weight gain begins significantly impacting your treatment or wellness, speak to your doctor. They may recommend changing your lithium dose, adding supplemental therapy, or transitioning medications if symptoms remain stable.
The following healthy lifestyle strategies may also help promote weight stabilization over long-term lithium treatment:
Watch Calories and Portions
Consuming fewer daily calories can counteract lithiums effects on metabolism and appetite. Keeping a food journal helps increase awareness of eating habits and portion sizes. Planning nutritious lower calorie meals and snacks ahead helps control quantity and quality of daily food intake.
Choose Nutrient-Dense Foods
Emphasize fresh fruits, vegetables, whole grains, lean protein, low-fat dairy, and healthy fats from plants and fish. Limit empty calorie sources like sweets, fried foods, and sugary drinks which promote weight gain without nutritional benefits.
Stay Physically Active
Aerobic, strength training, core, and flexibility exercises help burn additional calories and regulate weight. Aim for 150+ minutes per week of moderate activities like brisk walking, swimming, or gentle cycling. Even short 10 minute daily workout sessions provide metabolic benefits without overexertion.
Prioritize Sleep
Aim for 7 to 9 hours nightly since insufficient sleep alters hunger hormones increasing calorie intake. Establish a regular sleep-wake schedule and wind-down routine to support healthy sleep quality and duration.
Consider Supplements
Nutrient deficiencies may develop with lithium treatment. Your doctor can order blood tests to check levels. Supplements like zinc, calcium, magnesium, vitamin B12, or fish oil may be warranted if low to help support metabolism and electrolyte balance.
Weighing Lithium Benefits and Weight Gain Risk
Research suggests lithium poses about a 50% chance of weight gain over longer-term treatment for bipolar symptoms. But the likelihood and degree of weight change differs across individuals based on genetics, lifestyle habits, and dosage effects.
Monitoring body mass index and waist circumference together with mental health assessments during care helps gauge each persons response. Dose adjustments or preventative measures can minimize substantial gains to balance lithiums mental health benefits and physical side effects.
Discussing all symptom management options openly with your mental health provider is key. Never stop or change prescribed lithium treatment without medical supervision.
FAQs
Does lithium cause weight gain in everyone who takes it?
No. According to research, about 55% of people who take lithium long-term gain weight. The average amount gained is around 9 pounds, but each individual responds differently. Some gain minimal weight on lithium, while a few gain significant amounts over 20-30 pounds.
Is lithium or lamotrigine more likely to cause weight gain?
Studies show lamotrigine is less likely to increase body weight long-term than lithium. Lamotrigine often initially causes weight loss when starting treatment. Lithium may alter metabolism and fluid balance in ways that promote gradual weight gain in many users.
How soon might lithium cause weight changes?
Appetite changes happen early on when starting lithium treatment, so temporary weight fluctuations occur during the first few weeks for some people. Longer-term gradual weight gain is reported over months and years due to lithium’s effects on metabolism, kidney function, and other proposed mechanisms.
What lifestyle changes can help prevent lithium weight gain?
Healthy behaviors to help minimize lithium-related weight gain include: limiting calorie intake by reducing portion sizes, choosing nutritious whole foods over empty calorie items, staying active with 150+ minutes of exercise per week, prioritizing adequate nightly sleep, and asking your doctor about helpful supplements if deficiencies exist.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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