Amy writes:
In general, I have had extremely good experiences with my doctors. I
have numerous medical issues, and neither my GP, nor my gynaecologist, orthopedic surgeon, podiatrist or dermatologist have ever tried to blame a problem on my weight. I think I have been really lucky.
However, a few years ago I was suffering from pretty bad depression,
and had just broken up with my boyfriend. I’d been on Prozac for a
while, but it was having some unpleasant side effects, and had seemed to have stopped working. My psychologist recommended that I see a psychiatrist to get the medication adjusted to one that was better suited to me. She sent me to someone who had a practice just a few streets away from hers.
I don’t think I spent more than 10 minutes explaining what was going
on in my life, before he began with the fat hate. The first clue I
had, and it should have sent me running from his office, was that the
chair in his office was so small that I barely fit in it. I wear a UK
16/18, and I don’t usually have any trouble fitting in chairs – not
even airplane seats!
Basically he felt that all of my psychological problems were caused by
being fat, and that if I just lost the weight then all my problems
would be solved. I guess he never heard of the Fantasy of Being
Thin… He changed my medication to Zoloft, which is supposed to cause weight loss (it didn’t) and then told me that if I didn’t lose weight fast enough then I could come back to him and he would prescribe Topamax!
I have a friend who was taking Topamax at the time – an epilepsy drug – for migraines. Her side effects were pretty severe, and she lost so much weight (she was thin to start off with) that people kept asking her if she had cancer or something. Here are just some of the lovely side effects of Topamax: pins and needles in the fingers and toes, dizziness, lowered sense of feeling in the skin, difficulty with
language, nausea, diarrhea, forgetfulness, difficulty with
concentration or attention, difficulty in sleeping (insomnia),
anxiety, mood swings, depression, changes in taste and vision
disorders.
At the time, I just sat there and nodded and cried, and believed him.
Luckily for me, my mother recognises bullshit when she hears it, and
managed to convince me that he was full of it. Needless to say, I
never went back to him. I’m still furious with him. If I hadn’t been
in such a fragile state of mind I would have stood up and decked the
man. I wish that I had reported him for malpractice.
First, Do No Harm 
Lap
/ July 3, 2009Some people use prozac against depression but you must be sure about that medicine!
Catgal
/ July 3, 2009I think one of the main problems of this situation is that when you are seeing a doctor you (usually) don’t feel well. Nodding and crying in the psychiatrists office is probably not unusual. What was unusual is that you were vulnerable, and when you feel like that from depression, a chronic illness or just plain not feeling well, you (or at least I am) less likely to stand up for yourself, to fight, sometimes it seems not worth the effort, but they you look back on it you feel angry and or taken advantage of. I am glad that you never went back to this doctor!
Amananta
/ July 3, 2009I gained 70 pounds on Zoloft. It isn’t a weight loss drug… not that weight loss drugs have ever ben shown to be safe even if it were.
Stupid doctor.
Michelle
/ July 3, 2009My husband has taken Topamax for migraines, and the idea of using it just for weight loss makes me cringe.
You’re not alone in the experience that Zoloft doesn’t cause weight loss. It didn’t make my weight skyrocket like Paxil did, but that’s about all I can say for it, as far as weight is concerned.
G.
/ September 10, 2012So, why in my case, Effexor made me LOSE weight instead of GAINING weight ? Why on the earth some people do lose weight on AD and other people gain ?
Why such a difference ?
As dumb question as it is…
(at least, Ritalin has a pretty known side effect to suppress appetite. I managed to avoid weight loss and I am not a thick stick)
GR
/ July 3, 2009I am so sorry to hear about your horrible experience! As a fat woman myself, I know and dread the feeling.
I would like to point out though, that different people can have really different reactions to drugs – I take Topomax (as a mood stablizer; I also take antidepressants) and I have pretty much no side effects (which is usually how my body reacts to drugs). Small does of antidepressants which I would barely notice have been enough to make friends massively ill or uncomfortable when prescribed to them. You just can’t tell – which is one of the many reasons you need a good doctor, not idiots like this. Glad to hear you feel better despite him.
Electrogirl
/ July 4, 2009Wow. I would ask how that guy ever got his degree in psychiatry, if I didn’t already know that the medical community has branded fat with the Number of the Beast. Still, a fat-phobic psychiatrist… that is really low. As Catgal said, most of the time people are vulnerable when they go to see a psychiatrist or psychologist. A competent professional knows this and takes pains to avoid kicking his patients while they’re down. Good for you for not going back.
For anyone wondering about Topamax, I have epilepsy and I have taken it. I couldn’t focus and my short-term memory was shot to Hades. It did suppress my appetite, and I did lose weight, mainly due to the fact that my mom constantly had to remind me to eat. Doctors recommending potent mind-affecting drugs for weight loss is so wrong on so many levels.
Piffle
/ July 4, 2009My husband takes Topomax for migraines, and the side-effects are not trivial; plus it made no difference in his weight.
It certainly should not be a first line drug for depression, trying several SSRI’s or Wellbutrin is a much more reasonable approach. I hope that you found help for your depression.
meowser
/ July 4, 2009Topamax is a wonder drug for some people — particularly people who have absence/petit mal seizures — and a frigging nightmare for others. It should NOT be prescribed off-label for weight loss, and it’s not an antidepressant, either.
Zoloft caused a 10-pound weight loss in the first year I took it — and a 70-pound GAIN in the six following years I took it. Nobody associated the drug (or any chemically similar drugs) with weight gain then and assumed I must have had an evil potato-chip-destroying twin I wasn’t copping to. My weight started dropping when I went off antidepressants, but I wasn’t getting any happier, believe me. In fact, you wouldn’t believe how much not-happier I was getting. (Not that these drugs work for everyone or should be taken by everyone who’s depressed, but the people they work for, they work for.)
QueenAeron
/ July 4, 2009I was given Topamax as a mood stabilizer and to help me lose weight. It did neither. I ended up gaining around 10 or so pounds from the bags Reese’s Christmas Trees and Valentine Hearts I was eating. The minute I went back to Gabapentin, my eating restablized. I didn’t have any of those side effects, but soda tasted flat.
Zoloft is my security blanket AD. It always works. Maybe not perfectly, but when nothing else does, it will blunt the depression.
Right now I’m on small doses of Effexor and Gabapetin and I’ve never been happier. My psychologist and I just had a huge fight about whether or not I should lose weight. She hasn’t read HAES, but she willing to work with me on this. I’m reading Overcoming Overeating, HAES and The Mindway Way through Depression and it’s like the clouds have parted, the angels are singing and I’m finally understanding why life is worth living.
lilacsigil
/ July 4, 2009Zoloft to *lose* weight? What? It does suppress appetite in the short-term in some people, but in the vast majority of people, it causes weight gain.
If I hadn’t been
in such a fragile state of mind I would have stood up and decked the
man.
If you hadn’t been sick, you wouldn’t have been there at all – don’t blame yourself for having an illness. Praise yourself for knowing better than to listen to him.
Catgal
/ July 4, 2009I was prescribed Topomax by my OBGYN when I was in my 20’s and I didn’t like the way it made me feel, so I stopped taking it. Also, I didn’t lose any weight. I had no idea how wrong that was at the time…
Lindsay
/ July 5, 2009Like the other commenters, I’d never heard of Zoloft making people lose weight — instead, like most SSRIs, it seems more often to make people gain weight.
Whichever it does, the important part is whether it makes your depression go away!
(I also worry very much about that doctor’s other patients. Can you imagine what might happen if someone wandered into his office seeking help for depression, but also having a predisposition toward perfectionism or a history of eating disorders? This guy would probably trigger a relapse!!
All your problems will be solved if you just lose enough weight — yeesh! And I thought psychiatrists were supposed to be *realistic* about these things!)
Elle
/ July 10, 2009I must chime in with my outrage at Topamax being prescribed off-label as a weight-loss drug. Like others here, I have taken it for migraine prevention, and while it was initially very effective (for the first year or two), the side effects of brain fog and mild aphasia are professionally and personally frustrating. I did lose my appetite, and therefore some weight, the first half-year or so I was on it, but it horrifies me to learn of psychiatrists *prescribing* it for weight loss. Everyone responds differently to medications, and for some with seizure disorders or migraines, it can be miraculous, but it is NOT a diet drug. It actually stopped being effective for my migraines after a couple of years, and I am currently tapering off it.
Since the experience you report here was a few years ago, I’m assuming you’ve since found an ethical, responsible doctor who was able to treat your depression.
Jenny Rose
/ July 10, 2009Lose weight, feel great? I totally believed that. Of course I had a major ED. This guy is sicker than I ever was. I am so glad you are not seeing, er paying him for more abuse!
Amy
/ July 13, 2009Thanks everyone for your supportive messages!
Yes, I did see a better doctor after that, and I’ve been off the anti-depressants for about 6 months now, and i’m feeling great.
My friend who took Topamax for migraines still has her migraines, and put back all the weight and more (although she is still slim). She is now worried that it might have permanently damaged her metabolism.
I’m actually seeing an endocrinologist tomorrow, to try to decipher what has actually going on for the past few years – I know I have insulin resistance, and possibly other hormonal issues. I’m terrified that she’s just going to tell me I’m too fat and that it will all go away if I lose weight. Holding thumbs!
Bumerry
/ July 18, 2009Amy, there’s no statute of limitations on malpractice reporting. I BEG you to report this psychiatrist.
The same abuse and inappropriate Topomax prescription happened to me. I reported the doctors. They were called on the carpet (not that the arrogant bastards care, but their employers MUST be made aware of misconduct. What if someone needs to sue him? Your misconduct report would help!