Environmental Agents

Intrauterine Factors

Several intrauterine events influence postnatal weight and lifetime weight gain and fatness [10]. These include, among other things, maternal weight gain, maternal diabetes, maternal smoking, and intrauterine undernutrition, all of which heighten the individual’s risk for increased body weight and diabetes later in life.

Drug-Induced Weight Gain

In our current medicated society, it would not be surprising to find that drugs can cause weight gain. Table 8.1 is a list of medications that produce weight gain when used to treat various diseases such as psychosis, depression, allergies, and diabetes. Also listed in the table are alternative treatments that can be used to avoid the weight gain. In most instances, there are alternative strategies that can be used to treat a patient when weight gain is closely associated with the initiation of a new medication for one of these conditions. Several receptors, especially the histamine Hb adrenergic aJA, and serotonin (5-HT)-2C and -6 (5-HT2C and 5-HT6) receptors, explain much of the weight gain associated with atypical antipsychotic drugs (see [2]).

Table 8.1 Drugs that produce weight gain and alternatives

Category

Drugs that cause weight gain

Possible alternatives

Neuroleptics

Antidepressants

Thioridazine, olanzapine, quetiapine, risperidone, clozapine

Amitriptyline, nortriptyline

Molindone

Haloperidol

Ziprasidone

Protriptyline

Tricyclics

Imipramine

Bupropion

Monoamine oxidase inhibitors

Mirtazapine

Nefazodone

Selective serotonin reuptake inhibitors

Paroxetine

Fluoxetine

Sertraline

Anticonvulsants

Valproate, carbamazepine Gabapentin

Topiramate

Lamotrigine

Zonisamide

Antidiabetic drugs

Insulin

Sulfonylureas

Thiazolidinediones

Acarbose

Miglitol

Metformin

Sibutramine

Antiserotonin

Pizotifen

Antihistamines

Cyproheptidine

Inhalers

Decongestants

P-Adrenergic blockers

Propranolol

ACE inhibitors

a-Adrenergic blockers

Terazosin

Calcium channel blockers

Steroid hormones

Contraceptives Glucocorticoids Progestational steroids

Barrier methods

Nonsteroidal anti-inflammatory agents

 
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