Prior to beginning psych meds, my weight had been steady at 185 for about 8 years without any significant effort to watch what I ate.

A month or two after my first manic episode, I started to become seriously depressed, and began antidepressants. This was the first time I ever tried any psych med.

I was immediately starving. It was like night and day. I constantly ate candy bars from the vending machines at work and put on ten or twenty pounds right away.

Nearly all psych meds cause weight gain. Shrinks usually don't mention that a med causes weight gain. It's a big deal if one doesn't, and shrinks are more likely to mention that.

The mood stabilizer Topamax doesn't cause much weight gain, but it makes you really stupid. The antidepressant Wellbutrin doesn't cause much weight gain (the drug maker named it that because it's supposed to sound like "well, but trim"), but it can cause epileptic seizures if you drink alcohol while you're on it.

The antipsychotic Zyprexa causes 100 pounds of weight gain on 25% of the people who take it. I think the other 75% don't experience any significant weight gain. I've heard of cases of shrinks prescribing it to people without even warning them to be on guard for that little side effect.

Anyone who is on psych meds should own a bathroom scale and keep a weight log. Ideally record your weight, with the date, in a spreadsheet so you can track it later and plot it out. Weight loss apps (discussed later) can also help you with this.

After I'd been on lithium for a couple of years, I was about 35% overweight, which is how I've spent most of my life. Switching to Geodon (Ziprasidone) and Depakote (Vaproate) made no difference.

A couple of times, I've gone on Lamictal (Lamotrigine) which doesn't cause a lot of weight gain, and started going off my Valproate. During this time, I would be very rapidly losing weight, like 5 pounds per week, with no effort whatsoever. Both times I found the Lamictal to be unhelpful and went off it, went back on the Valproate, and the weight immediately came right back on.

Another time I tried reducing my Valproate dose just to see how little I could get by on. During this time I would experience rapid weight loss with no effort to watch what I ate. Then I found myself getting a little manic, increased the dose again, and the weight came right back on.

Some people who've never had any problem with weight in their lives are extremely judgmental about others who are overweight. I've heard people say that they don't believe that any medication causes weight gain. The fact is, the effect is so dramatic that this belief is only sustainable in a state of complete ignorance.

I've read that diets usually don't work. The person puts a tremendous amount of effort into watching what they eat for several months, succeeds at losing some weight, achieves their goal, and then the effort winds up being unsustainable, so they go off the diet and the weight eventually comes right back on. That's happened to me a couple of times.

In 1994, I did Weight Watchers and lost 40 pounds, but Weight Watchers is difficult. At the time they had books that you bought from them that gave a certain number of "points" to everything you might want to eat. Everything you ate, you had to add the points up. All day long you had to keep a tally, either in writing or in your head, of how many "points" you had remaining in the day. To make matters worse, there were different types of points, so you had to keep three numbers in your head all day long.

I did succeed in losing 40 pounts and was proud of myself. However, I eventually went off the diet, and the weight came right back.

I remember in 2003, I had been unemployed for over a year, and I applied for health insurance. At the time, California had a deal where if you were turned down for health insurance as "uninsurable", the state would make insurance companies insure you. But, you had to go through the formality of being rejected first.

Since I had been unemployed for a year, my health insurance through my previous employer had expired. I applied for new health insurance. I was rejected for two reasons -- being bipolar and my weight of 255 lbs. I was like "Holy cow! I'm so overweight that I'm uninsurable!" I'd been expecting to be turned down because I was bipolar, but turned down because of my weight was news. Around the same time, I also perceived myself to have been turned down for a job because I was so overweight. So I was thinking "Not only can't I get a girlfriend because I'm overweight, I can't even get a job either!"

I went on Weight Watchers again. This time I just went to one meeting and bought the books, and I decided to just translate the "points" to calories, and go by the labels on all the food in the supermarket.

Soon afterward, I got a job, but I kept at the diet, and was jogging every evening.

I eventually lost 40 pounds, but losing weight was a huge, constant effort.

I met a woman on Match.com, and before dating, we had a phone call. She wanted to know what was going on in my life. It turned out that I didn't have much going on in my life. I was just working very hard, and dieting, and jogging. I could visualize the gears turning in her head "This guy has no life. I don't want to date him." And, yes, she didn't date me.

So I stopped focusing so much on losing weight, and tried to focus more on getting a life. Eventually the weight came back.

In 2015, I decided to have another go at losing weight. I went to a Weight Watchers meeting and bought the books. Each diet, when I went back to Weight Watchers, they'd changed the system. This time it was really hard to translate their point system into calorie counting.

I started looking for a calorie counting website. I quickly found http://caloriecount.com which was fine. Unfortunately, after I had lost weight with it, they changed it so that it was no longer useful for counting calories. But there are plenty of calorie counters out there that are fine. Another one that I've used is http://myfitnesspal.com. MyFitnessPal isn't ideal, because they insist on tracking not only calories, but other nutrients that I'm not interested in hearing about that just complicate things. But there are plenty of websites and apps to choose from.

Both CalorieCount and MyFitnessPal had apps for the iPad and iPhone, as well as a website accessible from a desktop. That made counting calories much easier, because you no longer had to keep a running tally in your head all day.

Another advantage of the apps I used is that they're Wikis. Anybody can put a food into the database, so when you look up a type of food, you get a lot of estimates from different people of how many calories it has. You just take one that's in the middle. A huge problem with Weight Watchers was when you wanted to eat something that wasn't in the books. Then, you didn't know how many points it was.

The apps typically have the ability to save your favorite meals so you don't have to enter every aspect of the meal individually again. This is especially helpful for lunch.

With MyFitnessPal, to save a meal, you have to specify every food that went into it. This was annoying, since all I wanted to do was enter a number of calories. So for all my favorite meals, I just describe them as a certain number of slices of bread that adds up to the right number of calories. Then I can name the meal anything I want.

Somehow, losing weight this time was way easier than before. In the first few months I identified foods that I wasn't really that crazy about that were a lot of calories and eliminated them from my diet. Painless.

For my height of 6'2" I was entitled to about 1700 calories per day while losing weight. I would have about 400 calories per meal for breakfast (don't skip breakfast), lunch, and dinner. This left 500 calories in the day for snacks. I found a lot of snacks that would be about 100 calories or less apiece. Fruit is great, a piece of fruit is about 70 calories. I bought a gram scale and would weight out 16 grams of nuts for a snack, which is 100 calories. And watermelon is God's gift to a dieter -- you can eat 1/3 of a kilogram of watermelon and it's only about 100 calories -- it's basically air, water and a very small amount of sugar. it's really filling and tastes great.

So, the typical day consisted of the three main meals during the day and a bunch of 100 calorie snacks in the evening to keep the hunger pangs at bay.

While in the first 2 diets I was hungry a lot, this time I wasn't feeling hungry very much at all. I was losing a pound or two per week, sustained over months.

My Weight History

My weight from about 2005 until 2020. The spike downward in 2005 was when I was experimenting to see how little Depakote I could get by on. I don't remember why I lost weight in about 2007. The weight loss in 2011 was when I was trying Lamictal and reducing my Depakote, and the weight came back after I concluded that Lamictal didn't work for me and resumed the Depakote.

The dramatic weight loss in 2015 was dieting based on computer calorie counting apps. The really remarkable thing about this weight loss was that I wasn't hungry at the time. I had to buy new pants, reducing my waist measurement from 40" to 36".

Afterward I quit putting so much effort into it, quitting counting calories altogether. Some, but not most, of the weight came back. I still wear 36" pants, though.

One social activity I do a lot of is going on group hikes. There was a woman I met in 2011, I had her last name and her email address, but it was fairly clear she wasn't very interested and I didn't pursue her.

After I'd lost about 60 pounds in 2015 I ran into her again on a hike. She hadn't seen me in years. The first thing she said when she laid eyes on me was "You've lost weight." She walked next to me on the hike, and sat next to me at dinner afterward. We started dating, and now she's my wife.