Published Jan 26, 2026 | 7:00 AM ⚊ Updated Jan 26, 2026 | 7:00 AM
Close up of man's hand who is taking pills. (iStock)
Synopsis: From antipsychotics prescribed for schizophrenia to steroids for inflammation, a surprising range of popular medications list weight gain as a side effect. The key is recognising which drugs pose the highest risk, understanding realistic weight-gain expectations, and working proactively with your physician to minimise harm while maintaining treatment efficacy.
Last month, Rajesh, a 45-year-old Chartered Accountant from Hyderabad, noticed something troubling. Despite maintaining his usual diet and exercise routine, he’d gained aroung eight kilogram in four months. His doctor had recently prescribed olanzapine for bipolar disorder. “I felt like my body had betrayed me,” Rajesh recalled. “I was taking medicine to get better, but it seemed to make things worse.”
Rajesh’s story is far more common than most people realise. Across India’s hospitals and clinics, a silent problem is unfolding — one where the very medicines designed to heal us in one context end up causing weight gain without our being aware of it.
From antipsychotics prescribed for schizophrenia to steroids for inflammation, a surprising range of popular medications list weight gain as a side effect. Some are far more problematic than others.
Doctors have long known that certain medications cause weight gain, but patients often remain in the dark. Consider prednisone, a corticosteroid prescribed millions of times annually in India for everything from severe allergies to autoimmune diseases.
About 70 percent of patients on long-term prednisone therapy gain weight — some dramatically. A patient on low-dose prednisone for asthma might gain 3.5–4.5 kg over two years without an apparent reason.
“The issue is that weight gain becomes an additional burden on patients already struggling with their primary condition,” explained a well-known endocrinologist in Bengaluru. “A diabetic patient taking insulin to control blood sugar is paradoxically battling weight gain from the same insulin. It’s deeply frustrating for both patient and doctor.”
The mechanisms vary. Some drugs increase appetite. Others slow down metabolism. A few directly promote fat storage. Understanding which medications are culprits — and how much weight they typically cause — can help patients make informed decisions with their doctors.
The underlying mechanisms are complex but fascinating. Antipsychotics like olanzapine don’t just treat brain chemistry — they simultaneously trigger appetite centres and slow down metabolism. Corticosteroids mimic stress hormones that stimulate hunger and promote fat storage. Antihistamines block signals that normally suppress appetite.
For Sonia, a 38-year-old teacher with severe asthma, the solution came through collaboration with her doctor. “I was on prednisone 10 mg daily, and gaining weight felt unavoidable,” she said. “My doctor switched me to lower doses on alternate days — 5 mg every other day instead of daily. I still get the asthma control, but the weight gain stopped.”
This illustrates a key strategy: Dose optimisation. Lower doses often cause less weight gain. For some conditions, switching to a weight-neutral alternative within the same drug class helps. For diabetics on weight-gaining insulin, newer GLP-1 (glucagon-like peptide-1) drugs actually promote weight loss while controlling blood sugar.
Additional approaches include:
Taking medications shouldn’t mean accepting inevitable weight gain. Most patients don’t realise they have options. The key is recognising which drugs pose the highest risk, understanding realistic weight-gain expectations, and working proactively with your physician to minimise harm while maintaining treatment efficacy.
“The goal isn’t to stop taking necessary medications,” the endocrinologist emphasises. “It’s to make informed choices and manage the side effects thoughtfully. Many patients suffer in silence when solutions exist.”
For patients like Rajesh and Sonia, this approach has made all the difference — treating disease without sacrificing metabolic health.
The conversation about medication-induced weight gain deserves far more attention than it currently receives in India’s healthcare system. Start by asking your doctor. You might be surprised at what options exist.
(Edited by Muhammed Fazil.)
