Almost 11 years ago I was diagnosed with OCD. I finally—finally!—knew what was going on, and that meant I could get help. One of the first lines of defense against my intrusive thoughts was Paxil. The first few weeks were a mixed bag of effects: Dry mouth, brain “ticks,” and fatigue. I also started to feel better, sooner than I had expected. My obsessions came on less often, and with less intensity.
After a few months, I noticed something else: I had gained some weight. I knew exactly what had happened, too. Before I started on Paxil, for years and years, I suffered from anxiety-induced stomachaches. I felt nauseous every morning; my stomach dropped like a lead weight before I walked into work each day; and there weren’t many foods I could eat without feeling queasy afterward. And if I added any stress to my everyday routine, I could forget about eating much of anything for days at a time, learning to get by on bananas and yogurt.
I never thought taking an antidepressant would make the stomachaches stop. I swallowed those pills because my doctor told me they could help me stop obsessing, not because they’d give me an appetite. But, oh, did they ever. It wasn’t so much that I was suddenly hungrier than ever, it was that I could eat without regretting it. A cookie no longer made my stomach churn. Eating a big sandwich with fries no longer meant I’d be stuck at home all evening, curled up on the couch in agony. I took full advantage of this unexpected side effect, and it showed.
Five pounds was one thing. Ten was another. Thirty pounds was downright distressing. Now, granted, this all happened over many years, so I can’t blame it all on Paxil. Frustrated, I joined a gym and signed up for the cheapest weight loss program offered.
I sat down to chat with a personal trainer, telling her what I ate in a typical day and that due to my job as a proofreader and writer I was mostly sedentary. I also mentioned that I had initially gained weight after I went on Paxil.
She drew a sharp breath. “Oh, no,” she said. “That is toxic. Toxic.” She sighed heavily. “You have to go off of it.”
Dumbfounded, I said, “Okay.” I took a moment to gather my thoughts. “Well, I don’t plan to stop taking it, so can we work around it?”
“You won’t lose the weight if you don’t.”
“Well, Paxil has been shown to cause weight gain, but my doctor told me there’s no evidence that it prevents weight loss.”
“I’d be interested in seeing that study,” she said. “Wouldn’t surprise me if it was paid for by the drug manufacturer.”
“I don’t think it was just one study…”
“Do you want to lose the weight?”
“Well, yes, but I’m not just going to stop taking my medication. I have an anxiety disorder, and…”
“If we get your nutrition in line you’ll find that you won’t need it. You got that way for a reason. You weren’t eating the right foods or exercising enough. You need healthy fats and animal protein and you’ll feel better and won’t have that stress anymore.”
“I’ll definitely try all that, and I believe nutrition is important,” I said, my voice shaking. “But I won’t knock my medication—it saved my life. I was suicidal before I went on it.”
“But what about quality of life?”
I took a deep breath. “I’d rather be alive and a little overweight.”
Her version of a good quality of life included a tight, toned, and, yes, healthy body. And that’s great. But I had to ask myself that question. My quality of life is about being a relatively happy, well-rounded person—no pun intended. As with anything in life, it’s all about balance.
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