Q:  Weight Loss - Fasting and Axid

Dear Dr. Phelps,

I have Bipolar I disorder and for a time had to go on Zyprexa. I gained 70 pounds and now I can't seem to get it off. I've tried exercize and dieting and now I'm thinking of fasting. I really want to lose this weight. I told someone I wanted to try diet pills but they said that they would make my Bipolar get bad. I have two questions :  do you think a Drug like Axid that could help? and is it safe to fast?

Dear Ms. M'
Axid and others like it, e.g. Pepcid, seem to have helped some folks with the appetite thing when they're taking Zyprexa.  If you're off it now, theoretically the Axid would be of no benefit at all.  It's supposed to block the appetite increase. 

Fasting is not at all a good way to manage weight, generally, for anyone.  It really changes how your body is operating, including how your body manages "calories in, calories out", which is of course the whole basis of weight going up or down:  when you fast, your body goes in starvation mode, and tries to hang on to every calorie it gets.  

And fasting may be a particularly bad idea in bipolar disorder, because fasting is associated with the production of epinephrine (adrenalin) that can cause symptoms to be more severe.  

So, there's got to be another way.  Raise this issue as a priority with your doctor or treatment team. 

Dr. Phelps  

Published August, 2001