"별로 먹지 않는데... 체중이..", "믹스커피는 하루에 5잔" - 동대문구 답십리, 전농동, 우리안애 우리안愛 내과
- Byoung-Yeon Jun
- 1일 전
- 4분 분량
상기 환자
정기 평가 중 당화혈색소는 변화가 없으나 당뇨 기준의 한끗차이, 24년과 같으며...
D306300HZ | Hemoglobin A1c | ** | | | ** |
| HbA1c-NGSP | 6.4 | | 정상 ≤ 5.6 % 당뇨병전단계 5.7-6.4 % 당뇨 ≥ 6.5 % | 6.4 |
(D3022) | Glucose(공단) | 108 | H | 정상A < 100 mg/dL 정상B(경계) 100-125 질환의심 ≥ 126 | - |
체중은 한번은 주는 경향이어서 격려하였으나..
24년 9월
이후에 다시 늘고 있다. 25년 3월
25년 8월 직전과는 유사하나 조금 늘었고..
"2017년도에는 70 kg이었다."
그 해 이후로 정신과약 복용중인데 (오전에는 9알?)
"정신과 선생님은 살찌는 약은 없다고 한다."
그렇게 잘라 말할거 까지야..
A majority (대부분의) of psychiatric medications are known to generate weight gain (체중증가) and ultimately obesity in some patients. There is much speculation about the prevalence of weight gain and the degree of weight gain during acute and longitudinal treatment with these agents. There is newer literature looking at the aetiology of this weight gain and the potential treatments being used to alleviate this side-effect. We found solid evidence that weight gain is often associated with the mood stabilizers, and antipsychotics and antidepressants. Only few weight neutral or weight loss producing psychotropics are available, and weight gain, outside of an immediate side-effect, may generate secondary side-effects and medical comorbidity. Weight gain may cause hypertension, diabetes, osteoarthritis, sedentary lifestyle, coronary artery disease, etc. Given the likelihood of inducing weight gain with psychotropic medications and the longitudinal impact on physical health, a thorough literature review is warranted to determine the epidemiology, aetiology and treatment options of psychotropic-induced weight gain.
이런 고민을 하는 것이 바람직
Why do antidepressants cause weight changes? 왜 항우울제가 체중변화를 일으키는가?
All of these medications increase serotonin levels in the brain. Serotonin regulates mood and affects appetite, yet this can have varying results depending on length of treatment. Short-term use reduces impulsivity and increases satiety, which can reduce food intake and cause weight loss. However, long-term use (longer than a year) can cause downregulation of serotonin receptors, which subsequently causes cravings for carbohydrate-rich foods such as bread, pasta, and sweets that ultimately may lead to weight gain. The antidepressants with the highest risk of causing weight gain are amitriptyline, citalopram, mirtazapine, nortriptyline, trimipramine, paroxetine, and phenelzine.
Why do antipsychotic medications worsen obesity-related diseases? 왜 항정신병약제가 비만관련 질환을 악화시키는가?
Antipsychotics can also be categorized into two classes: typical and atypical antipsychotics. Both classes can cause weight gain, but they differ in that atypical antipsychotics cause fewer movement disorder side effects. Like antidepressants, antipsychotics affect the chemical messengers in the brain associated with appetite control and energy metabolism, namely serotonin, dopamine, histamine, and muscarinic receptors. In addition to causing weight gain, antipsychotics can also impair glucose metabolism, increase cholesterol and triglyceride levels, and cause hypertension, all of which can lead to metabolic syndrome and worsen obesity-related diseases. The antipsychotics most likely to cause weight gain are olanzapine, risperidone, and quetiapine.
What about anti-anxiety medications and weight changes? 항불안제와 체중과의 관계는?
There is no clear link between traditional anti-anxiety medications such as benzodiazepines and weight gain (항불안제와의 연관은 없지만). However, many antidepressants are also used for the treatment of anxiety, and may cause weight gain as discussed above. (많은 경우 항우울제가 같이 쓰인다면..)
Similarly, not all medications for sleep cause weight gain; one that has been associated with weight gain is diphenhydramine (the active ingredient in Benadryl that is also used in many over-the-counter sleep aids). Diphenhydramine can contribute to weight gain by causing increased hunger and tiredness, which can make a person less active. Other sleep aids such as zolpidem (Ambien) or eszopiclone (Lunesta) have not been linked to weight gain.
Trazodone, a medication used for depression as well as insomnia, reduces excess serotonin at some sites, while increasing serotonin levels at other sites, thus affecting appetite as previously discussed.
Mood stabilizers are often used to treat bipolar disease, and can increase appetite or cause changes in metabolism. Although some antidepressants and antipsychotics are also used to treat bipolar disease, mood stabilizers such as lithium, valproic acid, divalproex sodium, carbamazepine, and lamotrigine are the mood stabilizers often used for treatment of bipolar disorder, and with the exception of lamotrigine, they are all known to increase the risk of weight gain.
There are effective strategies to minimize weight gain... 일반적인 내용...
25년 9월
"진짜로 밥도 별로 안먹는데..." --> 그러나! 믹스커피를 확인하였다.
작년 겨울부터면 위에 체중 패턴의 변화와 일치한다. 중단하도록 상의하였다.
전체적으로는 정신과약 배경이 있어 체중이 늘었을 수도 있는데 최근의 줄었다가 느는 모습은 5잔이나 마시는 믹스커피가 기여하지 않을지?
믹스 커피 1봉지(약 12g)에는 평균적으로 5~7g의 설탕이 들어있으며, 이는 하루 권고 당류 섭취량(성인 기준 50g)의 약 10~15%에 해당합니다. 그러나 하루에 2~3잔만 마셔도 당 섭취량이 WHO 하루 권고량의 30%를 넘을 수 있으므로, 건강을 위해서는 섭취량 조절에 유의해야 합니다.
동대문구 답십리 우리안애, 우리안愛 내과, 건강검진 클리닉 내과 전문의 전병연
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