Teenage Boy, SSRI Change for Weight Gain

He is technically just barely overweight, not obese, using the BMI guidelines. Obese would be 180 or more at his height. Just don't make him too self conscious if possible.

Maybe a stupid question, but: Is his psychiatrist/prescribing doc a pediatric specialist? I ask because I know that meds are often a black box when it comes to how they'll affect someone during puberty, and if his doc has a lot of pediatric patients, they may have seen more kids do better (weight-wise, at least) on XYZ med. It might be worth finding someone who treats kids his age for a second opinion, if his current doc doesn't, so much.

If you're concerned about changing his meds since he's currently stable and they're working well for him, honestly - I would wait until he's done growing (and hormones level out) to make any decisions, 15lbs overweight isn't majorly endangering his health, particularly when its not due to a bad diet or sedentary lifestyle.

Is his psychiatrist/prescribing doc a pediatric specialist? Yes. He's been treating my son for years and has a great handle on him and knows a lot about medication. ...your son would have got the "right" medication for him from the start. He did. The Celexa works incredibly well for calming the OCD part of his brain. He's been able to access CBT and learn strategies and he hasn't had severe bad thoughts in years. His p-doc explained a few years back that puberty and the meds may bring on weight gain and it has, hence we are looking to switch meds. I do recognize that I have fear about him going off the meds because before he was medicated, he was in a very bad state and had some terrifying episodes, and I hate to think of him going through that again if it can be avoided. I don't want him to sacrifice his mental health for his weight, but like I said, if there's another med he could try...that would be good. ...is he a late bloomer? Actually he is and now that I think about it, his older sisters also put on weight first and then got taller. But they never got as disproportionate as he is, and my son's nutritionist and pediatrician have both expressed concern. Thanks for the responses and the kindness everyone is showing.

Apologies for not being on point, so feel free to flag this. Two angles to consider: "his stomach almost like he swallowed a basketball" This sounds like a bloated belly. Could he be sensitive to food? Personal anecdote: I am gluten intolerant and get this kind of weird sticking out stomach whenever there was (traces of) gluten in my food. Different foods can cause bloating for different people. Are his meds gluten& lactose free? If he's known his belly being like this for the better half of his life, he might not realize that it feels weird. About passing gas: http://www.merckmanuals.com/professional/gastrointestinal_disorders/symptoms_of_gi_disorders/gas-related_complaints.html?qt=&sc=&alt= is normal. More indicates a problem. A girl I know hoarded sweets/junk food and hid it from her family. Her diet was clean and healthy - normal sized home cooked meals every day. She also was overweight and it seemed unexplainable. Turns out she spent her entire allowance on candy. She had some mental health issues to work through and that was her way of coping. Once she started therapy the comfort/over eating got better. Could your son be eating more on occasions that you are not aware of? Good luck. Hope mefites versed on pharmaceuticals will chime in soon.

There is a well-known association between SSRIs and weight gain.http://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressants-and-weight-gain/FAQ-20058127 Weight gain is a possible side effect of nearly all antidepressants. However, each person responds to an antidepressant differently. Some people gain weight when taking a certain antidepressant, while others don't. Generally speaking, some antidepressants seem more likely to cause weight gain than others.http://www.webmd.com/depression/features/antidepressants-weight-gain Experts say that for up to 25% of people, most antidepressant medications -- including the popular SSRI (selective serotonin reuptake inhibitor) drugs like Lexapro, Paxil, Prozac, and Zoloft -- can cause a weight gain of 10 pounds or more.I have seen this first hand with family members. I believe the OP is looking for specific advice regarding medications that may be less likely to cause weight gain while still having the desired therapeutic effect. My understanding is that some drugs are more or less likely to cause weight gain, but that the effects vary by person as well, and that often it is a matter of trying different drugs until you find a combination that has the greatest benefit and least harm. Unfortunately many doctors don't take the weight gain issue seriously, either because they are unfamiliar with it, or they believe the benefit of the drug substantially outweighs the harm of the weight gain.

As you're kind of seeing here, there's a reason that it's best to rely on trained doctors to recommend medications. Antidepressants (which it seems are the main medications used to treat OCD) are often associated with weight gain, yes. Wellbutrin is the one that often tends to stall weight gain, but it looks like it's not approved by the FDA for treating OCD; psychiatrists can prescribe it "off-label," however, as either a replacement for other antidepressants or in addition to them, but "off label" means there is no govt-approved consensus saying that it will help the OCD symptoms. If you are seeing a psychiatrist who has training and experience in treating pediatric OCD, however, that doctor is going to have much more knowledge than you are about which medications seem to work and which side effects seem to occur on them. This is a good situation in which if you trust your son's doctor, you should also trust their judgment and suggestions about medications. The one thing that would be helpful for your doctor to know is whether your son has any blood relatives, especially male relatives, who have done particularly well (or particularly poorly) on any particular antidepressant. Responses to meds can be genetic and a good (or poor) response in a relative can help predict the same for the patient. I would definitely keep in mind (as you seem to be doing) that "healthy" includes "psychologically healthy," and that treating your son's mental-health symptoms is likely a much higher priority, health-wise, than his losing weight, especially if he's active and eating healthy foods. There is often a trade-off in treating mental illness between reducing symptoms and being skinny, and it's important to remember that all the societal stigma about how "fat = unhealthy" is not always true or helpful in such situations.

He is technically just barely overweight, not obese, using the BMI guidelines. Obese would be 180 or more at his height. Just don't make him too self conscious if possible. If he were an adult, he isn't. There is a different scale for teens and children. But it is worth considering that your "obese" son will be only just barely overweight (and possibly not even that if he's very active, has a large frame and gains muscle easily - he could be an outlier BMI wise) - medically speaking if he can prevent gaining any more weight for the next 3 years. Does his stomach seem to change size - are there days when he doesn't look like he's swallowed a basketball? Bloating could be a part of the problem and food issues can be hard to diagnose. My partner's waist can grow 4+ inches if he eats something that disagrees with him. (he's still overweight, just not as much as he looks) Do you think he looks obese? He's about 15lbs overweight which isn't massive, if he were an adult, he'd be only about 5lbs overweight. Your description makes it sound *much* worse than that. I was just looking at a photo of myself when I was that age and a similar amount overweight and it looks like nothing (especially by modern standards) - at the time I thought I was a whale but it really wasn't that noticeable at all. For the medication you're just going to have to trust your doctor, no-one here can tell you what definitely will or wont work for your son - if we could, you wouldn't be going through this because your son would have got the "right" medication for him from the start.

His psychiatrist wants to try tapering off the Celexa slowly over the next 9 weeks. He felt, as http://www.metafilter.com/user/175568 noted, that it's time to see if the boy can function without it.