Losing weight

A ketogenic diet supervised with the prescriber if you take lithium or an SGLT2 drug. Details and the mania case are on the bipolar keto card.

Weight fell in the pilots. The file does not treat that as a larger loss than a diet you can keep for a year.

Weight and blood pressure have moved, and lithium levels have been rechecked.

Lithium levels, SGLT2 drugs and ketoacidosis, and an antidepressant-without-a-mood-stabilizer mania case are on the bipolar card. They are not solved by the kilograms.

Clinician-supervised if you take lithium. Get a level when the diet starts.

Pick a lower-calorie pattern you can stay on. The trial comparison was low-fat versus low-carb. A second trial added a daily eating window to calorie restriction.

Both patterns lost a similar amount. The file’s point is adherence, not a winning brand of diet.

You are still on the pattern at a year, and weight is down in the range these trials saw. Stopping early is the result the trials were built to notice.

If you take lithium, a very low-salt crash diet can raise the level. That warning is the lithium guide’s, linked from the page notice.

Orlistat blocks some fat absorption. It is sold over the counter and by prescription. Take it with the prescriber if you are on other medicines.

Less dietary fat is absorbed. The four-year trial shows a few kilograms more than placebo, and fewer new diabetes cases.

You are still taking it, and the GI effects are tolerable. Half the trial did not finish.

Oily stools are the common objection. It can lower absorption of fat-soluble vitamins. The file marks the vitamin point as general knowledge.

Fat-soluble vitamins may be absorbed less well. The file does not cite a vitamin trial for that sentence.

If quetiapine, olanzapine, or a similar medicine is driving weight up, the prescriber can add one of these. Do not stop the psychiatric medicine to lose the weight.

The network meta-analysis ranks semaglutide as the largest add-on loss in those trials, then liraglutide, topiramate, and metformin.

Weight stops climbing and turns down, with the psychiatric medicine still in place.

Clinician-only. Not a bipolar trial. Lithium plus a GLP-1 drug needs a level check. See the page notice.

A structured program: coaching, food records, activity, and follow-up for years, not a week of tracking. USPSTF says offer or refer adults with obesity. The benefit rating is “moderate net benefit.”

People in the intensive arm of Look AHEAD were still lighter at eight years than the comparison group.

Years in, some of the loss is still gone. The file does not treat a return toward baseline as a personal failure. It is what the curves do.

Low medical risk compared with the drugs and surgery above it. Sleep still matters if you have bipolar disorder.

A prescriber combines naltrexone and bupropion. Do not start it for weight if you have bipolar disorder without the psychiatrist in the decision.

The phase 3 trial shows more weight loss than placebo. Completion was poor.

You are still on it at a year and the percent is in this range. Half the trial was not.

Bupropion is an antidepressant. Antidepressants without a mood stabilizer carry switch concerns. The file points at the keto-plus-venlafaxine mania case on the bipolar page and says this is reasoning, not a sourced bipolar trial of this combination.

Clinician-only. Nausea was common. Talk to the psychiatrist before using an antidepressant for weight.

High dose in the trial: phentermine 15 mg with topiramate 92 mg. Lower dose: 7.5 mg with 46 mg.

A prescriber uses phentermine with topiramate. Discuss it with the psychiatrist before anyone with bipolar I starts a stimulant-like drug.

The phase 3 trial shows a large one-year percent versus placebo.

Weight is down at a year and sleep is intact. Sleep loss is a separate mania risk, on the bipolar sleep card.

Phentermine is a stimulant-like amphetamine relative. The file says stimulants and sleep loss can tip bipolar I toward mania, marks that as pharmacology reasoning, and says no bipolar trial was found.

Clinician-only. Do not combine it with lost sleep.

A bariatric team offers bypass, sleeve, or band after the non-surgical steps have been considered. Plan lithium and other pills with the prescriber before surgery. Absorption of pills, including lithium, can change.

The operation changes how much food the stomach holds and, for bypass, how calories are absorbed. The three-year percents and the long mortality cohort are the file’s results.

Weight is down at three years and vitamin follow-up is in place. The risk is not zero: 0.2% died within 90 days in the Swedish cohort.

Surgery, lifelong vitamins, and changed absorption of medicines including lithium are not fully solved. The file’s answer is a bariatric team and the prescriber planning together.

Clinician-only. 90-day mortality 0.2% in the long cohort. Tell the prescriber about every pill, including lithium, before the operation.