ADHD meds and weight loss

OldDude · Mar 23, 2018

Decreased appetite is the only "real" side effect I've seen with ADD meds. If he will consistently drink the shake that would certainly work to increase his caloric intake and is the easiest fix but I've seen this attempted before and if you aren't there to tell him to drink it, like at lunch during school, it'll go in the trash.

Another option I've witnessed as a success is to go back to the standard release Ritalin. Give him the am dose with breakfast before school and have the noon dose administered during the latter part of his lunch at school, i.e., after he has eaten his food. Although the dosing isn't as consistent as the time release medicine, lunch comes at the standard dose trough and the kids seem to have a better appetite for lunch.

Let us know how it goes. This is a common issue and the more data the better.

KKEGS, MSN, RN · Mar 23, 2018

Yes! I had a student last year that kept Boost Chocolate Protein Shakes in the health office and would come down a couple times a day to drink his shake. :) His parents stop his meds during the summer and on weekends precisely because of the weight loss. He definitely needs his meds during school so we spend all school year trying to put some meat on his bones again.

iggywench, BSN, RN · Mar 23, 2018

My son has a very hard time keeping weight on. He is a cross country runner, and we had to take him off Vyvanse due to weight loss (more than 10% of his body weight). He was on Concerta for several years after Vyvanse, and that was actually better for him, until he said he didn't like the way it affected his moods. Now, he's on Evekeo, which is a newer name-brand only (expensive) ADHD med with fewer side effects. He's 16, and takes a 10mg tablet once per day. We do try to supplement his diet with protein shakes, but he just doesn't eat a lot. One doctor told me to make him milkshakes, or give him ice cream at night. He does like his ice cream!

I don't give him the medication on weekends or school holidays, and he does eat more then. Some kids do have success keeping weight on with Ensure or similar shakes twice a day, if you can get them to drink them.

GdBSN, RN · Mar 23, 2018

I have had the same situation as OD. I have a student who had lost 13lbs on XR ADD med. He went back to the standard dose of Ritalin, after breakfast and after lunch and has regained 5 lbs in one month. The students I give medication to at lunch seem to have better results. I had a student who was taking the 2 doses of Ritalin, and was then switched to XR. He had horrible side effects (dizzy, nausea, and even violent outbursts). He switched back to the 2 doses and feels fine now.

SaltineQueen · Mar 23, 2018

What dose is he on? Could he go lower? My son also takes Concerta, is thin, & is such a picky eater, so I'm always concerned about his weight. I've often thought about having him drink shakes, but then we'll go for a check and he's OK. He's started swimming, though...so we'll see how that changes things.

KannedyRN · Mar 23, 2018

My daughter and son (they are 10 and 14 now) both have had weight issues with different ADHD medications. We have had good success with using shakes (we used Pediasure because they preferred the taste) once to twice a day depending on where they are with their weight. They drank theirs at school either during snack time or, once they were older, during lunch. This is what we found worked the best for us.

Amethya · Mar 23, 2018

I seen this in both my students and myself too (but sadly not the weight loss for me...) but we recommend this to the parents, but the students usually got used to the medication and started to eat normally. But I'll keep these in mind for future students.

As for myself, I just feel less hungry, so I eat less, but I still eat.

WineRN · Mar 23, 2018

I have had the same situation as OD. I have a student who had lost 13lbs on XR ADD med. He went back to the standard dose of Ritalin, after breakfast and after lunch and has regained 5 lbs in one month. The students I give medication to at lunch seem to have better results. I had a student who was taking the 2 doses of Ritalin, and was then switched to XR. He had horrible side effects (dizzy, nausea, and even violent outbursts). He switched back to the 2 doses and feels fine now.

I'm in the middle of a similar situation with a student but the problem we have is that he is doing SO MUCH better socially and academically on the XR that the student doesn't want to switch back despite the appetite issues. He's lost 10 pounds since November, and refuses extra snacks because he doesn't want to be singled out.

UsernameNotFound, BSN, RN · Mar 24, 2018

On my child/adolescent inpatient unit, we see good success with the use of Intuniv (guanfacine). It can be a great alternative to stimulants for a host of reasons, including the avoidance of weight loss. It also lacks the addictive qualities and street value of Adderall, Ritalin, and their cousins. The main concern is potential hypotension, but in otherwise healthy and hemodynamically stable kids, it's simply something to monitor. Most of my patients are also on SSRIs and/or antipsychotics, so it can be a safe option in polypharmacy.

Just throwing it out there! (smile)