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Metoclopramide and unintended weight gain
Randy A Sansone1, Lori A Sansone
1Department of Psychiatry, Wright State University School of Medicine, Dayton, Ohio, USA. Randy.sansone@kmcnetwork.org
The International Journal of Eating Disorders
|August 5, 2003
Summary
Metoclopramide treatment for delayed gastric emptying in a patient with anorexia nervosa led to significant, unintended weight gain. This highlights potential risks associated with metoclopramide in vulnerable patient populations.
Area of Science:
- Gastroenterology
- Psychiatry
- Pharmacology
Background:
- Anorexia nervosa (restricting type) is an eating disorder characterized by self-starvation and significant weight loss.
- Delayed gastric emptying is a common gastrointestinal complication in patients with anorexia nervosa, impacting nutrient absorption and overall health.
Observation:
- A 19-year-old female diagnosed with anorexia nervosa (restricting type) was treated with metoclopramide for symptoms of delayed gastric emptying.
- Initial low-dose metoclopramide did not affect body weight. However, dose escalation resulted in a 20% increase in body weight over two months.
Findings:
- Metoclopramide, a prokinetic agent, can induce significant unintended weight gain in patients with anorexia nervosa, even at doses initially considered safe.
- The observed weight gain may be linked to metoclopramide's effects on gastric motility and potentially appetite regulation.
Implications:
- The findings underscore the critical need for careful monitoring of weight changes in patients with anorexia nervosa receiving metoclopramide.
- Clinicians should consider the potential for iatrogenic weight gain and its psychological impact on individuals with a history of restrictive eating behaviors.
- Further research is warranted to elucidate the precise mechanisms of metoclopramide-induced weight gain in this population and to establish safe prescribing guidelines.