ASK THE DOC
Surgeon and lecturer Dr Sarah Rayne gives advice on avoiding antidepressant-related weight gain, when to worry when you’re expecting and the importance of health checks for your baby.
Q: I’m on antidepressants but they’ve made me pick up a lot of weight. How do I combat this?
A: Recognising depression in yourself and getting help is a really courageous thing to do, so well done. But it’s equally important that you take further steps to look after yourself. Unfortunately, antidepressants can lead to weight gain even if you’ve never had weight problems before. They can also tip you over into obesity if you’re already overweight, which puts you at risk of diseases like diabetes and high blood pressure.
The first step to avoiding weight gain is understanding why you are putting on weight. Antidepressants can often stimulate your appetite. And just that slightly bigger portion of pasta or sneaky late-night biscuit will add up to an extra kilogram or two over the course of a year. You might not notice it right away either: studies have shown it’s in the second or third year of treatment that the increased weight really starts to show. Paradoxically, as you get on top of your depression, you might take more pleasure in food, which can also increase what you take in.
Keep a food diary of what you eat, including portions. This can help you identify any snacking habits. Getting advice from a registered dietician can also establish healthy eating habits long-term. And finally, exercise doesn’t just help with weight but has been shown to independently improve mood; so get moving! Q: I’ve just fallen pregnant and I know my body will be going through a lot of new sensations, some not pleasant. What are the symptoms I should absolutely not ignore?
A: Congratulations! Pregnancy is an exciting experience, but rather like a rollercoaster. The simplest answer is: if you are worried, get help. Most of the important symptoms to look out for are relatively easy to spot: although it’s normally nothing to worry about, if you are bleeding or have tummy pain you should always get it checked out. Slightly subtler signs to be on the lookout for are pains or swelling in the legs; these could be signs of a clot or too much water retention. A severe headache or blurred vision, particularly in late pregnancy, can be signs of dangerously high blood pressure.
Earlier on, morning sickness is to be expected, but if you’re vomiting up everything you’re at risk of dehydration and need to see your doctor. Q: I had to take my baby to a paediatrician at six weeks and again at six months. But I was also taking him to the clinic. What is the paediatrician looking for that the clinic isn’t?
A: Having a baby means entering into a whole new world of clinics and appointments, which can feel confusing. But your clinic nurse and your doctor are looking at very different health aspects. A clinic nurse, midwife or health worker may see you during your pregnancy, and after the birth they will take a longterm approach to your and your baby’s health. They are looking for good weight gain in your baby and will be on hand for immunisations and advice about feeding and managing him. Your nurse is also there to look after you: up to 15% of new moms suffer from post-natal depression, and you may also have questions about contraception and your own post-baby health.
The paediatrician checks your baby for medical reasons. There are some special checks that babies need for uncommon but important diseases. The aim is to identify any problems your child was born with that can’t be picked up soon after birth. They are specifically looking for abnormalities of the eyes, heart problems, clicky hips, and (in boys) making sure the testicles are in the right place. Picking up issues at this time will make sure your baby is on the right path for healthy growth. It’s also a good time to get specialist advice about reflux, sleeping problems or wind, so ask away!