Occasionally, because of other drug interactions, health conditions such as liver or kidney problems, allergies, or very complex medical conditions — after an organ transplant, for example — there is no substitute drug that will work for a specific patient. But those cases are rare and even then doctors can sometimes find solutions or at least improvements.
Cheskin says, for example, physicians can change the doses or even the time of day to reduce the risk of weight gain. Another strategy is to combine the drugs — keep the patient on an essential drug but use a little less of that and a little more of another medicine — for an individualized drug cocktail that deals with the underlying disease or condition without the weight issue.
Lien says patients known to be at risk of weight gain, or those who start to put on the pounds as soon as they take a drug, also can be helped with a supervised diet and exercise program.
Doctors say patients should talk to them about drugs and weight, and not just assume that the physician is aware of every potential side effect of every medicine. If weight gain is a concern, ask the doctor to check your medicine.
Joanne Kenen is a Washington writer who covers health and health policy issues.