Multiple Sclerosis (MS) is a chronic neurological condition that impacts the brain, spinal cord, and optic nerves. Managing MS often involves medication to slow disease progression and alleviate symptoms. While these medications are important for disease management, they can also lead to various side effects. This article explores whether certain MS drugs can cause weight loss, delving into the specific medications involved, the mechanisms behind this effect, and strategies for managing unintended weight changes.
MS Medications Linked to Weight Loss
Some medications used to treat multiple sclerosis have been associated with unintended weight loss. Among these, certain oral disease-modifying therapies (DMTs) are notable.
Fingolimod (Gilenya) has been linked to weight loss, with one retrospective study in 2022 suggesting an incidence of 11.4% for significant weight reduction. While earlier literature reported weight loss with fingolimod as rare, this study indicates it might be more common than previously thought.
Another oral medication, dimethyl fumarate (Tecfidera), is also known to have gastrointestinal side effects that can indirectly contribute to weight changes. Although a study on rats did not observe significant weight changes directly linked to dimethyl fumarate treatment, clinical use has shown gastrointestinal effects that may impact weight.
Teriflunomide (Aubagio), another oral DMT, lists feeling sick and diarrhea as common side effects, which can also influence weight.
How These Medications Can Lead to Weight Loss
The weight loss observed with some MS medications is often a result of their side effects rather than a direct intended action on metabolism. Gastrointestinal issues are a common pathway. Medications like dimethyl fumarate and teriflunomide can cause symptoms such as nausea, vomiting, and diarrhea. These digestive disturbances can lead to reduced food intake, as individuals may experience discomfort or a decreased appetite.
Furthermore, persistent gastrointestinal side effects can sometimes impair the absorption of nutrients from food. If the body is not effectively absorbing calories and essential nutrients, it can result in a calorie deficit, contributing to weight loss over time.
While the exact mechanisms for all instances of weight loss are still being explored, the impact on appetite and digestion plays a significant role in these unintended changes. For example, fingolimod’s impact on weight might be related to its interaction with S1P receptors, which are present in areas of the brain that influence appetite.
Addressing and Managing Unintended Weight Changes
Monitoring weight is an important aspect of managing MS treatment, especially when medications might lead to unintended changes. Individuals experiencing weight loss should promptly communicate these changes with their healthcare provider, including neurologists and potentially a dietitian. Open discussion allows for a comprehensive assessment of the situation and helps determine the underlying cause.
Strategies for managing weight loss often involve dietary adjustments to ensure adequate caloric and nutrient intake. A dietitian can provide personalized advice, such as incorporating nutrient-dense foods or increasing meal frequency.
If gastrointestinal side effects are the primary cause, managing these symptoms through medication adjustments or supportive therapies can help improve food tolerance and absorption. It is important that patients never stop or alter their medication regimen without explicit guidance from their healthcare team, as this could negatively impact MS management.