Zonisamide for weight loss (Zonegran)

What is zonisamide?

Zonisamide is the generic name for the branded medication Zonegran. This medication is an anticonvulsant or antiepileptic prescribed to manage certain seizure disorders.¹ However, some doctors may prescribe it for weight loss as well, in certain circumstances.²

What are the risks of taking Zonegran “weight loss pills”?

Although Zonegran is a prescription medication that can help people with seizure disorders, it also has its risks and disadvantages. Because a side effect of zonisamide is reduced appetite and subsequent weight loss, people have begun taking it in pursuit of their “ideal” body weight or size. Doctors have helped perpetuate weight stigma, too, by prescribing it for weight loss. 

Taking Zonegran can not only cause a myriad of medical consequences, but it can also be a sign that someone is struggling with disordered eating behaviors or a clinical eating disorder like binge eating disorder, bulimia, or anorexia.

Zonisamide side effects and health risks

Some zonisamide side effects are more serious than others. If you experience any of the following, call your doctor immediately or 911 if it’s an emergency:¹

• Severe stomach pain
• Shallow breathing
• Irregular heartbeat
• Pain when urinating
• Dark or bloody urine
• Signs of infection like fever
• Abrupt back pain
• Blistering skin or rash
• Mouth sores
• Problems speaking, concentrating, or thinking
• Coordination issues
• Severe muscle pain
• Loss of consciousness

Moreover, Zonegran can cause metabolic acidosis, which involves too much acid accumulating in the bloodstream. This condition causes rapid breathing, fatigue, confusion, and even shock.³

Can you overdose on zonisamide?

It is possible to overdose on zonisamide. Symptoms of a zonisamide overdose include:^1,4

• Dizziness
• Slowed breathing
• Slow heartbeat
• Abnormal heartbeat
• Fainting
• Coma
• Seizures

If you suspect you or someone else has overdosed on Zonegran or any other substance, call 911 immediately and give the operator as much information as you possibly can. Stay beside the person until the first responders arrive.

The problem with using medication like zonisamide for “weight loss”

Taking zonisamide for weight loss is not only physically dangerous but can also increase a person’s risk of developing an eating disorder like anorexia or bulimia.⁵ This practice can also be a sign of an existing eating disorder, especially when other disordered eating behaviors and symptoms are present, such as:⁶

• Fasting
• Restricting calories
• Using diuretics or laxatives
• Self-inducing vomiting
• Excessive exercise
• Binge eating episodes
• Feeling extreme shame related to eating disorder
• Eating in private
• Poor self-esteem
• An extreme preoccupation with weight, food, and thinness
• Distorted body image
• Skipping meals
• Cutting out entire food groups

Zonegran, diet culture, and anti-fatness

Weight-loss pills like zonisamide are commonly used because of the influence diet culture has over our society. Diet culture is a set of societal beliefs responsible for our negative beliefs about our bodies. And it connects our weight, shape, and size to our self-worth. Diet culture is the reason we view certain foods as “good” and demonize others as “bad.” It’s why we may feel the need to “punish” ourselves after eating “bad” foods. It’s why we feel guilty if we skip the gym or eat something we enjoy.

Diet culture is also connected to anti-fatness (or fatphobia) and weight stigma because diet culture’s goal is to shame us into losing weight, convincing us that thinness is the ultimate ideal we should strive for, that it’s more important than our health, happiness, or well-being. As such, people in higher-weight bodies are stigmatized, shamed, and blamed for the bodies they live in, with diet culture and healthism viewing fatness as a moral failing. 

Often, anti-fatness hides behind flawed medical reasoning, such as the idea that living at a higher body weight is a medical problem when, really, the weight stigma fat people experience is the major risk factor for physical and mental health issues.^7,8

Unfortunately, systemic influences like diet culture and anti-fatness are ever-present in our society—so much so that it can feel challenging to heal your relationship with your body and eating. But professional eating disorder treatment can help you on the road to recovery. If you use zonisamide or laxatives or engage in other disordered eating practices, our virtual treatment program at Within Health is here to support you.