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Antidepressants & Weight Gain

How to Get Help without Gaining Weight

For many people, depression and weight problems go hand in hand. Depression itself is highly associated with changes in weight. In fact, significant weight loss or gain is one of the symptoms used to diagnose depression. And research has shown that up to 25% of the people who take antidepressant medications may also experience weight gain. Needless to say, finding yourself in that group can be very frustrating.

While we know there is a connection between depression, antidepressant medications and weight gain, it's impossible to predict how a particular medication will affect your weight, or what other side effects it might have for you. And even if you do start gaining weight after starting on antidepressants, it will be hard to know for certain if the medication is causing the problem, or if changing it will solve the problem.

This means that, if you do find yourself gaining weight when taking antidepressant meds, you and your doctor may need to do some real detective work to figure out what's going on and what to do about it. It can be hard enough finding a medication that works well on your depression with minimal side effects, so giving up an effective medication for the chance that a different one might cause less weight gain can be a dangerous proposition.

Here's some general information that can help you do this necessary detective work, so that you and your doctor can make the right decision for you.

Why do antidepressant medications lead to weight gain?
The answer is multifaceted. Sometimes the weight gain may simply be due to the fact that the medication is actually working. For many people, depression causes loss of normal appetite, reduced interest in food, or an inability to experience the pleasure you normally get from eating. If that was the case for you, it could be that you're simply eating more food now because the medication is helping you get back to "normal" eating habits. Or maybe you're feeling a little better than normal, and eating more for the pleasure of it, without even realizing that's what you're doing. Changing your medication probably won't make much difference here. In this case, you'll just need to work on balancing your eating and exercise to get your weight where you want it to be.

But medications can have other effects as well. In some people, they can increase appetite above and beyond what's "normal," or even increase cravings for certain foods, especially carbohydrates. Sometimes people gain weight even though their actual eating habits haven't changed, so it's also possible that antidepressant medications can alter your basic metabolism.

ACTION STEP: Start by carefully tracking your food intake and exercise for several weeks using SparkPeople's free food and fitness trackers to find out exactly how much you're eating and where your calories are coming from. Also start a basic journal describing anything that feels out of the ordinary to you—whether your appetite is heartier than usual, you're exercising more or less than usual, or you're experiencing food cravings that are really hard to resist. If you find that you're having a lot of trouble managing your appetite or cravings, or that your weight is going up even though you're sure you're not eating more or exercising less than before, then it's time to talk to your doctor about the situation. Bring these records with you when you go.

Should I change medications to prevent weight gain?
The side effects of virtually all antidepressant medications can potentially include weight gain. But since individuals vary a great deal in whether or how much any particular medication will cause this or any other side effect, changing medications can be an effective way to deal with this problem. There's no way to predict in advance how you'll react to any specific medication, but studies have shown that some medications are more commonly associated with weight gain than others. Among the selective serotonin reuptake inhibitor (SSRI) drugs commonly prescribed, Paxil seems to be associated with weight gain most often, while Zoloft is at the other end of the spectrum. The SNRI (serotonin and norepinephrine reuptake inhibitor) drugs Effexor and Serzone don't seem to cause weight gain in most people, and Welbutrin may actually cause weight loss for some individuals. There is also evidence that combining two different antidepressant medications, or adding a small dosage of certain other medications (such as anti-seizure medications), can also reduce problems with weight gain. So, changing drugs can make a difference.

The downside of changing drugs, of course, is that this could also affect your depression symptoms. The brain chemistry of depression is extremely complex and varies from person to person, which is why some drugs work for you while others don't. It may take some experimentation to find something that will do the job on your depression without affecting your weight, and that can take some time.

ACTION STEP: Talk over your options thoroughly with your doctor, and don't stop taking a medication, change your dosage, or add any weight-loss supplements or OTC depression remedies without discussing it first with your doctor. Some combinations can be very dangerous, and others may cancel each other out.

Is there anything else I can do to prevent weight gain when taking antidepressants?
For some people, changing medications won't be an option because the drug they're using is the one they need to control depression symptoms; in these cases some weight gain may be unavoidable if you want to keep your depression symptoms under control. Or you may have to wait until your mood stabilizes enough to do some experimentation with other medications.

If your weight gain is very troubling, it can take a lot of courage and determination to do the right thing for your overall health and well-being (staying on antidepressants), and resist the temptation to do whatever is necessary to lose the weight. Getting the right kind of support can be crucial to getting through this situation, so be sure to talk it over with your doctor and visit the SparkTeams for people dealing with depression—you'll find you're not alone in dealing with this problem.

ACTION STEP: As always when you're talking about weight management, a balanced, healthy diet and plenty of exercise are the foundations of success. Regular exercise not only burns calories to help keep your weight gain to a minimum, it can improve mood, reduce the effects of stress, and help you enjoy life more—even if you are carrying a few more pounds than you'd like. Likewise, a healthy diet can make it easier for your brain to keep your neurotransmitters in balance and avoid big swings in energy levels and mood that can provoke depressive reactions. Be careful to avoid extreme weight-loss diets, as this can have the opposite effect.  Many people find that the combination of a diet and exercise are enough, over time, to reduce or eliminate the weight gain associated with antidepressant medications.

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Member Comments

  • I've been clinically depressed for years and have been on many different medications as well as seeing a psychiatrist and going through a course of behavioural modification, which was very effective. I will be on antidepressants for the rest of my life, and have found one which is very effective for me. If it means carrying around a bit of extra weight, so be it. I'll take happier over thinner any day.
  • Within a year 3 drastic events happened to me. I PLUNGED into a deep, dark depression which meant several hospitalizations hence make it #4 because I could not keep up with my job. A job I LOVED and was very good at. Depression though (plus from the car accident) I was no longer able to work. BINGO GOODBYE to my luxury apt.

    I had the WORSE Dr EVER who is HAHAHA Now SUPPOSEDLY in CHARGE of the place. I have NO CLUE why. She kept telling me "YOU TAKE IT OR ELSE I'll PUT YOU BACK INTO THE HOSPITAL!" So I did. SIXTY lbs later on THAT med (Seroquel) the OLD BAT (I weighed 115 at the start at the end of THAT 1 I was at 145!) than she put me on risperdal and BAMB ANOTHER 30 LBS! So UP to 175 in ONLY A FEW MONTHS!! I got SMART and got RID of that old bat!!

    I had been talking to someone I had met online and he recommended asking about an MAOI which I did ask my Dr. This is rarely used now since if you eat a WHOLE BUNCH of normal every day food, you can easily have a stroke or heart attack. I AGREED (We did a contract since it can be proved if you accidentally ate an item (often when eating out at any place, including family friends. A friend had a big spread for a bunch of us. THANKFULLY as I went to put the mashed potato into my mouth I thought and asked "What did you put in here?" It was cheese. A NO NO item! PHEW!!) it was necessary for a contract to be done.

    In ONLy 3 days I felt so much better! In ONLY 3 weeks I felt as wonderful as I had used to. PHEW!!

    If you are ever in a shrinks office, look around. I have. MOST of us where QUITE heavy. It could be that office, but I DOUBT it.

    I will say that the MAOI Literally saved my life. I went on to gain and gain. Now it's FINALLY coming off. I've been OFF the MAOI now for almost 2 years an doing very well.
    Very good advice for those that take antidepressants.
  • Thanks for posting this. I can't tell you how many times as a psych nurse I tried to explain this to patients. For so many, the first and only thing they saw on the medication info sheet was 'possible weight gain.' It's so important to emphasize the benefits of getting depression under control, and to note that every body is different and will react differently.
  • I've been on a bunch of antidepressants, found my appetite increase a bit on ones which were meant to often cause weight loss, and seen my weight slide while on ones supposedly linked to weight gain.

    As someone on the other end of the scale, struggling to keep weight on, I know how stressful these changes can be - I can imagine they're as bad though different if you're trying to lose. However, that weight gain is the most depressing thing ever... Try drug resistant anti depressants and the sheer desperation that nothing will ever get better and life will be long term unliveable.

    Weight of course affects mood, but to give a physical example, easier for some - my young outdoorsy cousin was diagnosed with leukaemia. The drugs robbed him of the sun and of swimming, made him sick and made him balloon from skinny to pasty and fat. They saved his life. He's now back in the sea, living life, laughing with me.

    Meds aren't perfect. They might affect weight. But the side effects won't always affect you, and they are prescribed to you for a reason and can help (or so I'm told, with antidepressants!)
    I feel so sorry for the person who can think of nothing more depressing than weight gain. How about war, genocide, famine? To think that weight gain is that important, that's pathetic. While I am trying to lose weight and become healthier, it is NOT the end all, be all of my existence. How sad that it is for someone else?
  • Oh, puh-leeze! The person who commented that losing weight is the greatest anti-depressant doesn't have a clue. I'm a behavioral health nurse, have been for 23 years, and I have depression. Anyone who knows about depression will agree that feeling a little heavy is a heck of a lot better than feeling like throwing yourself in front of a big truck. And for some folks, the depression can be so severe that the last thing you want to do is get out of bed, let alone go exercise. Medication can help you get to the point where you can begin to help yourself. Remember, depression isn't a choice or an attitude, it is a medical illness, like diabetes is a medical illness.
  • Sweetie, walk a mile in my shoes, than post a comment about depression.
  • I can think of NOTHING MORE DEPRESSING than taking something that actually CAUSES weight gain. So how can these things possibly work? Losing weight, all by itself, is the best depression-fighte
    r on the planet. So these meds seem like a cruel trick on the people who want HELP.
  • i take wellbutrin, i cant tell it has effected my weight positively or negatively.
    doctors should first prescribe diet and exercise, and introduce antidep after the patient has started a healthy program.
    physical therapy as well as depression really can lead to physical pain and vice versa.
  • JWHW606
    I gained 50 lbs when I started my medication and it doesn't want to come back off. However, mental health care is extremely important and should only be handled by a professional. Going on and off medications should only be done under the supervision and direction of a doctor. No one should encourage people to quit their medicine because of weight gain. It's hard enough to step out against the stigma that goes with being on anti-depressants/
    anxiety meds without ignorant bystanders suggesting people stop their much needed meds for vain reasons. Sure obesity is harmful to your health, but often so is depression etc...
    I agree with the commenter who did NOT agree with those who recommend getting/staying off antidepressants. For many of us, it is an actual life saving med. I learned to go back on them when I would notice my overall mood slipping, and that prevented those really bad spells. Afetr cancer treatment, however, and some huge personal losses, I slipped into a horrible depression that went on for two years. Prozac had always worked for me in the past, but did little to help this time. My doctor suggested I try Zoloft, and I agreed, but never expected it to work. I had (and occasionally still have) bad stomach gas and pain the first two weeks - I mean BAD. Anyway, I was desparate, so I stayed on it. !5 days into it, that depression lifted. I have tried Wellbutrin in the past, and that does not work for me, but I have a sister who swears by it. Now I'm on SparkPeople to lose the weight I gained during those horrible two years, but am so happy that that is my biggest challenge now. Good luck to all of you who are struggling - never give up and the answer is probably as individual as you are!
  • my dr put me on Paxil in 2010... and i not only ballooned in my thoracic and abdominal area I haven't been able to take any of it off... I hover around 5 lbs more of less of the weight I've been for the past 13 years even with exercise and appropriate portions... ill never use antidepressants again instead I will concur my depression no matter what and exercise my heart out!
  • Thanks for sharing.
    I've suffered with depression for the past two and half years or so, and a few months ago I was put on mirtazapine. Terrible, terrible medication. At first my appetite lessened, but after about a week my appetite skyrocketed and I craved nothing but sugary foods and nothing was ever sweet enough. This went on for a few months and I gained 30lbs+. A few weeks ago I stopped taking it (with doctor's blessing, of course) and my appetite became manageable again.

    I am now on fluoxetine (Prozac), which doesn't seem to have any affect on appetite, thank God.

    I don't agree with what others are saying that "you should simply stop taking antidepressants immediately! They're bad for you!" there are so many antidepressants out there and they all affect everyone differently. Rather than coming off medication altogether, my main recommendation would be to talk with your doctor and try a few medications until you find one that works for you. Unfortunately for me, fluoxetine doesn't seem to do much to alleviate the depression, but at least I no longer have to deal with the side effects of mirtazapine (lethargy due to hangover from the drug's soporific effect, and an insatiable sweet tooth).

    TL;DR work with your doctor to find a medication that works for you. You might have to try a few, but you'll get there eventually.

About The Author

Dean Anderson Dean Anderson
Dean Anderson has master's degrees in human services (behavioral psychology/stress management) and liberal studies. His interest in healthy living began at the age of 50 when he confronted his own morbid obesity and health issues. He joined SparkPeople and lost 150 pounds and regained his health. Dean has earned a personal training certification from ACE and received training as a lifestyle and weight management consultant. See all of Dean's articles.