Antidepressants and Weight Increase: Essential Information You Should Be Aware Of
In a 24-month study, people who took Zoloft (sertraline) gained an average of 3.2 pounds. This weight gain is not a universal experience, but a complex interplay of factors that includes increased appetite, changes in body chemistry affecting hunger and cravings, and lifestyle choices.
Selective serotonin reuptake inhibitors (SSRIs) like Paxil (paroxetine), Prozac (fluoxetine), and Zoloft, as well as tricyclic antidepressants (TCAs) such as amitriptyline and nortriptyline, are known to increase appetite and cravings, leading to weight gain. The improvement in mood caused by antidepressants may also boost appetite in patients who previously experienced reduced eating due to depression.
Habitual or lifestyle factors like poor eating patterns (high in processed foods and sugars), smoking, and insufficient physical activity can amplify the risk of weight gain while on these medications. The weight gain risk often becomes more noticeable during the second and third years of treatment rather than immediately after initiation.
Contrary to some beliefs, antidepressants do not typically slow metabolism; rather, they tend to increase appetite and hunger signals without reducing metabolic rate. Some antidepressants have a stronger association with weight gain than others. For example, Sertraline causes slightly more weight gain than fluoxetine, though both are associated with modest increases.
Corticosteroids, used for various medical conditions, may also contribute to weight gain through increased appetite and fluid retention. This is more relevant when these drugs are taken concurrently or as part of other treatments.
It is crucial to consider weight changes in the context of aging, as some weight gain is typical as people age. If a weight change is causing concern, it is advised to talk to a healthcare provider. Dr. Maline urges against stopping the medication or making changes to it without consulting a healthcare provider.
Mental health conditions can affect appetite, potentially leading to weight loss or gain. If rapid or significant weight gain occurs while taking antidepressants, it is advised to talk to a healthcare provider.
Escitalopram (Lexapro®), Duloxetine (Cymbalta®), Paroxetine (Paxil®), and some other antidepressants are associated with potential weight gain. On the other hand, Bupropion (Wellbutrin®) is associated with lower weight gain compared to some other antidepressants.
The most commonly prescribed antidepressant, sertraline (Zoloft®), was used as a baseline in a study on antidepressants and weight change. The study showed that weight increases, if they occur, are typically minor, averaging about 3 pounds within two years of starting a medication.
The same rules for weight management apply to those taking antidepressants and those who aren't: eat a healthier diet, start an exercise routine, reduce stress, and get enough sleep. Improved emotional state while taking an antidepressant may make it easier to adopt lifestyle changes for weight management.
Focus should be on how the medication is addressing symptoms of depression or anxiety, rather than on slight changes on the scale. Unless weight increase is quick and dramatic (like putting on 5-plus pounds within a week), it is recommended not to be overly preoccupied with slight changes on the scale.
Beyond managing weight, it's essential to prioritise mental health. If a weight change is causing concern, there are options to consider. Working with a healthcare provider to balance mental health benefits and metabolic side effects is crucial in maintaining overall well-being.
- Lifestyle choices, such as eating a healthier diet, starting an exercise routine, and reducing stress, can help manage weight gain that may occur while taking certain antidepressants like Zoloft (sertraline), Paxil (paroxetine), and Prozac (fluoxetine).
- The health-and-wellness benefits of regular mental health check-ups should not be overlooked. Changes in weight, if they cause concern, can be addressed by discussing them with a healthcare provider.
- In the context of holistic health care, it's important to focus on the mental health benefits of antidepressants like Zoloft, rather than minor weight changes that might occur during treatment. Prioritizing a balanced approach to mental health and weight management is essential for overall well-being.
