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Roughly 13 percent of Americans over the age of 12 take antidepressant medications. If you’re one of them, your medication can help ease common symptoms of depression and anxiety to improve your quality of life. Unfortunately, like all medications, antidepressants pose a risk for side effects, including weight gain and weight loss challenges. Understanding how antidepressants affect your weight allows you to choose the right approach to diet, exercise, and lifestyle changes to set you up for lasting weight loss success.

Depression and weight: what’s the connection?

Depression and obesity are closely related. The U.S. Centers for Disease Control and Prevention (CDC) explains that people with depression are more likely to have body mass index (BMI) ratings that fall under the obese category than those who don’t have depression. In fact, about 43 percent of adults with depression are obese — and those with moderate to severe depression who take antidepressants are the most likely to be obese among all people with depression.

Whether depression causes obesity or vice versa is open for debate. Some experts believe that obesity contributes to depression due to a poor self-image and low self-esteem that trigger or worsen depression symptoms. Other experts think that depression leads to obesity because it makes weight management difficult.

It’s also possible that obesity and depression have a bidirectional relationship—obesity increases your risk of depression, and depression increases your risk for obesity. A systematic review of previous studies explains that obesity and depression may even develop at the same time—you may begin to gain weight and experience symptoms of depression at roughly the same time. 

Weight gain as a side effect of antidepressants

Many antidepressant medications are associated with weight gain. One study found that people taking one of 12 commonly prescribed drugs for depression were 21 percent more likely to gain weight than people who weren’t. Research suggests that around 10% of people who take SSRIs longer than six months experience some weight gain.

Science has yet to uncover whether antidepressants cause weight gain due to their pharmacological properties. What is certain is that some people experience weight gain while taking antidepressants. The increase in pounds can interfere with efforts to lose weight, and for some people, weight loss becomes more difficult after starting on antidepressants.

Antidepressants commonly associated with weight gain

Which antidepressant you take may influence whether or not you gain weight. One systematic review of 27 clinical studies found that most antidepressants caused an average weight gain of five pounds — but the drug bupropion (Wellbutrin) actually triggered weight loss.

Some of the antidepressants most commonly associated with weight gain include:

  • Tricyclic antidepressants: Drugs in this class include amitriptyline, doxepin and imipramine (Tofranil). These work by reducing how much of the brain chemicals serotonin and norepinephrine your body absorbs.
  • Monoamine oxidase inhibitors (MAOIs): Drugs in this class include phenelzine (Nardil) and isocarboxazid (Marplan). They work by keeping your body from breaking down the chemicals serotonin, dopamine and norepinephrine.
  • Selective serotonin reuptake inhibitors (SSRI): Drugs in this class include paroxetine (Paxil, Pexeva) and sertraline (Zoloft). They work by blocking the reabsorption of serotonin.
  • Mirtazapine (Remeron): How this antidepressant works is still under investigation, but researchers believe it may boost the activity of serotonin and another brain chemical called noradrenaline.

Other causes of weight gain while taking antidepressants

While experts still aren’t sure if antidepressants are the direct cause of weight gain, it’s possible that they may be indirectly responsible in one or more of the following ways:

  • Increases in appetite: Some people lose their appetite due to depression. As an antidepressant changes the chemical balance in your brain, your appetite may return, leading to weight gain.
  • Appetite as a depression symptom: Increased appetite can also be a symptom of depression. When you begin taking an antidepressant, other symptoms may diminish before changes in appetite occur. As a result, weight gain due to your diet may appear to be a side effect of the new drug, even if it isn’t.
  • Lack of energy: Many people with depression struggle with physical activity, and it can take time for energy levels to normalize, even with antidepressants. You may mistake weight gain caused by a sedentary lifestyle as a side effect of your medication.

In addition, your age may be a factor in weight gain when taking an antidepressant. Men tend to gain weight from the age of 30 to 55, and women often put on extra pounds from the age of 30 to 65. This weight gain occurs gradually. If you start on an antidepressant, it’s possible that a small upward shift reflected on the scale is a natural effect of growing older.

Weight loss and antidepressant tips

Although antidepressants may complicate your weight loss efforts, you can still reach a healthy goal weight—and maintain it—while undergoing treatment for depression. Here are some tips to lose weight while taking antidepressants.

Don’t quit your depression treatment on your own

Although it’s tempting to simply stop taking your antidepressant in an effort to lose weight, don’t. Suddenly discontinuing the use of antidepressants may cause a return in your symptoms. Depending on the drug you take, you could also develop withdrawal symptoms. Because some antidepressants require a weaning-off schedule, you should never stop taking your medication on your own.

Talk to your doctor about medication

Instead of going it alone, talk to your doctor about your weight gain. Your primary care provider can help you evaluate your diet, exercise plan, and your depression treatment plan to help determine the most likely causes of your weight gain. They can also determine whether another antidepressant can help manage your depression symptoms.

Some antidepressants that are less likely to cause weight gain than others include:

  • Cymbalta (duloxetine)
  • Effexor (venlafaxine)
  • Lexapro (escitalopram)
  • Pristiq (desvenlafaxine)
  • Trintellix (vortioxetine)

Keep in mind that an antidepressant that works well for one person may not be as effective for another. As a result, your doctor may not wish to take you off an antidepressant that is working well for you.

Examine why you eat, not just what

People with depression are prone to eating due to their feelings rather than hunger, and this may continue even after you start taking antidepressants. Stick to a healthy diet plan, incorporating nutritious foods like:

  • Lean proteins
  • Whole grains
  • Fruits and vegetables
  • Low-fat dairy products
  • Polyunsaturated and monosaturated fats (in moderation)

When you get the urge to snack or go for seconds, don’t act on it immediately. Instead, assess how you’re feeling at the moment. Are you experiencing signs of hunger, like a growling stomach, shakiness, or problems focusing? Are you bored? Stressed? Feeling sad? After your assessment, wait 10 minutes. If you still feel hungry, then enjoy a nutritious snack.

Some people find it useful to keep a food journal and record what they’re feeling as well as what they’re eating. This can help you find patterns of emotional eating.

Take a slow and steady approach to fitness

Exercise is vital to lasting weight loss—and your overall health. The CDC even reports that regular exercise can ease symptoms of depression. Its general guidelines for adults is 150 minutes of moderate-intensity exercise or 75 minutes of high-intensity exercise per week. While this should be your ultimate goal, fatigue caused by depression may undermine your efforts to get active.

To lose weight while taking antidepressants, ease into a fitness routine—instead of trying for the full 150 minutes, start with 30 or 45 minutes per week. When you stick to your commitment for two or three weeks, celebrate your success! Then, increase your exercise goal by 15 or 30 minutes the following week.

Seek mental health support

Cognitive behavioral therapy (CBT) has been repeatedly shown to be an effective treatment for clinical depression. This mental health treatment helps you:

  • Identify patterns of thinking that contribute both to depression and obesity
  • Develop coping skills for stress and challenging situations so you’re less likely to use food as a coping mechanism
  • Increase your self-confidence
  • Recognize patterns of behavior that worsen your depression and interfere with weight loss
  • Develop strategies to help you change problematic behaviors
  • Adopt healthy stress relief strategies that don’t involve eating

How Forward can help you balance depression treatment and weight management

As your primary care provider, Forward is uniquely able to help you deal with depression and achieve your weight loss goals. We deliver one-to-one personalized care that can combine healthy lifestyle modifications, identify emotional eating,  and address stress eating behavioral changes with our 12-week, doctor-led Weight Management Program. In addition, we can perform assessments and diagnostic tests to explore how your overall health and the medications you take may impact your efforts to lose weight. The findings then inform the customized eating and exercise plan we design for you. Throughout the program, you’ll receive ongoing support to ensure that the changes you make are ones you can stick to for the long term so you can maintain your goal weight going forward.

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