Why do people gain weight when on antidepressants?
Posted by kathryn in Mental & emotional health
Finally in today’s Q & A Thursday a reader asks: how do SSRI antidepressants cause weight gain?
I’m not an expert in pharmacology but as far as I know, there’s no answer to this question – yet!
SSRIs or Selective Serotonin Reuptake Inhibitors are a group of antidepressants which include prozac, zoloft and lexapro. About 25 percent of the people who take these antidepressants gain weight, but at the moment we don’t know the precise mechanism by which this occurs.
It’s believed that SSRIs affect both appetite and metabolism. It’s also been suggested that as people’s mood improves, the pleasure and enjoyment they get from food returns – causing an increase in food consumed.
What to do?
If you are on antidepressants and are concerned about weight gain, this is the best advice I can give:
- Speak to your doctor: weight gain is not guaranteed when on SSRIs and it may be that a different drug or a different dosage may give you the mental health benefits, while reducing weight gain.
- See a nutritionist: Many people who are not on medication struggle with maintaining a healthy weight. Professional help can assist you with working out the best foods, the right portions and how to manage your appetite.
- Exercise: Given it’s believed SSRIs impact metabolism one of the best routines you can get into is regular exercise. Both cardiovascular, but also strength training. Reducing fat and increasing your muscle mass will boost your metabolism. This has the added benefit of improving mood.
- Eat low GI foods: Carbohydrates are a much maligned food. While I don’t recommend giving them up, switching to low GI carbohydrates will help you control your appetite.
- Deal with carbohydrate cravings: Some people on SSRIs mention carbohydrate cravings. There are some good dietary strategies for dealing with this in how to deal with a carbohydrate addiction in five steps.
Q & A Thursday is over for this month
That’s the end of Q & A Thursday for this month. Hope you’ve enjoyed the four posts.
The next forum will be on Thursday 2nd October. If you have a question you’d like answered send me an "email":mailto:me@kathrynelliott.com.au. For more information you can take a look at the Q & A Thursday archives.
04 September, 2008
Comments
Hi Kathryn,
Interesting post. The psychiatrists that I work with usually educate their patients about this possible “side effect” when they know that weight gain would cause distress in their patients. This way, their patients can make an informed choice or at least be mindful/aware of it.
Hope that you are having a nice week so far and a good weekend ahead,
Nora
Hi Kathryn,
Many people do indeed suffer weight gain on anti-depressants and anti-psychotics…which could of course exacerbate the feelings of depression…
SSRI’s are most definitely helpful for severely depressed people. However, there are non-weight-gaining alternatives to this approach to dealing with depression: cognitive behaviour therapy, psychotherapy and other forms of therapy being a useful alternative. Also, a recent study found that many people taking anti-depressants may not really be getting any benefit from them http://www.abc.net.au/news/stories/2008/02/27/2173810.htm
Interesting post/question; this is such a complicated area!
Some people also find that they lose weight on SSRIs (often, but not always a desirable side-effect). Sibutramine, one of the three main approved weight loss drugs in use in the UK, is actually a serotonin and noradrenaline reuptake inhibitor. For some reason this SSRI doesn’t cut it as an anti-depressant but was discovered to decrease appetite and has been licensed as a weight loss drug instead!
A whole of health and balanced plan is surely the optimal approach to depression? Antidepressants have their place, and are an invaluable medication for many. But combining this with talking therapies, life skills, education, exercise and lifestyle changes is so much more powerful. It’s a long-term, empowering approach – that allows people to make informed decisions, take responsibility and manage their own health.
Sophie: that’s interesting about sibutramine, I don’t know a lot about weight loss drugs. Have you heard anything about their relative success?
On the flip side I’ve also been reading about some SSRIs being used to treat anorexia nervosa – because of their mood improving and appetite stimulating properties.
And thanks for the link Victoria. There is a question over depression medication – how much is the medication and how much is placebo, particularly in mild-moderate depression. Much the same is discussed in the Quarterly Essay The depression epidemic and the medicalisation of our sorrows.
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