- How to Avoid Weight Gain When Taking Antidepressant Medication
- Effect of Formal Weight Loss Programs with Psych Medication
- Weight Gain—Causes Added Worry with Psych Meds
- Balancing Mental and Physical Health is Often Complicated
- Steps to Avoid Weight Gain When Starting a Psych Medication
- Long-term body weight outcomes of antidepressant–environment interactions
- Chronic antidepressant treatment study
- Stress-antidepressant-diet study
- Repeated restraint stress
- BW and FI
- Does Taking Prozac Cause Weight Gain?
- What is Prozac?
- What is Prozac used to treat?
- Does taking Prozac cause weight gain?
- What side effects are associated with Prozac?
- Do SSRIs (Antidepressants) Cause Weight Gain?
- Predicting Weight Gain
- What You Can Do
How to Avoid Weight Gain When Taking Antidepressant Medication
With Sean Wharton, MD, PharmD, Michael McGee, MD, and J. Michael Gonzalez-Campoy, MD, PhD
Are you among the nearly one in eight adults in the United States) who should be or is already taking an antidepressant to address a mood disorder,1 or an antipsychotic medication for other mental health conditions such as obsessive compulsive disorder or bipolar disorder—but your hesitate worry about gaining weight?
While these medications are very effective, they often come with a major downside for many patients—undesirable and often significant weight gain.2 For anyone who may benefit from a psychiatric drug but fears the prospect of obesity and its related complications, there is now a good answer.
As simple as it may sound, the best chance of avoiding, or lessening further, undesirable weight gain when taking a prescribed antidepressant or antipsychotic medication, is to simultaneously participate in a formal weight management program. This is true regardless of the psych medication you are taking,2 according to the experience of patients who were treated at the Wharton Medical Clinics in Toronto, Canada.
Effect of Formal Weight Loss Programs with Psych Medication
Even if you are already taking one of these psych-related medications and you’re stressed about weight gain, or if your doctor has recently suggested that you consider taking one of these drugs but you're stalling due to concerns about weight gain—this study points to an effective way forward—to enroll in a structured weight loss program.2
After evaluating the experience of more than 17,000 men and women, comparing medical data of those who were on psychiatric medications to those not taking such medication, the researchers found that an organized weight management plan helped everyone—overall and on average—to lose weight.2
Sean Wharton, MD, PharmD, an internal medicine specialist and director of the Wharton Medical Clinics, which is devoted to weight and diabetes management, in Toronto, Canada, and his team, reports that individuals who are taking a prescribed medication for a mental illness and following a structured weight loss program avoid weight gain their analysis.
In all, 4094 patients, or about 1 in 4 of those in the study, were taking at least one psychiatric medication. Most were taking an antidepressant, although about 11% took both. The aim of the study was to compare weight loss for those taking the medications and those not taking them. Data was collected from 2008 to 2017.2
The men and women were, on average, in their late 40s or early 50s. Their average body mass index or BMI was about 39 or 40.2 The program stresses effective, personalized lifestyle changes, Dr. Wharton says.
Patients answered questions about family medical history, weight management history, and other health information.
Then, a trained weight management educator gave suggestions regarding eating and physical activity to help avoid weight gain.2
In general, participants were taught to cut out 500 calories a day from their usual intake, and they returned to the clinic for ongoing dietary guidance every 3-4 weeks.2
Over the average of 16 months of clinic attendance, on average, patients lost about 7.5 pounds, or 2.9% of their body weight. That translated to 27.6% of patients losing 5% or more of their baseline weight and 10.1% losing twice that amount or more.2
You may be saying….a 2.9% weight loss is not such a big deal…but according to Dr. Wharton, these results correlate with those of other weight loss interventions and, this number indicates an average, meaning some lost more, some lost less.
More importantly, Dr. Wharton tells EndocrineWeb, contrary to past beliefs, the findings from this study suggest that weight gain is not inevitable when taking psychiatric medications. Also, weight loss is achieved in direct contrast to the expectation that everyone would gain weight when taking an antidepressant or antipsychotic medication.2
Men who were taking antidepressants lost slightly less than people in the other groups, but it wasn't a big difference,2 says Ms. Christensen.
While the researchers can't explain the reason for this finding, they believe it could be that the other patients were feeling better mentally so they were a bit more successful with their weight loss goal but this would require further testing to gain a clear answer.
Weight Gain—Causes Added Worry with Psych Meds
You are not alone in gaining benefit from psychiatric medication—and you aren’t the only one who stresses about the weight gain linked with many of the drugs. As such, this challenge inspired Ms.
Christensen to test for a solution that would address this vexing problem.
She tells EndocrineWeb that concern about weight gain is both a real and almost universal experience among the patients in her clinic that are prescribed psychiatric medications.2
«The fear of weight gain is sometimes so powerful that people will stop taking their [mental health] medication,» says Dr. Wharton who is the senior investigator of the study that shows that participating in an organized, medical weight loss programs work.
As if to confirm how common this conundrum is, Michael McGee, MD, chief medical officer at The Haven at Pismo, an addiction treatment center near San Luis Obispo in California, says that he frequently hears about the anxiety linked with medication-related weight gain.
«My patients fear and complain about weight gain, particularly the women, who often do gain weight, but it is not a given,» he tells EndocrineWeb. With years of practice, Dr. McGee has seen many patients who have experienced weight gain, increasing about five to 10% of their starting weight. That means, for example, a 150-pound woman would be facing up to a 15-pound gain in body weight.
Balancing Mental and Physical Health is Often Complicated
Even when not taking a psychiatric medication, some people with mental health disorders may already be battling overweight or obesity, says Dr. Wharton and his colleagues. Research has shown that those with mental health disorders seem to have up to 1.5 times greater odds of having obesity. 2,3
In addition, the weight gain linked with antidepressant and antipsychotic drugs has been well recognized, although the experience varies and is not the same for everyone.4-7
So how much weight gain are we talking about? In another recent study,7 researchers looked at the weight status of 362 patients taking an antidepressant medication for six to 36 months.
More than half of them gained weight, with 40% of individuals gaining at least 7% of their starting weight. The only drug of the eight psych medications evaluated in the study not linked with weight gain was fluoxetine (ie, Prozac).
The study did not have funding from pharmaceutical companies.7
The links between weight gain and medications have been shown to differ by medication type, says J. Michael Gonzalez-Campoy, MD, PhD, FACE, medical director and CEO of the Minnesota Center for Obesity, Metabolism and Endocrinology.
«In general, the use of antipsychotic medications are most often associated with weight gain,» Dr. Gonzalez-Campoy tells EndocrineWeb «In general, the use of antidepressants is associated with more modest weight gain—with the exception of fluoxetine and bupropion (Wellbutrin, others), which appear to be weight neutral.''
Steps to Avoid Weight Gain When Starting a Psych Medication
Asking for a referral to a qualified weight loss program in your area is a good idea, says Dr. McGee. What else?
- Focus on what (ie, choose a Mediterranean approach to eating) and how you eat (eg, seated at the table, with other people, chewing slowly and mindfully)
- Don't eat for gratification, boredom, or self-soothing or overeat to punish yourself
- Discuss whether weight loss medicines, in addition to the structured weight loss program, may be appropriate, at least to start.
According to Dr. Gonzalez-Campoy, ''along with a prescription for antipsychotic medications and most antidepressants, a concomitant prescription for weight management should be provided [for patients who already have overweight or obesity].''
And for those on antipsychotics, you should be made aware of the health risks that come with significant weight gain such as the development or worsening of high blood sugar, high blood pressure, and high cholesterol, he says. These are medical issues that should be monitored as well, he says.
The bottom line—For anyone who is taking an antidepressant or antipsychotic medication: «Taking these medications [to manage a mental health issue] is very important,» Ms. Christensen says. «Don't be concerned about the potential weight gain because that can be mitigated [ie, managed].»
None of the healthcare practitioners had relevant financial conflicts with regard to this study.
Last updated on 09/19/2019
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Long-term body weight outcomes of antidepressant–environment interactions
Long-term body weight outcomes of antidepressant–environment interactions
Both obesity rates and antidepressant use have escalated in the last 20 years. Most people who start antidepressant treatment discontinue it on their own. Meanwhile, obesity rates continue to increase.
To test the hypothesis that antidepressant use is a risk factor for obesity, even after long-term discontinuation, we developed a novel animal paradigm consisting of short-term exposure to stress and antidepressants, followed by long-term high-fat diet.
We show here that recurrent restraint stress (RRS)-related weight loss is recovered 2 weeks after the end of stress in young growing rats receiving a high-fat diet.
It is noteworthy that animals that received short-term antidepressant treatment with either imipramine or fluoxetine during 7 days of RRS showed behavioral evidence of antidepressant effects.
When exposed to a high-fat diet after stress and when antidepressant treatment had ended, the animals had significant increases in caloric intake, body weight (BW) and size from 17 to 22 weeks following antidepressant discontinuation when compared with (control) RRS animals treated with saline and fed with a high-fat diet.
These data are consistent with the previously described phenomenon of time-dependent sensitization, and support the notion that enduring effects of short-term antidepressant treatment become manifest on a long-term basis after antidepressant discontinuation, during conditions of high stress followed by high-fat intake.
Analyses of open field and body size measurements obtained in a small subset of animals show that animals previously exposed to antidepressant had no deficits in locomotor activity and were larger. Antidepressant exposure may therefore be a covert, insidious and enduring risk factor for obesity, even after discontinuation of antidepressant treatment. Our data support the concept of persistent, long-term effects of pharmacological–environment interactions on BW regulation.
Major depressive disorder (MDD) is a serious public health problem. Currently, the point prevalence of MDD is ∼4–7%, and the lifetime prevalence estimate ranges from 15 to 20%.1, 2 MDD is the leading cause of disability measured in years lost because of disability, and the largest single cause of nonfatal disease burden in Australia.
3 It will become the second leading contributor to global burden of disease by the year 2020 (disability-adjusted life year).4 Approximately 59% of individuals with MDD seek help for their condition, and 35% receive medication or psychological treatment.
3 According to the Canadian Community Health Survey, the prevalence of antidepressant use over a period of 12 months between 2001 and 2002 was estimated at 5.8%.5
MDD is a common complex disorder that affects ∼121 million people worldwide. In the United States, the economic burden of MDD is in the order of $100 billions per year, with workplace costs being the largest component.6 Antidepressant dispensing has increased substantially during the last two decades in Western countries.
In the United States, antidepressants are prescribed to 27 million people and they are the most frequently prescribed class of medication.
7, 8 In the United Kingdom, France and Australia, antidepressant prescriptions have increased substantially since the early 1990s with the entry of selective serotonin reuptake inhibitors (SSRIs) in the marketplace.9, 10, 11
Studies examining weight gain during long-term SSRI treatment have reported inconsistent results.
The results of a large, cross-sectional study the General Electric Medical Records Database of MDD patients treated with antidepressant monotherapy for at least 1 year suggested differences in the proportion of patients who gained at least 7% of their body weight (BW) during treatment.
The highest percentage of patients with weight gain was associated with mirtazapine (26%), followed by the SSRIs (16–19%).12 Antidepressant treatment can be effective in MDD, but compliance is low: in a large European study of 7525 patients, 56% abandoned treatment within 4 months.13
It is generally accepted that the side effects such as weight gain can adversely affect adherence to therapy, but according to Bulloch and Patten,5 the main reason for non-adherence was forgetting (74.
5% of responders), followed by ‘felt better’ (10.7%); side effects were reported as the fourth reason (5.9%).
It is commonly stated that patients return to their previous weight after they stop taking antidepressants, but this assumption is not evidence based.
To complicate matters, clinical and animal weight data during antidepressant treatment have been difficult to integrate because they appear to support divergent effects; a large body of studies have supported that administration of several antidepressants result in failure to gain weight or ‘paradoxical’ weight loss in rats, especially at high doses.
14, 15 Consequently, animal paradigms that help close some of these gaps could significantly expand our understanding of the interface between obesity and MDD. There is a strong body of translational work that uses rodents to study the biology of depression and antidepressants.
These studies have shown that a mechanism of action of antidepressants is to promote neurogenesis in the adult rat hippocampus.
16 Animal models of depression have included stress paradigms (such as uncontrollable stress, chronic mild stress and repeated restraint stress (RRS)) that have been shown to decrease cell proliferation in the hippocampus, and administration of antidepressants can block this downregulation of cell proliferation.17
The use of antidepressants has grown dramatically since the late 1980s with the advent of the selective monoamine reuptake inhibitors.27 Vast numbers of people are exposed to antidepressants on a short-term basis, as long-term compliance is not usually achieved.
3, 5 Such increased exposure to even short courses of antidepressant drugs temporally coincides with the emerging epidemic of obesity that is faced by developed countries.
Could the current dramatic increase in obesity be attributed at least in part to exposure to antidepressants? It has been previously demonstrated that the effects of drugs may continue to increase over time, even after a single dose and as drug levels decrease: this intriguing phenomenon is known as time-dependent sensitization (TDS).18
We have hypothesized that TDS, which has been described during short-term antidepressant treatment, may apply to weight regulation after exposure to antidepressants. To test this hypothesis, we developed an animal paradigm that combines RRS and behaviorally effective, short-term antidepressant treatment, followed by long-term high-fat diet.
This mimics a clinical situation experienced by millions of people: stress/depression is associated with short-term exposure to antidepressants and with long-term ingestion of high-fat diets.
In such a paradigm, we tested the specific hypothesis that even short-term exposure to antidepressants represents a long-term risk factor for obesity, manifested protractedly when unmasked by environmental factors, such as high-fat diet.
All procedures were performed under established guidelines of humane care and use of rats, and were approved by the University of Miami Institutional Animal Care and Use Committee, and by the Australian National University Ethics Committee.
Upon arrival, virus- and antibody-free young adult male Sprague-Dawley rats (Harlan, Indianapolis, IN, USA) were housed at 24 °C and 12 h light/dark schedule (lights on from 0600 to 1800 h) in a stress-free environment and divided into two studies: (1) chronic antidepressant treatment and (2) stress, antidepressant and diet (hereafter, stress-antidepressant-diet study).
Chronic antidepressant treatment study
Young growing rats (150–200 g) were housed two per cage in a stress-free environment for at least 5 days before the initiation of experimental procedures. Rats were randomly assigned to two experimental groups: control (0.
9% saline; Hospira, Lake Forest, IL, USA), n=10 and fluoxetine 10 mg (SSRI, Sigma-Aldrich, St Louis, MO, USA), n=10. Animals received daily 0.5 ml intraperitoneal injections of either 0.9% saline or fluoxetine 10.0 mg kg–1 dissolved in 0.9% saline, for 5 weeks.
Dose and treatment duration were previous reports.19, 20, 21 BW was measured weekly.
Rats (200–230 g) were housed one per cage (11″ wide × 8.5″ height × 14.5″ long). Food intake (FI) and BW were measured several times a week starting one day after arrival (experimental day 1). Rats were given ad libitum access to food and water, except during the RRS sessions. This experiment lasted 177 days.
Rats were randomly assigned to two main groups: (1) non-restrained control (non-RRS) group (n=26) and (2) restrained (RRS) group (n=38).
Animals in the non-RRS group were not injected or restrained, and this group comprised two subgroups: (i) NR-CC (n=13), comprising non-RRS animals fed with regular chow diet throughout the whole experiment; and (ii) NR-CF (n=13), comprising non-RRS animals fed with chow diet until day 11, and fed with adjusted fat diet thereafter (TD95217; Harlan, Saint Louis, MO, USA).
Animals in the RRS group were subjected to RRS as described below, and received adjusted fat diet (TD95217; Harlan) after day 11. The RSS group comprised two subgroups: (i) R-C group (n=13), comprising RRS animals that received once daily intraperitoneal injection of 0.5 ml of saline (0.
9% NaCl; Hospira); and (ii) R-AD group (n=25), comprising RRS plus antidepressant-treated animals receiving daily intraperitoneal injection of antidepressants for 7 days during the RRS period.
Those animals received imipramine (Sigma-Aldrich) 10 mg kg–1 (R-IMI, n=13) or fluoxetine (Sigma-Aldrich) 10 mg kg–1 (R-FLX, n=12).
Repeated restraint stress
We used flat-bottom clear acrylic restrainers (20.3 × 8.3 cm) (Cat no. 544-RR; Plas Labs, Lansing, MI, USA). RRS sessions occurred during the period of 0900 to 1600 h and lasted 6 h each; they occurred for 7 consecutive days (days 5–11).
BW and FI
During the RRS period, BW and FI were measured daily in all animals; BW gain was calculated as the area under the BW curve for non-RRS (n=26) or RSS (n=38) groups between days 5 and 11 (Figure 2b). After the restraining period, BW and FI were recorded three times per week until the end of the study at day 177.
Interactions of recurrent restraint stress (RRS) and short-term antidepressant treatment on food intake and body weight during the RRS sessions.
(a) Cumulative absolute intake (kcal) during the restraint stress (days 5–11) period in non-RRS (n=26) and RRS rats (n=38); during this period, all animals were fed with regular chow. Non-RRS consumed a larger amount of kcal.
(b) Body weight gain was calculated by obtaining the area under the weight curve (AUC, g × day) during the restraining period. Non-RRS animals were heavier than RRS ones. ***P
Does Taking Prozac Cause Weight Gain?
Many people who suffer from mental health conditions depression and panic disorder are interested in pursuing prescription medication treatment, but weight gain is a common concern.
Prozac is perhaps the most well-known antidepressant on the market, and while its safety and effectiveness are well documented, the drug is also associated with a long list of side effects.
Does taking Prozac cause weight gain, and how does the drug compare to other medications in its class in terms of side effects?
What is Prozac?
Prozac is a brand-name prescription medication that belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). FDA-approved in 1987, Prozac was the first SSRI antidepressant medication, which revolutionized the treatment of depression and other common mental health conditions.
Today, SSRIs are one of the most popularly prescribed classes of drugs in the United States due to the prevalence of depression and anxiety and the effectiveness of this class of drugs as a treatment option.
Other SSRIs include citalopram (Celexa), escitalopram (Lexapro), sertraline (Zoloft), and paroxetine (Paxil).
Approximately 22 million prescriptions were written for Prozac in 2017, making it the most well-known and one of the most popular SSRIs on the market. Prozac is also sold under the generic name fluoxetine.
What is Prozac used to treat?
Prozac was first approved by the FDA in 1987 for the treatment of major depressive disorder, otherwise known as clinical depression.
Since that time the FDA has approved Prozac for the treatment of a number of other common mental health conditions, including obsessive-compulsive disorder (OCD), panic disorder, and bulimia nervosa. It is also marketed under a different name, Sarafem, to treat premenstrual dysphoric disorder (PMDD).
Depending on the condition being treated, Prozac can be used safely in both children and adults.
Does taking Prozac cause weight gain?
While most antidepressants have a reputation for causing weight gain, Prozac does not typically cause weight gain.
Numerous studies have been conducted to determine the effect of antidepressant use on weight.
These studies have found that mild to significant weight gain is a common side effect of atypical antipsychotics and many newer antidepressant drugs except Prozac, which was associated with moderate weight loss when used for the acute treatment of depression.
These newer antidepressants include tricyclic antidepressants (TCAs) such as amitriptyline (Elavil); monoamine oxidase inhibitors MAOIs including phenelzine (Nardil); and SNRIs duloxetine (Cymbalta) and venlafaxine (Effexor).
Other studies have shown that acute treatment with Prozac is ly to cause weight loss, while long-term treatment with the drug may lead to some degree of weight gain. However, the extra pounds may be attributed to improvement in depression symptoms rather than the medication itself.
Prozac is considered to be a weight-neutral antidepressant, so it may be a good treatment option for patients who are concerned about body weight change.
What side effects are associated with Prozac?
Prozac is associated with side effects that can be categorized as both common and rare/serious.
Common side effects associated with Prozac include:
- Flu- symptoms
- Increased sweating
- Dry mouth
- Increased bruising or minor skin rashes
- Difficulty sleeping (insomnia)
- Decreased libido or sex drive
- Weight loss
- Drowsiness and tiredness
- Sexual dysfunction, such as difficulty with orgasm or ejaculatory delay
Rare but serious side effects associated with Prozac include:
- Low sodium blood levels, which can cause symptoms such as:
- Difficulty concentrating
Suicidal thoughts or behaviors
Visual problems such as:
- Changes in vision
- Eye pain
- Swelling or redness in or around the eye
Serotonin syndrome, which can cause symptoms such as:
- Severe muscular tightness
QT prolongation and ventricular arrhythmia, or changes in the electrical activity of your heart
This may not be a complete list of side effects. Consult a healthcare provider for other possible side effects associated with Prozac.
Prozac is one of the few antidepressants that is not associated with weight gain and is considered a weight-neutral medication. Many people taking Prozac for acute treatment end up losing weight while taking the drug.
When taken for an extended period of time, patients using Prozac were found to gain an amount of weight that was comparable to weight gain in study participants who received a placebo.
Therefore, it is ly that this weight gain is due to recovery from depression rather than the medication itself. This weight gain can be mitigated by wellness practices such as regular physical activity, nutritional supplements, and changes in diet overseen by a nutritionist.
Seek medical advice from your prescribing doctor to see if Prozac is right for you. Patients who have been prescribed Prozac can save money on the generic or brand name forms of the medication using a pharmacy discount card from USA Rx.
Do SSRIs (Antidepressants) Cause Weight Gain?
There’s good news and bad news about antidepressant medications and weight gain. The good news is not every antidepressant causes weight gain and not everyone who takes an antidepressant gains weight.
The bad news: If you do start gaining weight when you first begin taking antidepressants, you may just keep piling on the pounds over time and ultimately find it hard to lose that excess weight.
But you can turn bad news into good by working with your healthcare provider to monitor both your mood and medication on a regular basis and stop weight gain before it gets hand.
The antidepressants most ly to cause weight gain include amitriptyline (Brand name: Elavil), mirtazapine (Remeron), paroxetine (Paxil, Brisdelle, Pexeva), escitalopram (Lexapro), sertraline (Zoloft), duloxetine (Cymbalta), and citalopram (Celexa).
Tricyclic antidepressants such as amitriptyline and tetracyclic antidepressants such as mirtazapine are linked to the most weight gain.
Other antidepressants, fluoxetine (Prozac, Sarafem) and bupropion (Wellbutrin, Aplenzin, Forfivo, Zyban) are ly to have no effect on weight or might even cause some weight loss. (1, 2, 3)
It’s not always possible, however, to choose a specific type of antidepressant simply because of its effect on your weight.
When choosing the most appropriate and effective medication, or switching from one type of antidepressant to another, psychiatrists and medical doctors who prescribe these medications must consider other factors individual needs.
You may find that one type of antidepressant works better to alleviate depression than another, or that one type gives you other unacceptable side effects, regardless of the effect on your weight.
There are many theories but not much hard evidence showing exactly why so many people gain weight when taking antidepressants, and many factors may come into play. A state of depression, in and of itself, can contribute to weight gain if your condition is causing you to overeat or you can’t work up the motivation to participate in any physical activity.
On the other hand, you may not feel eating when you are depressed and initially lose weight, but then gain back your lost weight, and then some, when your medication kicks in and you are feeling better.
Antidepressant medications may cause weight gain more directly by interfering with brain chemistry as well as your body’s normal metabolism and regulation of sugar and fat.
A family history of obesity could also make you more generally susceptible to weight gain. 3,4
Predicting Weight Gain
One study followed 260 patients suffering from major depressive disorder who were not overweight when antidepressant medication was first prescribed for a major depressive episode.
The researchers found that those who experienced at least a 3% weight gain during the first month of antidepressant therapy were at higher risk of long-term gain than those who did not gain any significant weight in the first month.
5 These findings suggest that careful monitoring of weight throughout the first month of taking antidepressant medications can help predict who is ly to gain a significant amount of excess weight over the course of treatment and signal the need for preventative measures.
A 3% weight gain in someone who initially weighs 125 to 130 pounds is approximately 3 1/2 to 4 pounds.
So, if that person gains more than 3 pounds after just one month of taking antidepressant medication, they may be at especially high risk of gaining even more weight.
When that’s the case, a medication may be changed to one less ly to promote weight gain and further steps can be taken to control body weight, such as watching one’s diet and getting more exercise.
Not only were the study patients at higher risk of gaining weight, data gathered from the same study indicated that those who gained excess weight were also at higher risk of developing metabolic syndrome during the 6-month treatment period.
6 Metabolic Syndrome is a group of unhealthy conditions that occur at the same time—excess abdominal fat, elevated blood pressure, blood sugar, and cholesterol.
Having metabolic syndrome puts you at higher risk of developing heart disease, diabetes, and stroke.
What You Can Do
Psychiatrist and addiction expert Michael McGee, MD, agrees that weight gain is a real problem with many of the medications he prescribes. “Women get especially concerned about it,” admits Dr.
McGee, who is also the chief medical officer at the Haven Treatment Center in California and the author of The Joy of Recovery.
Some patients can eventually go off antidepressants by adopting evidence-based lifestyle interventions to prevent weight gain, he says.
“I recommend the Mediterranean Diet because it has antidepressant qualities and I encourage good eating habits eating slowly and mindfully, avoiding ‘red light’ foods with lots of added sugar or foods that are overly processed,” he explains, adding that it’s also important for patients to make friends with hunger. “Accepting that a little hunger is OK and is necessary to maintain weight.” Dr. McGee also recommends spending time in nature, becoming involved in a spiritual community and connecting with others through volunteer work or by socializing with friends.
Be sure to voice your concerns with your physician. Ask your prescribing doctor if there is more than one option and if they can recommend an antidepressant that isn’t associated with weight gain. If your doctor feels the most effective medication is one that has been found to cause weight gain in some people, start taking preventative steps right away.
For additional support, ask your physician to refer you to a cognitive behavioral therapist, motivational counselor, and/or a registered dietitian or licensed nutritionist before switching to a different antidepressant or prescribing additional medication to control weight gain.7
You may not be able to fully prevent medically-induced weight gain, but you can take these steps to help keep it under control:
- Skip fad diets and quick weight-loss schemes. Instead, base your food choices on a proven healthful eating plan, such as a Mediterranean-style diet, the DASH diet designed to control blood pressure or a Flexitarian Diet. These are all plant-based diets that don’t necessarily eliminate meat and other animal foods but put more emphasis on fresh vegetables and fruits, whole grains, nuts, and legumes.
- Increase your protein intake, if necessary, to boost your metabolism.
- Increase the fiber in your diet, if necessary by eating more complex carbohydrates by including more beans, lentils, whole grains, fruits, and vegetables at every meal and also when you snack.
- Eliminate or cut way back on low-fiber, simple carbohydrates such as bread and pastries made with only white flour, sugary desserts, candies, sodas, and soft drinks.
- Drink more water, and eat more watery foods, plain low-fat yogurt, fresh fruits, and vegetables.
- Walk more often and incorporate muscle-building techniques (no special equipment needed for moves pushups, planks, and lounges) in addition to aerobic exercise. Healthy muscle is necessary to efficiently burn excess fat.
- Don’t forget mind-body exercises, yoga, tai chi, and meditation, that help reduce any stress that may be contributing to overeating and weight gain.
- Make sure you get enough sleep every night. Good sleep habits can also help regulate weight.
- Serretti A, Mandelli L. Antidepressants and body weight: A comprehensive review and meta-analysis. Journal of Clinical Psychiatry. 2010; 71(10): 1259-1272.
- Uguz F, Sahingoz M, Gungor B, Aksoy F, Askin R. Weight gain and associated factors in patients using newer antidepressant drugs. Gen Hosp Psychiatry. 2015; 37 (1): 46-48.
- Salvi V, Mencacci C, Barones-Adesi F. H1-histamine receptor affinity predicts weight gain with antidepressants. European Neuropsychopharmacology. 2016; 26(10): 1673-1677.
- Uguz F, Sahingoz M, Gungor B, et al. Weight gain and associated factors in patients using newer antidepressant drugs. Gen Hosp Psychiatry. 2015;37(1):46-48.
- Asmar KE, Feve B, Colle R, et al. Early weight gain predicts later weight gain in depressed patients treated with antidepressants: findings form the METADAP cohort. Journal of Affective Disorders. December 1, 2018: 22-28
- Asmar KE, Feve B, Colle R, et al. Early weight gain predicts later metabolic syndrome in depressed patients treated with antidepressants: findings from the METADAP cohort. Journal of Psychiatric Research. December 2018: (107); 120-127.
- MacDaniels, Jeffrey S., and Thomas L. Schwartz. How to control weight gain when prescribing antidepressants: address diet and exercise first, then consider switching antidepressants or prescribing an adjunctive agent. Current Psychiatry, vol. 15, no. 6, 2016, p. 30+. Academic OneFile, Accessed 25 Apr. 2019.