New Study Says Some Antidepressants May Pose Higher Risk of Weight Gain Than Others: Doctors Respond

Antidepressants are a valuable medical option to help maintain mental health, but they could be linked to weight gain. While not all people who take antidepressants experience weight gain, it is a potential side effect cautioned by many medical professionals and manufacturers. A new study looks at how different drugs in this class compare to one another in terms of weight gain, and doctors offer their own insights about the findings. 

New study reveals which antidepressants may be linked to weight gain 

A new study published in the journal Annals of Internal Medicine found that compared to sertraline, commonly known by brand names Zoloft and Lustral, estimated six-month weight gain was higher for escitalopram (brand names Lexapro and Cipralex), paroxetine (Paxil, Aropax, Pexeva, Seroxat, Sereupin and Brisdelle), and duloxetine (Cymbalta, Loxentia and Yentreve) which were associated with 10 percent to 15 percent higher risk for gaining at least 5 percent of a patient’s baseline weight. Bupropion (sold under names Wellbutrin and Zyban) was associated with 15 percent reduced weight gain risk.  

“Small differences in mean weight change were found between 8 first-line antidepressants, with bupropion consistently showing the least weight gain, although adherence to medications over follow-up was low,” the study said. “Clinicians could consider potential weight gain when initiating antidepressant treatment.”  

Experts weigh in on antidepressants causing weight gain  

Weight gain is not a guarantee for every person taking these antidepressants, but there are multiple reasons it may be a possibility in certain patients. Additionally, the medication itself is not always a direct correlation to weight gain, but may impact other lifestyle factors that do so. 

“Because of serotonin’s action on appetite regulation, it is possible to have weight gain as a potential side effect of taking antidepressants,” says Frances Javier, M.D. Psychiatrist and Medical Director at Neuro Wellness Spa. She explains that many antidepressants work to increase serotonin levels in the brain to improve mood, ease depression and anxiety. “Some, but not all, may experience this. In my clinical practice, I see far more people improving with antidepressants without appreciable weight gain as a side effect, than those that do. It is important to note that depression itself can also be associated with weight gain due to multiple factors.”  

Weight gain from antidepressants can result from a combination of increased appetite, metabolic and hormonal changes affecting hunger and fat storage, explains Sarah Oreck, MD, Reproductive Psychiatrist, Co-Founder and CEO of Mavida Health. Dr. Oreck says she often sees that improvements in depression and anxiety can restore normal eating patterns, potentially leading to weight gain if appetite returns after a period of depression-related weight loss.  

Choosing your treatment method  

In a doctor's office with a mature female patient and doctor
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So, is potential weight gain something you should consider regarding whether to start or continue to take an antidepressant? The short answer is yes, doctors say, because significant weight gain can impact a person’s overall health and quality of life. If it’s something of concern, you can certainly discuss it with your doctor and implement proactive strategies. There are various classes of antidepressants, and some have less impact on weight than others, but they have their own sets of side effects to be mindful of as well.  

For example, Wellbutrin, which was shown to correlate with the least amount of weight loss in this study, does not work for everyone, notes Dr. Oreck. It is effective for many people, she says, particularly those with depression and seasonal affective disorder. However, it is not suitable for individuals with a history of seizures or eating disorders as it can increase the risk of seizures. 

“There are proactive steps that can be taken to avoid weight gain while taking antidepressants, such as maintaining a healthy diet and engaging in regular physical activity,” Dr. Oreck says. “We also know that nutrition and movement themselves can be helpful in combating depression and anxiety. Lifestyle changes, like reducing sugar and processed food intake and increasing fiber and protein, can help manage weight. Despite these efforts, some people may still experience weight gain due to the medication's effects on metabolism and appetite. Having to manage weight gain can indeed make depression harder to handle, as it adds another layer of stress and can affect self-esteem. Therefore, it's important to work closely with a healthcare provider to find a balance and address any concerns promptly.” 

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This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.