Do antidepressants cause weight gain? What can you do about it?

Weight gain from medications is not uncommon, and in fact, is an often overlooked cause of weight gain or difficulty losing weight. Antidepressants are one example of medications with this potential. But this isn’t the case for everyone or all antidepressants. Some people are particularly prone to this side effect and we unfortunately don’t know who this will be until they take the medication. Additionally, some antidepressants are more likely to promote weight gain than others. Read on to learn more about antidepressants and weight gain if this treatment has been recommended for you.

How common is weight gain from antidepressants?

How much antidepressants contribute to weight gain is difficult to determine, as there are many overlapping factors that affect our weight. Depression itself is associated with elevated weight, and emotions affect what we eat, why we eat, our physical activity level, and our sleep. Another factor making it difficult to know if your antidepressant is causing weight gain, is that this side effect frequently doesn’t happen until the second or third year of treatment, so you may not notice it right away. There is research to suggest that weight gain from antidepressants can happen as frequently as 50% of the time when looking at long-term data.

What antidepressants cause weight gain?

The potential for any one antidepressant to cause weight gain varies significantly from person to person. As with any medication, we see a lot of variability in terms of an individual’s response, both in terms of benefits and the unwanted side effects of the drug. With that being said, some antidepressants do appear to cause weight gain more often than others. 

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are the most commonly prescribed antidepressants and all SSRIs have some potential for weight gain. Paroxetine (Paxil^Ⓡ), sertraline (Zoloft^Ⓡ), escitalopram (Lexapro^Ⓡ), and citalopram (Celexa^Ⓡ) tend to be the greatest offenders whereas fluoxetine (Prozac^Ⓡ) tends to cause less weight gain.

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs are another commonly prescribed class of medication and have modest weight gain potential. Medications in this class include venlafaxine (Effexor XR^Ⓡ), desvenlafaxine (Pristiq^Ⓡ), and duloxetine (Cymbalta^Ⓡ).

Tricyclic Antidepressants (TCAs)

Amitriptyline and nortriptyline (Pamelor^Ⓡ) are commonly used TCAs for depression as well as migraine headaches and nerve pain. Weight gain is a common side effect of both of these medications.

Monoamine Oxidase Inhibitors (MAOIs)

This is an older class of drugs that tends to have more side effects, so they are prescribed less often. Phenelzine (Nardil^Ⓡ) is a drug in this class shown to induce significant weight gain.

Other antidepressants

Mirtazapine (Remeron^Ⓡ) is an antidepressant that doesn’t fit into any of the above categories, but should be mentioned because it is frequently associated with weight gain. Similarly, trazodone is an atypical antidepressant that is commonly used to assist with sleep disturbances related to depression and this medication has known weight gain potential as well.

The best way to assess whether you have experienced weight gain as a side effect of taking an antidepressant or any medication is to monitor your weight closely. If you have noticed the scale going up despite no significant change in your lifestyle or are feeling hungrier than usual after starting a medication, then you may be experiencing a side effect of your medication.

How do antidepressants cause weight gain?

The mechanism by which antidepressants cause weight gain is complicated and poorly understood. It is also going to vary depending on the antidepressant. Generally speaking, these medications act on signaling pathways in our brain that influence mood and appetite. As a result, people taking antidepressants may consume more calories, leading to weight gain. 

It’s also important to keep in mind how common symptoms of mood disorders impact our weight. Negative symptoms associated with anxiety and depression can lead to less healthful food choices, emotional eating, irregular sleep patterns, and a sedentary lifestyle, all of which can cause weight gain. 

Would discontinuing use of antidepressants help weight loss?

Regardless of what is happening with your weight, abrupt discontinuation of an antidepressant medication is not advised without first discussing it with your healthcare provider. Stopping your medication can have concerning side effects including a disturbance in your mental health or withdrawal symptoms. If you are concerned that an antidepressant is causing weight gain, changing medications could be beneficial, but it should be done in close communication with your healthcare provider as the benefits and risks should be carefully considered. 

One antidepressant that has been consistently associated with weight loss (not weight gain) is bupropion, approved for treatment of depression under the brand name Wellbutrin^Ⓡ. Bupropion has been shown to decrease appetite and cravings for food. It can be a good option for treating depression without causing weight gain or even potentially helping with weight loss. Bupropion is not right for everyone though, so a discussion with your healthcare provider is the most appropriate next step.

5 Ways you can counter antidepressant weight gain

If you are experiencing weight gain as a side effect of your antidepressant, but changing medications is not an option, there are still things you can do to counteract antidepressant weight gain. An added bonus is that many of these things can also help to improve symptoms of anxiety and depression.

1. Eat a healthy, balanced diet

Consuming a diet high in vegetables, fruits, whole grains, and lean protein while limiting your intake of refined carbohydrates, saturated fats, and sugar-sweetened beverages will help you to avoid eating too many calories, which leads to weight gain. Additionally, there has been research to suggest that diets high in refined carbohydrates (think white bread, sugary cereals, and packaged desserts) are linked to symptoms of depression. So eating a more healthful diet not only helps you to manage your weight, but could actually improve your mood as well. 

2. Participate in regular physical activity

Incorporating regular physical activity into your daily routine is important for weight management. We believe that antidepressants can encourage you to eat more calories in a day, which could be offset by the calories burned when taking a walk or participating in an exercise class. Not only that, studies have shown exercise has an immediate mood-boosting effect, so this in and of itself is a treatment for your depression.

3. Self monitoring

Self monitoring your food intake, physical activity and weighing yourself are good ideas when trying to manage your weight. Given that antidepressant use can often lead to increased food intake, monitoring what you’re eating can help you to be more aware and mindful about what you’re consuming, thereby helping to offset some of the antidepressant weight gain.

4. Get adequate sleep

Sleep problems are a common symptom of depression and anxiety, but getting adequate sleep is vital to your physical and mental health including managing your weight. If you’re having trouble sleeping, seeking the guidance of your healthcare provider is a good idea to help you manage your weight and improve your mood.

5. Seek assistance from a healthcare provider

If you’re struggling with weight gain despite your best efforts to eat a healthy diet and participate in regular physical activity, a healthcare provider may be able to help. There may be opportunities to adjust your medication plan to include more weight-friendly options. There are also research-backed tools like prescription weight loss medications that may be able to counteract some of the increase in appetite you can experience from antidepressant medication. Weight loss medications are not for everyone, though, and your healthcare provider will need to consider if they can be taken safely with your antidepressant medication before providing you with a prescription. 

How Form Health can help you lose weight from antidepressants

If you’re struggling to lose excess weight gained while taking certain medications and are interested in working with experts to help you reach weight loss goals, Form Health could be a good fit for you! Form's board certified health care professionals have extensive expertise in medication-induced weight gain, and will work with you on a personalized treatment plan. Our insurance-covered medical weight loss program uses science-backed tools like behavioral support, nutrition, physical activity, and medications, if appropriate, as part of a comprehensive weight loss program to help you lose weight and improve your overall health. Take our quiz to see if our medical weight loss program could be right for you.

Paxil^Ⓡ and Wellbutrin^Ⓡ are registered trademarks of GLAXOSMITHKLINE LLC 

Zoloft^Ⓡ, Effexor XR^Ⓡ, Pristiq^Ⓡ and Nardil^Ⓡ are registered trademarks of Pfizer Inc.

Lexapro^Ⓡ and Celexa^Ⓡ are registered trademarks of AbbVie Inc

Prozac^Ⓡ and Cymbalta^Ⓡ are registered trademarks of Eli Lilly and Company

Pamelor^Ⓡ is a registered trademark of Mallinckrodt PharmaceuticalsRemeron^Ⓡ is a registered trademark of the Organon group of companies