How To Lose Weight Due To Antidepressants

Mental health is essential to your overall quality of life and sense of well-being.  Globally, depression affects 17% of the population and is expected to increase to almost one in four individuals by 2030. Depression is a common obesity-related health condition and the two can be so interconnected that it is sometimes even difficult to determine which came first – feelings of depression or struggles with weight. Unfortunately, antidepressants, which are the most commonly recommended treatment for moderate to severe depression, often cause significant weight gain.

First, antidepressants are effective. In fact, 89% of individuals with depression report that medication improves their symptoms. Unfortunately, weight gain is the 3rd most commonly reported negative side effect behind withdrawal effects and sexual dysfunction. Weight gain has been reported by 65% of individuals on long-term antidepressant therapy, while only 15% of individuals on antidepressants reported weight-loss.

Furthermore, the length of antidepressant therapy seems to matter. In a patient-reported survey, those on antidepressants for more than three years had more severe side effects than patients on therapy for less than two years, with weight gain being one of main reported side effects.

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Both changes in weight depend on the length of antidepressant therapy and choice of medication. Additionally, the body’s response to medication can change over time.

For example, let us consider a common class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). This class includes medications that are used frequently like:

They help with depression by blocking the reuptake of serotonin, a hormone in the brain that stabilizes our mood, feelings of well-being, and happiness. Serotonin levels are lower in people with depression and SSRIs help increase the amount of serotonin that is available to the brain. In the short-term, this increase in serotonin helps us feel full, decreases our food intake, and decreases our impulsiveness. But in the long-term, our body seems to adjust to these changes in stimulation. After 12 months of treatment, an SSRI can sometimes lead to weight gain due to cravings for carbohydrates and other potential factors.

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Another factor that plays a role in weight while on antidepressants is whether or not you are struggling with obesity at the time the medication is initiated. For example, antidepressant medications that increase dopamine levels in the brain also affect energy balance. Individuals with obesity tend to have decreased dopamine, which is a chemical in the brain that influences mood as well as feelings of reward and motivation. Improving dopamine levels may help them lose weight. However, individuals without obesity may gain weight in response to an increase in dopamine signaling. This is a perfect example of how intertwined these two diseases can become as we try to improve one or both.

By following patients over time, we have been able to categorize antidepressants based on their risk of “drug-induced weight gain.” In the chart featured in this article, you will see that medications can be high, medium or low-risk.

When possible, it is beneficial to choose from medications that have a lower risk of weight gain. In fact, with the help of your physician or psychiatrist, you may find that you want to trying shifting to a lower-risk medication.

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In summary, there are many pieces to the puzzle when it comes to treating obesity while also taking antidepressants. The journey must be individualized. If depression and obesity are two areas that you are working on as you strive to improve your health, then it is time to map out your plan. You know your body best, so always be sure to tell your healthcare provider about any struggles you may be having with depression or weight gain. You can work together to develop a plan that meets your mental and physical needs.

Deborah Horn, DO, MPH, MFOMA, is the President of the Obesity Medicine Association and Clinical Assistant Professor in the Department of Surgery at The University of Texas McGovern Medical School at Houston. She is the Medical Director for the UTHealth Center for Obesity Medicine and Metabolic Performance. Dr. Horn was also the recipient of the Obesity Action Coalition’s (OAC) Healthcare Provider Advocate of the Year award – an award given to a healthcare provider who is a tireless advocate for patients, the OAC and the cause of obesity.by Holly Higgins | Mar 1, 2019 | Antidepressant Withdrawal, Anxiety, Client Success Story, Depression, Mental Health, Mindset, Nutrition for Mental Health, Psychiatry, Weight Loss, Whole30 | 0 comments

This post comes from my client Liz, who has overcome so much! Read on to learn about her struggles with antidepressants, weight loss, and challenging life circumstances. Liz proves that determination, time, hard work, and self-love can create radical transformation. I am so proud of her!  

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I was a sturdy kid and a curvy teenager. Looking back, I can see that while I was never slender, I was never overweight either. I developed early (got my period a month before I turned 9) and was immediately hit with raging hormones and depression. I never received any counseling, but by the time I was 19, I had been through three pretty significant depressions. I finally worked up the confidence to ask my primary care doctor about it and he put me on Prozac. It worked immediately and I felt so much better. I was able to go off it within a few months.

I graduated from college and got pregnant (surprise!) within a week. I had a successful pregnancy, but gained 50 lbs. I was able to drop the weight very quickly and was back in my pre-pregnancy size 8 jeans within 3 months. I met and married my husband by the time my son was 18 months.

I went back on Prozac for a short stretch prior to my next pregnancy with less of a positive effect. In fact, I felt guilty for my depression—things were going so well—and noticed a weight gain when I was on the Prozac. I had two more babies in the next three years. Each time gaining about 50 lbs, each time losing a little less. By 2003, I had three kids under 5, a husband, a mortgage, and a full-time job. I weighed 180-185 lbs.

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I was still experiencing depression—and still feeling guilty. I was prescribed a variety of psych meds over the next 12 years. I took Prozac, Zoloft, Lexapro, Paxil, Effexor, then Nuvigil, Lamictal, Cymbalta, and I’m sure others that I forgot. I was diagnosed with bipolar and shift-work related sleep issues. I started to be anxious about everything.  

At this point, none of the medications seemed to be working. I was exhausted all the time, my body ached, I didn’t experience normal emotions—I was either numb or sad. I had debilitating migraines a couple of times per week. I also had two surgeries for embedded kidney stones. I’m sure my diet of Diet Coke, fast food, and Tums didn’t help.

My highest weight was about 265 lbs. I might have been higher, but I hated to get on the scale. I was embarrassed to see friends, embarrassed for my kids that their mother was so fat, and sad for my husband that I wasn’t a fully engaged partner in our relationship.  

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Everything about my life felt out of control. I hated my job. The house was a mess. The kids had so much energy and I couldn’t keep up. We had $30, 000 in medical debt (despite having health insurance). We were underwater on our mortgage and ended up selling our house in a short sale just after the recession, and we were forced to move in with my aging in-laws.

The one thing I decided during this very difficult time was that I would join a local gym. To be honest, I thought, “If this marriage doesn’t survive, I’ll be out on my own, and who’s going to want a fat, 40-year-old woman with depression and anxiety?”  

I joined an amazing gym (shoutout to EarthFIT NF!) that offered group training and recommended the Whole30. I did my first Whole30 in 2015. My migraines were the first thing to go. Then breast tenderness, PMS, and cramps during my period (all big issues for me in the past). I also noticed a connection between gluten and my mood. When I did my first reintroduction, I realized it didn’t take much for me to go right back into a depression.

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I decided to stay on a slightly modified Whole30 with occasional resets and lost about 85 lbs, putting me at 175-180 lbs. My doctor was thrilled with my weight loss and lab results, although I was still technically overweight. I felt so much better that I decided to wean off all my psych meds. For the first time in years, I had energy and a full range of emotions. I was able to keep the weight off for the next two and a half years.

BUT I still wanted to lose about 30 pounds, and without psych meds, I noticed that I was angry. A lot. This surprised me, since so many other things had improved.  

This is where Holly came in. I found Holly through the Whole30 website. I was drawn to her because of her candidness regarding mental health issues, psych medication,

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