Weight gain is a common side effect that can prevent individuals from consistently taking their prescribed antidepressants. A recent study examined the effects of widely used antidepressants such as Lexapro, Cymbalta, Zoloft, Paxil, and Wellbutrin to determine their impact on weight over time.
The study revealed that certain antidepressants are more likely to cause weight gain than others. Specifically, medications like escitalopram (Lexapro), paroxetine (Paxil), and duloxetine (Cymbalta) showed a higher likelihood of leading to weight gain after six months of use compared to sertraline (Zoloft).
On the other hand, bupropion (Wellbutrin) appeared to be a better option for those concerned about weight gain, as it was associated with less weight gain than sertraline over the same period. This information could be valuable for both doctors and patients when considering treatment options, particularly for individuals worried about managing their weight while on antidepressants.
These findings provide insights that may help guide decisions in selecting the most suitable antidepressant for patients who are particularly concerned about the potential side effect of weight gain.
Antidepressants and Weight Gain: A Common Concern
One of the most frequent side effects of many antidepressants is weight gain. While these medications play a crucial role in managing mental health conditions, the added pounds can present long-term health risks. Excessive weight gain over time may increase the likelihood of developing conditions such as heart disease or diabetes. For many individuals, the concern over gaining weight can even become a barrier to adhering to their treatment plan. In some cases, this may lead to discontinuing medication entirely.
Weight gain does not affect all antidepressants equally, and some medications are more likely to cause this side effect than others. For instance, some selective serotonin reuptake inhibitors (SSRIs) may lead to weight gain in certain individuals, whereas other antidepressants, such as bupropion (Wellbutrin)—a norepinephrine-dopamine reuptake inhibitor—have been linked to slight weight loss.
A recent large-scale study examined the weight gain potential of eight common antidepressants. This study provides vital information for healthcare professionals and patients alike, especially for those concerned about managing their weight while undergoing treatment.
The Study’s Key Findings
The findings of the study were published in the Annals of Internal Medicine on July 2. The study analyzed data from over 183,000 adults, offering one of the most comprehensive looks at how antidepressants can affect weight over time. The study revealed that people taking bupropion were 15 to 20 percent less likely to experience significant weight gain compared to individuals taking the SSRI sertraline (Zoloft), one of the most widely prescribed antidepressants. For this study, significant weight gain was defined as an increase of more than 5 percent of a person’s starting weight.
On the flip side, the SSRIs escitalopram (Lexapro, Cipralex) and paroxetine (Paxil) were associated with a 10 to 15 percent greater likelihood of significant weight gain within the first six months of treatment compared to sertraline. This distinction in how different antidepressants affect weight highlights the importance of personalizing treatment plans based on the patient’s overall health and concerns.
Variations Between Medications
“Even among medications in the same category, like SSRIs, there are notable differences in weight gain,” explains Joshua Petimar, ScD, the lead author of the study and an assistant professor of population medicine at the Harvard Pilgrim Health Care Institute and Harvard Medical School. “Our results can be helpful for doctors who are weighing different options for a patient, especially if either the patient or doctor is concerned about potential weight gain,” he adds.
The study analyzed data from 183,118 adults, ranging in age from 18 to 80, who had just started antidepressant treatment. Researchers tracked changes in their weight at six months, one year, and two years. The antidepressants studied included sertraline, citalopram (Celexa), escitalopram, fluoxetine (Prozac), paroxetine, bupropion, duloxetine (Cymbalta), and venlafaxine (Effexor XR).
In terms of weight gain, escitalopram and paroxetine were linked to the highest average weight gain after six months, compared to sertraline. “On average, we found that escitalopram and paroxetine users gained about one pound more than sertraline users after six months,” says Petimar. In contrast, those taking bupropion lost around half a pound compared to sertraline users during the same period.
Long-Term Weight Gain Trends
The potential for weight gain is not limited to short-term use. “Long-term use of antidepressants increases the likelihood of weight gain,” says Manish Jha, MD, a psychiatrist with UT Southwestern’s O’Donnell Brain Institute in Dallas, who was not involved in the study. Since depression is often a chronic condition, many individuals remain on antidepressants for extended periods, which makes understanding the long-term impact on weight even more critical.
For example, participants in the study who were taking sertraline saw an average weight gain of 0.5 pounds after six months. This modest increase, however, escalated to an average of 3.2 pounds after two years. In comparison, those taking bupropion experienced a slight weight loss of 0.25 pounds at six months but had gained an average of 1.2 pounds by the two-year mark.
Meanwhile, people taking escitalopram or paroxetine gained an average of 1.4 pounds after six months. After two years, escitalopram users had gained an average of 3.6 pounds, while paroxetine users had added around 3 pounds. According to Petimar, “There were no clinically significant differences in the amount of weight gained among these medications after two years.” However, early weight gain may be enough to discourage some individuals from continuing their treatment, even if the medication is effectively managing their symptoms.
“A patient might initially avoid paroxetine because of its higher short-term weight gain risk compared to sertraline, but over two years, the difference in weight gain between these two drugs was minimal,” Petimar adds.
The Individual Nature of Weight Gain
Weight gain from antidepressants can vary significantly from person to person. According to Jami Woods, MD, an assistant professor of psychiatry at the University of California, Riverside, for some individuals, the risk of weight gain could influence their decision about whether to start an antidepressant. “It’s a risk-benefit decision, but ultimately, treating your mental and emotional health is far more important than worrying about a small amount of weight gain,” says Woods.
Moreover, there are strategies that can help mitigate weight gain, such as incorporating regular physical activity and following a healthy diet. Woods also emphasizes that individual responses to medications can differ greatly. “Some patients gain a lot of weight on any type of antidepressant, while others don’t. Genetics likely play a significant role. Some people may become more active as their mood improves on medication and lose weight, while others may not see the same effect,” she explains.
Additionally, the dosage of the antidepressant may play a role in weight gain, with higher doses being more likely to cause weight increases than lower doses. “If a patient is experiencing unwanted weight gain that they think is related to their medication, it’s crucial to discuss this with their doctor so that they can explore solutions together,” advises Petimar.
Navigating Treatment with Weight in Mind
The study’s findings provide valuable insights into the relationship between antidepressants and weight gain. For patients concerned about this side effect, the study underscores the importance of working closely with healthcare providers to find a treatment plan that addresses both mental health needs and physical well-being. With an individualized approach that considers factors such as genetics, lifestyle, and dosage, it is possible to manage depression effectively while minimizing the impact on weight.
While the possibility of weight gain is a valid concern for individuals starting antidepressant treatment, it should not deter them from addressing their mental health. By staying informed and maintaining open communication with their healthcare providers, patients can navigate treatment options that offer both mental and physical benefits.
Recommended For You
