Which Antidepressants Cause Weight Loss?
Weight changes as a potential side effect
Medically reviewed by Mary Choy, PharmDMedically reviewed by Mary Choy, PharmD
Weight changes are not uncommon while taking certain antidepressants. Some cause weight gain, while others may cause weight loss.
If your healthcare provider prescribes an antidepressant for you, you may want to know which ones can cause weight loss as a side effect.
Antidepressants that can cause weight loss may include certain selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).
Usually, antidepressants that cause weight loss may do so indirectly by decreasing appetite. Typically, this side effect is temporary.
This article will describe how antidepressants affect weight and which are more likely to cause weight loss or weight gain. It will also discuss how depression may affect your weight and give a few tips for healthy ways to manage your weight while taking an antidepressant.
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Antidepressants That Can Cause Weight Loss
Many antidepressants can cause weight changes as a side effect. Although antidepressants are more likely to increase weight than decrease it, a few can cause weight loss. In many cases, the weight loss is temporary.
Antidepressants that cause weight loss typically do so because they decrease appetite as a side effect. Some examples are:
Cymbalta (duloxetine): In an analysis of 10 studies that took place during Cymbalta's approval process, people with depression who took duloxetine lost an average of about 1 pound in the short term (eight to nine weeks). However, in the long term (26 to 52 weeks), people who took duloxetine tended to gain an average of about 2 pounds.
Prozac (fluoxetine): A review of studies in 2022 found that adults who took fluoxetine 20 to 60 milligrams (mg) once daily lost an average of about 6 pounds after two to 52 weeks.
Wellbutrin (bupropion): Another study found that people who took bupropion lost an average of about 7 pounds after two years of treatment. However, this weight loss only occurred in study participants who did not smoke. People who smoked gained an average of about 2 pounds instead.
Though Zoloft (sertraline) does not seem to cause weight loss in adults, studies of children taking the same drug reported decreased appetite and weight loss as common side effects.
The manufacturer of Zoloft recommends monitoring children who take it for signs of weight loss and problems with growth. If your child takes Zoloft, let their healthcare provider know if you have concerns about your child's weight or growth during their treatment.
Which Antidepressant Is Most Likely to Cause Weight Loss?
Antidepressants that have caused some weight loss in studies include Wellbutrin, Prozac, and Cymbalta. Of the three, Wellbutrin was associated with the most significant weight loss.
Keep in mind that study results may differ from your individual results. Talk with your healthcare provider if you have questions about weight loss caused by antidepressants.
Antidepressants That Can Cause Weight Gain
Some antidepressants have been associated with weight gain. In studies, weight gain was more likely to happen during the second and third years of taking an antidepressant.
The following antidepressants can cause some weight gain:
Remeron (mirtazapine)
Tricyclic antidepressants, such as amitriptyline and doxepin
Paxil (paroxetine)
Explainer
Many antidepressants can cause weight changes as a side effect. Although antidepressants are more likely to increase weight than decrease it, a few can cause weight loss. In many cases, the weight loss is temporary.
How Do Antidepressants Affect Weight?
Antidepressants may affect weight in several ways. Sometimes, weight gain or loss is a result of a side effect of the medication. Other times, antidepressants affect weight indirectly by improving the symptoms of your condition.
The following explanations may help you better understand the link between antidepressant therapy and weight changes.
Improves Depression Symptoms
One way antidepressants can affect weight is indirectly by improving your depression symptoms.
Changes in appetite can be a symptom of depression.
Depression can affect your weight in several ways. Some researchers believe that depression can be divided into two categories:
Type 1 has symptoms such as decreased appetite, weight loss, trouble sleeping, and suicidal thoughts.
Type 2 has symptoms such as increased appetite, weight gain, excessive sleeping, heaviness in the arms and legs, and metabolic hormone imbalance.
For some people, depression may cause weight loss due to a decrease in appetite. Others may gain weight because of an increased appetite. Decreased physical activity due to excessive sleepiness or feelings of heaviness in your body may also lead to weight gain.
As your antidepressant starts to work, your appetite may return to normal. In time, your weight may also return to what it was before your depression symptoms began.
Blocks Histamine Receptors
Some antidepressants may affect weight by increasing your appetite. They do this by blocking histamine receptors in your brain.
Histamine is a chemical in your body typically associated with allergic reactions. However, histamine in your brain is also responsible for regulating your appetite. It's released when you eat and plays a part in letting you know when you are full.
Tricyclic antidepressants, such as amitriptyline, block the action of histamine. This may prevent you from feeling full after eating and contribute to overeating.
Increases Serotonin
Other antidepressants, such as SSRIs, may affect weight through their action on serotonin.
SSRIs increase the amount of serotonin available for your brain to use. They do this by downregulating (decreasing the action of) serotonin receptors in your body.
Serotonin is a chemical found in your brain and throughout your body that helps regulate mood.
However, serotonin also has other functions, including regulating your appetite. Researchers believe the downregulation of serotonin receptors by SSRIs over time may affect how serotonin affects appetite.
Other Side Effects Associated With Antidepressants
Commonly prescribed antidepressants can have other side effects besides weight changes.
These can include:
Vomiting
Increased risk of bleeding
A lot of times, side effects with antidepressants are mild and resolve over time. Seeing noticeable benefits from the medication can also take some time.
However, your provider can work with you to better optimize your treatment if side effects become too disruptive. Finding the right drug can sometimes take some trial and error.
How to Safely Manage Weight While on Antidepressants
If you're worried about weight changes due to antidepressant therapy, there are a few steps you can take to manage this potential side effect.
You can also speak to your provider about your concerns. They'll likely consider your preferences when choosing an antidepressant to prescribe and can work with you to find one that helps you feel the best.
Maintain a Healthy Diet
Whether you're experiencing weight loss or weight gain during your antidepressant treatment, it's important to stick to a healthy, well-balanced diet to maintain your weight at a healthy level.
The following are tips for a healthy eating plan from the Dietary Guidelines for Americans 2020-2025:
Prioritize fruits, vegetables, whole grains, and fat-free or low-fat milk products.
Opt for healthy protein sources, such as lean meats, seafood, eggs, beans, peas, nuts, and soy products.
Minimize foods with added sugars, salt, saturated fats, and high cholesterol.
Exercise
Increasing your physical activity can help with both your weight management and depression symptoms.
Exercising regularly can have a positive impact on your physical as well as mental health. And studies show that you can benefit from just a moderate amount of regular physical activity.
The good news is that many ways to increase your physical activity don't require extra expenses or equipment. You can even incorporate some of these activities into your daily routine.
For example, you can try:
Taking a short walk during your lunch break
Parking your vehicle farther than you usually do when running errands
Washing your car yourself instead of using a drive-through car wash service
Raking leaves or shoveling snow instead of using a leaf or snow blower
Other activities that can help increase your physical activity include:
Running or jogging
Biking
Swimming
Yoga
Weight lifting
Resistance band training
Are Antidepressants Taken for Weight Loss?
Most antidepressants are not approved by the U.S. Food and Drug Administration (FDA) for weight loss. However, healthcare providers may use certain antidepressants off-label for weight management.
Off-label use is when a medication is prescribed to treat a condition or at doses that differ from the drug's approved dosage.
For example, fluoxetine and bupropion may sometimes be taken off-label for weight loss.
A different drug called Contrave (bupropion/naltrexone) is approved for weight management in certain adults. This medication contains a combination of the antidepressant bupropion and the opioid antagonist naltrexone.
Keep in mind that bupropion should not be prescribed for people who have a history of eating disorders, such as bulimia or anorexia nervosa.
If you are interested in losing weight, talk with your healthcare provider. They can discuss the many options now available for weight management. Together, you can decide which is best for you.
Help Is Available
If you or someone you know are having suicidal thoughts, call or text 988 to contact the 988 Suicide & Crisis Lifeline and connect with a trained counselor.
If you or a loved one is in immediate danger, call 911. For more mental health resources, see the National Helpline Database.
Summary
Changes in weight can be a common side effect of antidepressants. Although weight gain is more likely to happen with antidepressants, weight loss is also possible.
Examples of antidepressants that may cause some weight loss include Cymbalta, Prozac, and Wellbutrin. Of the three, Wellbutrin is the most likely to cause weight loss. Antidepressants more likely to cause weight gain include amitriptyline, Paxil, and Remeron.
Keep in mind that depression can also affect your weight. Often, taking an antidepressant may cause changes in your weight as it starts to work and improve your symptoms.
While taking an antidepressant, It's important to maintain a healthy lifestyle, including a well-balanced diet and exercise. This can greatly help you manage a healthy weight while improving your mental well-being.
Read the original article on Verywell Health.
