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Everyday Health
Antidepressants and Weight Gain: Why It Happens and 5 Ways to Cope With It
By By Shelby House, BSN-RN. Medically Reviewed by Angela D. Harper, MD,
22 days ago
If you're taking an antidepressant, tell your doctor if you're experiencing side effects like weight gain. Getty Images Weight gain is a common and often unwanted side effect of certain antidepressants , such as tricyclic antidepressants (TCAs). It's a major reason some people don't take their antidepressants as directed or even stop altogether, research shows.
"Weight gain can be particularly frustrating for patients because it can negatively impact self-esteem, affecting body image and confidence," says Brent Nelson, MD , an adult interventional psychiatrist and chief medical information officer at PrairieCare , a psychiatric care practice in Brooklyn Park, Minnesota. "This side effect can overshadow the positive mental health benefits of antidepressants, causing additional distress."
What's more, too much weight gain is linked several serious health problems. "It can increase the risk of chronic conditions such as obesity , diabetes , and cardiovascular disease ," says Nelson.
People with depression are more likely to have these conditions than the general population because of factors including weight gain. That's why it's so important to work with your doctor to manage this side effect if you're experiencing it.
Here's everything you need to know about why certain antidepressants are more likely to cause weight gain than others and what you can do about it.
Which Antidepressants Are Most Likely to Cause Weight Gain?
Not all antidepressants cause weight gain, but some are more likely than others. In general, the odds of weight gain are higher with older antidepressants like TCAs and monoamine oxidase (MAOIs) than newer antidepressants like selective serotonin reuptake inhibitors (SSRIs) or drugs like bupropion , though there are some exceptions. Antidepressants that are most likely to lead to weight gain include:
"The reasons behind weight gain from antidepressants are not entirely clear, but several factors likely contribute," says Nelson. These could include:
Certain antidepressants - namely TCAs - may lead to alterations in fat metabolism, or how your body stores fat
Certain antidepressants, like TCAs, are associated with increased appetite or cravings for sweets or carbohydrates
Some antidepressants, like TCAs, affect neurotransmitters (chemical messengers in the brain) like serotonin, which play a role in weight and appetite regulation
Bear in mind, though, that there are other reasons you may be experiencing weight gain if you have depression. Your antidepressant might not be the sole cause. Other factors that sometimes play a role include:
Antidepressant use could alleviate depressive symptoms such as decreased appetite and resulting weight loss. Thus, an improved appetite could lead to weight gain.
Adults often gain weight as they get older, regardless of what medications they use.
What to Do If Your Antidepressants Cause Weight Gain
These six expert-recommended strategies can help you cope with weight gain while taking antidepressants.
1. Talk to Your Doctor
Before anything else, it's crucial to talk to your doctor about any side effects you're experiencing, including weight gain. "Since each person's response to medication can vary, an individualized approach is necessary to find the most effective and manageable treatment," says Nelson.
Your doctor may opt to change the dose of your medication or switch you to a different antidepressant, depending on how this side effect is affecting you. Don't try to make any changes to your medications or stop taking them without clearing it with your doctor first. Taking your antidepressants inconsistently or stopping them cold turkey can lead to withdrawal, especially if you've been taking them for more than a month. Withdrawal symptoms can include anxiety, flu-like symptoms, nausea, headaches, vivid dreams, irritability, or a return of depressive symptoms, among others.
2. Learn Everything You Can About Your Medication
Educating yourself in advance about your antidepressant can help you understand its potential side effects, like weight gain, and enable you to anticipate and manage them better. "For many of the individuals I work with, having this information helps to recognize physical, emotional, and behavioral side effects," explains Deborah Serani, PsyD , a psychologist and senior adjunct professor at Adelphi University in Garden City, New York. "Such information helps us to address side effects that occur," she explains.
3. Tweak Your Diet
While weight gain is a side effect of some antidepressants, many medications do not alter a person's metabolism, and weight loss is still possible through strategies like diet .
"Maintaining a healthy diet, rich in fruits, vegetables, lean proteins, and whole grains, supports overall health and weight management," adds Dr. Nelson.
A few tips that can help:
Keep a food log to help you become more aware of what you're eating each day.
Eat smaller and more frequent meals.
Include more protein in your diet, which can help you feel fuller, longer.
Eat a nutritious breakfast.
If you're not sure where to start, consider consulting a registered dietitian nutritionist, who can help you come up with a nutrition plan that works for you.
4. Move Your Body
"Consistent physical activity is a key component of managing weight-related medication effects," says Joel Frank, PsyD , a clinical psychologist with a private practice in Los Angeles. "It not only helps burn excess calories and increase metabolism but also boosts your mood," he says.
In general, adults should aim to get at least 150 minutes (2.5 hours) of moderate aerobic activity - think walking, jogging, swimming, or biking, for example - each week, along with at least two days of strength training.
It's key to find activities you enjoy and that you can stick with in the long run. Ideally, they should be something you look forward to rather than a chore, says Dr. Frank.
That said, this can be a challenge for some with depression due to symptoms like fatigue, lack of energy, or loss of pleasure in activities once enjoyed. It can help to start small and gradually work your way up, especially if you haven't exercised in awhile. Any activity is better than none, and even a quick 10-minute walk can help.
5. Get Plenty of Sleep
Getting enough shut-eye each night is essential for keeping your weight in check, says Frank.
"Poor sleep can affect hormones that regulate hunger and appetite, leading to increased cravings for unhealthy foods," he says. "Establishing a sleep schedule and creating an environment that promotes sleep quality can go a long way in helping with weight and mental health management."
But getting good sleep can be difficult for many with depression because insomnia is a common symptom of the condition. Up to 75 percent of those with depression have difficulty falling asleep or staying asleep. Some tips to boost your odds of a good night's sleep every night :
Go to bed and wake up at the same time every day to help train your body's internal clock.
Put your phone and other screens away an hour before bed to help your body and mind wind down.
Keep your bedroom between 60 and 67 degrees F (the optimal range for sleep).
Keep your room dark, and use blackout curtains if needed.
Calm your mind with light yoga stretches, journaling , or progressive muscle relaxation.
If you've tried strategies like these but still have sleep troubles, let your doctor or therapist know. They can help you find professional help for sleep issues.
6. Decide if the Benefits of Your Antidepressant Outweigh the Side Effects
Finding a balance between effectively managing depression and maintaining a healthy weight is key, says Nelson. That said, if your antidepressant is helping you feel better, you and your doctor may find that the benefits of your antidepressant outweigh potential drawbacks like weight gain.
"Learning to live with certain side effects may enable a better quality of life for you than forgoing medication altogether and having your depression take center stage again," Dr. Serani says.
The Takeaway
Weight gain is a common side effect of some (but not all) antidepressants. TCAs and MAOIs are more likely to cause weight gain than SSRIs or drugs like bupropion. Telling your doctor about any side effects you're having, as well as prioritizing a healthy diet, exercise, and sleep, can help you manage weight gain.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy . We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Firth J et al. The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness. The Lancet Psychiatry . August 2019.
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