Battling Antidepressant Induced Weight Gain

Battling Antidepressant Induced Weight Gain

Introduction

So you’ve decided to take charge of your mental health, and you have sought out the help from a medical professional. You finally found a medication that works, but unfortunately it comes with a nasty little side effect: weight gain. Is the antidepressant induced weight gain real, or have you just been too lax with your exercise and diet? Well, if you’ve been reading the news and the scientific literature, you will quickly find that it’s not really clear on whether antidepressants cause weight gain or not. And then there are the articles that list the medications least likely to gain weight, indicating that some do, some don’t. So what’s the deal?

In the scientific literature, there have been numerous studies showing that antidepressants are linked to weight gain in the longer term. A landmark comprehensive study by Blumenthal et al. examined the electronic health records of ~23,000 adults in New England over a period of 12 months from the date of the initial prescription. Most studies generally examine weight gain over a period of only 4-12 weeks, which is generally about the time frame where the medication has reached its full therapeutic potential. From Figure 2 of the paper, you see that the SSRIs don’t fair as well as one would expect, and actually performed the worst. The best performing antidepressant is Wellbutrin (bupropion), which is a weight-neutral drug, not the weight loss drug it was marketed as. Mirtazapine, the one I am on, performed the worst. In fact, the curve looks like it will keep climbing forever. The tricyclic antidepressants (amitriptyline and nortriptyline) faired better than the SSRIs.

Just a quick disclaimer: the point of this post isn’t to turn you off to antidepressants, because they really do help a lot of people (myself included). I want people to be informed consumers, and I hope this discussion encourages you to perform your own searches on scholar.google.com on any medications that you are interested in trying. Knowledge is power. By knowing the extent of possible weight gain, you can bump up your exercise frequency and intensity and start cutting back on unhealthy foods. Also, it’s worth discussing this side effect with your doctor if you are concerned about it.

Listed below are some of the methods and tricks that I have used to halt my antidepressant induced weight gain (stable at a total of 6-8 pounds gained in the first 3-4 months).

Exercise

Exercise is important for a lot of reasons, but it is especially important in keeping the weight gain under control. If you are on a medication for your mental health that has weight gain listed as a side effect, then you are going to want to get into an exercise routine as soon as possible if you aren’t already.

  • What if your mental illness (and/or your medication) have you so fatigued that it’s hard to just get out of bed?
    • Then start with baby steps. This is what I had to do. At one point my anxiety was so bad, that just elevating my heart rate for 5 minutes gave me a panic attack. To combat this, I would wait for a period when I was feeling calm, and then I would go running for 5 minutes. By not choosing a set time, but a window, that greatly reduced the anticipatory anxiety. Once 5 minutes of running didn’t bother me anymore, then I moved up to 6 minutes. Then 7, etc. Now, the anxiety is no longer the limiting step, and my physical fitness is. As you can see, the baby steps turn into bigger steps as you feel better. Now, I do still have off days where I will have anxiety. For those runs, I give myself permission to stop and walk it out. If I feel better before the end of the run, then I can start running again.
  • What types of exercise are effective?
    • It likely has to be rigorous exercise, such as running, cycling, hiking, zumba, etc. From what I’ve found in my own experimentation, walking and yoga do not budge the numbers on the scale because they simply do not elevate my heart rate enough. Running 3-5 miles/week does move the scale, along with the cardio workouts I found on YouTube by PopSugar Fitness. In fact, rigorous exercise is known for its mood-lifting benefits and antidepressant effects. In fact, several studies have shown that at the 12-week mark, those who were prescribed an exercise regimen fared just as well as those prescribed an antidepressant. Beyond that mark, those that were prescribed exercise actually fared better than those prescribed antidepressants. A similar conclusion was found for those with panic disorder, but the medication group edged out the exercise group a little bit in my opinion. You will notice that I mention vigorous exercise. Walking and yoga likely aren’t going to cut it for weight loss. For me personally, the only exercise that has kept me skinny is running at least 3-5 miles/week. I would recommend something similar, whether it be the elliptical, stair stepper, hiking up mountains, etc. The heart rate needs to be elevated.

Diet

Are you eating healthy? Be honest with yourself here. I’ve had a lot of people tell me that they’re eating healthy and upon closer inspection, turns out they were way off the mark. You don’t need to give up all of your goodies and restaurant outings, but you will likely have to cut back a little bit. Cleaning up my diet was much tougher than making sure I exercised regularly. Unfortunately, some of the medications, including mine, cause an INTENSE carbohydrate/sweets craving all the time. The other drawback is that I also never feel full. I have to use my brain to know when to stop eating because it seems like the feedback loop has been altered a little bit.

  • What is a good diet?
    • It was recommended to me, to eat a high protein and high fiber diet with some sweets mixed in. This way, I feel full longer and it stabilizes my blood sugar (some medicines can also interfere with this). This means my diets consists of mainly fruits, vegetables, meat, fish, eggs, nuts, and beans. I also avoid caffeine and alcohol, and have lowered my added sugar intake. The one diet that I have read to avoid is a low carbohydrate diet because of the following reason: serotonin plays a role in satiety. When you ingest any carbohydrate other than fructose (found in fruit), it gets converted into tryptophan, which is a precursor to serotonin synthesis. So, if you eat a low carbohydrate diet, you are going to miss out on making a lot of serotonin, which means you are not going to feel as full. What is recommended instead, is to eat about 30g of a sweet or starchy food (e.g. breakfast cereal, pretzels, popcorn, rice or soy crackers, graham crackers, etc.) in the absence of protein (less than 3g per serving), preferably two hours before a meal. Another thing worth mentioning is that you have any food sensitivities or intolerances, I would avoid these foods as well because they still take a toll on the body. I would also avoid going out to restaurants and ordering take out food, or at least restrict it to once a month maybe. You don’t really know what’s going into your food, and it makes it harder to make sure you are eating healthy.
  • How do I handle cravings?
    • Unfortunately, some medications actually have increased appetite as one of the side effects (mirtazapine, I’m looking at you). Believe me when I say that they are going to really challenge your will power. However, there are some things you can do:
      • Chew gum. I exclusively chew peppermint flavored gum because it doesn’t remind me of food, and because peppermint has anti-anxiety properties. My gum of choice is the peppermint flavored Icebreaker cubes because they last a really long time.
      • Exercise. Aerobic exercise such as running and cycling boost serotonin.
      • Appetite vs. hunger. It’s important to differentiate between the two. If you are truly hungry, you will be able to eat the food you like the least. If it’s appetite, than that is a fallacy created by your brain. Ignore it.
  • I’m really having a hard time controlling my intake, what else can I do?
    • If all else fails, you can resort to the tried and true method of just keeping unhealthy food out of the house. This trick has actually helped me the most. Even though the grocery store is across the street and I could easily buy something unhealthy, there’s just enough of a barrier that I don’t. If I buy a bag of chips, that bag is gone within two days :). This is also the method I resort to when I know my cycle is coming.

Track Your Progress

Every weight loss article I have read says to throw out your scale. Please don’t do that! The scale is a good way to check in and track your progress, along with using other guidelines such as how your clothes are fitting. The general recommendation is to weigh yourself once a week. I disagree with this, and especially if you are on a medication that makes you more vulnerable to weight gain. I would recommend every few days, or even every day (this is what I do). It is much easier to correct yourself if you are up 1-3 pounds, versus 5-7. By weighing yourself more frequently, you will catch the weight gain sooner and will be able to take faster corrective action.

Change Your Medication

If the weight gain is getting out of control, it might be a good idea to check in with your doctor. There are several medications out there to try (each with their own side effect profiles), and not all of them cause weight gain. Gaining too much weight comes with its own set of health issues, both physically and mentally. Once you get started down that path, it’s hard to go back. A question you’ll want to ask yourself, is how much weight are you possibly willing to gain in exchange for having better mental health? For me personally, the bar is low at 5-10 pounds. I’m on the leaner side, and prefer to stay that way. Before you start your medication, make sure you weigh yourself so you have a reference point. If you start gaining weight, you should run an experiment to make sure it is actually the medication. The experiment is simple: eat a constant diet (all your food and drinks the same) for 2 weeks. If you are still gaining weight, then it’s likely the medication is altering your body in an undesirable way. You shouldn’t have to endure substantial weight gain in exchange for good mental health.

My Meal Plan

Outlined below is the meal plan that has worked for me. Feel free to try out some variation that is tailored to your medical and dietary needs. I gained 6-8 pounds over a course of 3-4 months when I started my AD but my weight has been stable for a year:

  • Breakfast
    • Thomas Lite Multi-grain English Muffin + 2 tablespoons peanut butter
  • Lunch
    • Light tuna fish sandwich on multigrain bread + 1 serving chips
    • Egg salad sandwich on multigrain bread + 1 serving chips
    • Microwave Apple Peanut Butter Oatmeal
    • Deli sandwich on multigrain bread
  • Dinner
    • Whatever I make for the week. I generally have 1 week of meals with red meat (I usually time this for my cycle, so I get a boost of iron), 1 week of meals with beans, 1 week of meals with chicken, and the last week of meals with beans or chickpea pasta
  • Snacks
    • Chobani plain yogurt
    • Any piece of fruit
    • Spring mix salad with some dressing
    • Homemade granola bars
    • Raisins
    • Handful of nuts
    • Salad with a full fat dressing (helps you absorb the nutrients)
  • Splurges
    • Homemade baked goods
    • Candies
    • Chocolate
  • Beverages

Unfortunately, antidepressant induced weight gain is often not mentioned when prescribing medications. We still do not have a full understanding of how these illnesses occur, and even less of an understanding on how the medications work. The best we can do, is to work with the choices we have and be proactive about our health. I hope people find these methods and tips useful! I know it’s a lot to take in, and a lot of work to execute. But the silver lining in all of this is that you will develop very healthy exercise and eating habits that will sustain your overall health long after you taper off your antidepressant. 🙂 In order to make the changes stick, I would change things slowly over a long period of time. This will ensure that the habits will be permanent.

NOTES: If you decide to research your medication on Google Scholar, you will find that a lot of the research articles are locked. In order to unlock them, you need to pay for them. Don’t do that though. Keep clicking on titles until you get a free one that you can read. A good idea too, would be to print it off and bring a copy with you to your doctor to help guide the discussion.

For those of you on medications that caused weight gain, what has helped you the most in terms of stabilizing your weight? Are any of you currently using the methods and tips above, and have found them successful?

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Antidepressant induced weight gain is an understated side effect. A quick look through the scientific literature shows that nearly all antidepressants cause weight gain. However, antidepressants are often a life saver for many people. This post gives tips on how to manage and curtail weight gain. #thepanickedfoodie #antidepressants #antidepressantssideeffects #antidepressantstruths #antidepressantsgettingoff #antidepressantsweightgain #weightgain


10 thoughts on “Battling Antidepressant Induced Weight Gain”

  • This post is so informative. I’m definitely working on something similar. I’m not anti-depressants but I’m working on diet and exercise to help alieve my mental illness. I love the chewing gum idea to prevent cravings. .I didn’t know peppermint had anti-anxiety properties, so I’m def going to get some up next time I’m out.

    • Thank you! I put a lot of research into it to make sure it was informative and factual :). The gum I use is the Icebreakers Peppermint Cubes because it’s super pepperminty and one cube lasts for hours. They are packaged in a blue container. You can also buy them in bulk at Target, and just refill the container once it’s empty. My only word of caution, which my therapist brought up, is to be careful not to become dependent upon it to relieve your anxiety. I generally use it as a last resort type of thing, or I’ll chew some before something stressful. Another thing you can do too, which is less obvious than chewing gum, is to buy a peppermint infused chapstick like Burt’s Bees. Hope it helps some! And good for you for working on your diet and exercise to help your illness!! Lots of studies show that there is definitely a connection between our minds and our bodies, and diet and exercise help to bring them more into balance. 🙂

  • This post is definitely informative. Being in same field of work I always prefer do for counselling before going to a psychiatrist for a medicine. The most important stuff is try and keep your mind calm.

  • thank you for sharing this informative and educational words. this blog offers great tips. you have done a lot of research and efforts. well done 🙂

  • After an ugly divorce, my doctor recommended me antidepressants. However, I did feel more of them. Constant tired. So I used some of your advice instead of medicines. I started out outside and walked, changed my diet (lowered charcoal hydrates) and decided to go out with my friends at least once a week. It took me about a year, but I did it! I left the depression and looked better than before.

  • This is such a informative post I have had this problem lately so it’s awesome to have this post. The weight gain is so annoying. I am definitely saving this to refer to

  • I’m sorry to hear you gained weight when you started taking ADs. You made such a positive step in asking for help and taking the meds in the first place, it seems like such a kick back that you end up gaining weight 🙁 but good on you for not giving up and then finding a diet that works for you x

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