Can antidepressants cause weight loss or weight gain?

The way we feel about our bodies can impact the way we feel about ourselves. Changes to our bodies can impact our emotional wellbeing, too. If you’re experiencing symptoms of depression, antidepressants are a common part of many treatments. These medications are generally very effective. They can also, in some cases, have an impact on your weight. If you’ve had questions about this, your doctor will be able to give you specific answers and medical advice about your specific treatment, but we also wanted to provide some information from our own doctors so you can make the most informed choices about your care.  

How do antidepressants affect your weight?

Antidepressants affect everyone differently though and for the most part any weight changes, in either direction, are small. These effects can also differ depending on factors like your genetics, lifestyle, and other health conditions you might have.

Some people might experience weight gain as a side effect due to increased appetite or changes in metabolism—while others may notice the opposite, losing a few pounds from a loss of appetite, even when they take the same type of antidepressant.  

Additionally, research has shown that the initial weight loss that some people experience on antidepressants fades after several months of use. A meta-analysis of 10 clinical studies found that, in the short term, patients taking duloxetine (Cymbalta), fluoxetine (Prozac), or paroxetine (Paxil) experienced similar and slight weight loss (roughly one pound) compared to a group of patients taking a placebo.  

After 34 weeks, however, patients taking duloxetine did not have a difference in weight compared to the placebo group, and after a year’s time, the patients on this antidepressant even gained some weight (less than three pounds) compared to the placebo group. These small fluctuations over time suggest that antidepressants have a minimal effect on weight for most people.

To learn about other antidepressants, check out our articles on escitalopram (Lexapro) and sertraline (Zoloft)

Antidepressants that cause weight loss

Most antidepressants might cause weight gain, but only one is known for not causing weight gain—bupropion (Wellbutrin).  In one study, participants taking Wellbutrin lost as much as seven pounds.  Sometimes people lose weight when going on any antidepressant because they become much more active again when feeling better. Sometimes people also lose weight on an antidepressant if they were overeating when depressed: When the overeating stops the weight goes down. Other times people lose weight when going onto Wellbutrin because they stopped another antidepressant that had caused them to weight gain, and so afterwards their weight starts to go down.

However, your response to Wellbutrin might be different. Make sure to let your healthcare provider know of any weight changes as well as other side effects you may experience if you’re taking it.

Wellbutrin is an atypical antidepressant that can also be prescribed for anxiety, seasonal affective disorder, smoking cessation, and ADHD (attention-deficit/hyperactivity disorder). The exact reason why isn't fully understood, but Wellbutrin may contribute to weight loss by stimulating norepinephrine and dopamine—neurotransmitters in the brain that affect appetite, energy, and pleasure.

It’s also important to note that Wellbutrin can reduce seizure thresholds in some people and is therefore not prescribed to people with eating disorders who may be at increased risk. If you have a history of eating disorders or seizures, be sure to talk to your doctor before starting this antidepressant.

Related article: Can depression make you lose weight?

Antidepressants that cause weight gain

Weight gain is a common side effect of antidepressants, with one study showing that as many as 65% of people on antidepressants report weight gain. There is a stronger link between some antidepressants and weight gain than others, and these include:

• Paroxetine (Paxil)
• Mirtazapine (Remeron)  

Paroxetine is a type of SSRIs (selective serotonin reuptake inhibitors) that one study found to had the greatest long-term effects on weight, with patients gaining as much as  7% of their body weight.

Mirtazapine is an atypical antidepressant in a class of drugs called tetracyclic antidepressants or TeCas. They come with side effects, including weight gain, increased appetite, and drowsiness and in certain circumstances your psychiatrist might consider them right for your specific needs because of them. For example, someone is depressed with cancer and losing weight may need to gain weight as part of overall health. In one study participants’ weight found that mirtazapine had weight-gaining effects in both short and long-term treatments, with people gaining as much as 11 pounds in two years. Often lower doses do not cause weight gain though.

Antipsychotics and mood stabilizers, like olanzapine and clozapine, are sometimes prescribed for the treatment of depression and other mood disorders. These drugs are more strongly linked to weight gain and other metabolic changes in people who take them.  

While there is a link between some antidepressant medications and weight gain, it’s important to note that these medications don’t cause weight gain in every person who takes them. If you’re worried about gaining or losing weight while comparing treatment for your depression, make sure to talk to your doctor. They can tell you about any potential impact these drugs could have before you start them and give you further medical advice.

Can you get antidepressants for weight loss?

The Food and Drug Administration (FDA) has not approved an antidepressant for weight loss to date, and doctors do not prescribe them for this use alone. If you’re struggling with weight management  and are looking to lose weight there are other prescription medications your doctor can recommend that have been approved for this purpose. For example, some medications that use bupropion as an active ingredient have been approved to help with obesity and may help with weight loss goals for certain people. These medications may come with their own side effects, so be sure to discuss it with your healthcare provider. (Most weight loss medications also need to be paired with diet and exercise in order to be effective.)

To learn more about different types of antidepressants, check out a list of MAOIs and TCAs.

6 tips for managing your weight when on antidepressants

You don’t have to feel powerless over changes in your weight while on antidepressants. Eating a balanced diet, managing energy levels, and practicing sleep hygiene can all help. Talk to your doctor about creating a plan that works best for you. They can give you the support and guidance you need to feel better and can recommend a nutritionist, too.

Here are some strategies to get you started:

Eat a balanced diet

It can be hard to stick with a balanced diet, especially if you’re struggling with your emotional wellbeing. Try making sure you eat regular meals and snacks throughout the day. This helps you avoid getting too hungry and reaching for anything in sight. Focusing on a balanced diet rich in vegetables, whole grains, and lean proteins can also go a long way; processed foods high are high sugar and unhealthy fats, which can induce cravings and contribute to weight gain.  

Practice portion control

Be mindful of portion sizes to prevent overeating, especially if you experience increased appetite as a side effect of taking your antidepressants. Use smaller plates, measure portions, and pay attention to hunger and fullness cues to avoid consuming more calories than your body needs.

Keep a consistent sleep schedule

Not getting enough sleep or poor quality sleep can lead to weight gain by disrupting the systems in our body systems that regulate our appetite. In a sleep-deprived state, your body craves foods high in fats and carbohydrates to replenish its reserve of energy. At the same time, it tends to make you feel less motivated to move or be active. Over time, this can lead to weight gain and even put some people at an increased risk of diabetes or obesity.

To help keep your appetite well-regulated, aim for 7-8 hours of quality sleep each night. You can do so by establishing a regular sleep schedule and practicing good sleep hygiene habits. This includes creating a relaxing bedtime routine, avoiding stimulants like caffeine and screens before bed, and ensuring your sleep environment is dark, quiet, and comfortable.

Exercise regularly

Getting regular exercise can help manage weight, boost mood, and increase energy levels. If you’re struggling with your mental health, this can be hard to put into practice. Try breaking up your exercise routine into manageable chunks of time, like 10 minutes, three times a day. This can also be a great way to keep your mental health in check throughout the work day. To get started, choose activities you enjoy, such as walking, jogging, cycling, swimming, or yoga, and gradually increase intensity and duration as tolerated.

Reduce your stress

When it comes to managing weight gain, we can't ignore the impact of stress. Stress has a way of leading us to unhealthy eating habits and making it harder to maintain a healthy weight.

One strategy is to add relaxation techniques into your daily routine. Deep breathing exercises, meditation, and mindfulness are great options to help unwind.  

Relaxation doesn't have to be limited to formal practices. Spending time in nature can be incredibly therapeutic, too. Taking a leisurely stroll in the park, hiking in the woods, or simply sitting by a tranquil lake can work wonders for our stress levels.

Learn more about grounding techniques for anxiety

Stay in touch with your healthcare provider

You should try to keep open communication with your doctor about any concerns you have regarding weight management, energy levels, or side effects of antidepressants. By keeping them in the loop, they can give you  personalized guidance. That can mean adjusting your medication or dosage, and supporting you to create a plan for managing your weight and improving overall health. This might mean connecting you with other doctors or resources. .

If you’re seeking treatment for depression, or are struggling with your mental health, consider Talkiatry. We’re a national psychiatry practice that provides in-network, 100% virtual care so you can talk to a psychiatrist from the comfort of your home. We treat conditions like major depressive disorder, anxiety disorder, and more. To get started, take our free online assessment and see if Talkatry is right for you.‍

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.