Do Antidepressants Cause Weight Gain? Here's What You Need to Know
From antipsychotics to SSRIs, here's how different types of antidepressants can affect your weight.
When it comes to medication side effects, it can be tricky to separate the anecdotal from the scientific. For instance, Ariel Winter recently opened up about her weight loss in a Q&A on her Instagram Stories, explaining that it may have been a "change in medication" that "instantly made [her] drop all of the weight [she] couldn't lose before." More specifically, Winter wrote that she had been taking antidepressants "for years," and that she believes the medication may have caused her to gain weight over time. But do antidepressants actually cause weight gain-or weight loss, for that matter? Or was this simply Winter's unique experience with the medication? (Related: How Quitting Antidepressants Changed This Woman's Life Forever)
Here's what an expert says
Antidepressants-including both atypical antipsychotic medications (such as Risperdal, Abilify, and Zyprexa) and selective serotonin reuptake inhibitors (a.k.a SSRIs, such as Paxil, Remeron, and Zoloft)-can lead to weight gain "quite often," says Steven Levine, M.D., founder of Actify Neurotherapies. In fact, "weight gain while on antidepressants is typically the rule, rather than the exception," he tells Shape. Not only that, atypical antipsychotic medications, as a class, are often associated with increased cholesterol and an increased risk of diabetes, explains Dr. Levine.
Though the relationship between antidepressants and weight gain isn't fully understood, Dr. Levine says it's likely due to "direct metabolic effects," including, but not limited to changes in insulin sensitivity. However, it's just as important to keep in mind that symptoms of depression can include changes in appetite, changes in sleep patterns, as well as reduced activity levels among other things, says Dr. Levine-all of which are completely independent of antidepressants. In other words, depression in and of itself "may contribute to weight fluctuations," he explains, but at the same time, antidepressants can affect the body in a similar way. (Related: 9 Women On What Not to Say to a Friend Dealing with Depression)
It's important to note that everyone responds to antidepressants differently, according to Mayo Clinic-meaning some people might gain weight while taking a certain type of medication, while others might not.
So what do you do about it?
In terms of Ariel Winter's experience with antidepressants, she wrote on Instagram that taking a new combination of medication seemed to help both her brain and her body get to a healthy, balanced place. If you're struggling with the way an antidepressant is affecting your body, think about just how much a healthy diet and lifestyle, outside of your medication, can contribute to the way you feel overall, says Caroline Fenkel, DSW, LCSW, a clinician with Newport Academy.
"Exercise is known to help naturally fight depression," Fenkel says. "Regular exercise can have a large positive impact on depression, anxiety and more."
Furthermore, the foods you eat can have a pretty significant impact on your overall mental health, too, says Fenkel. She cites a January 2017 study published in BMC Medicine, known as the "SMILES trial," which was the first randomized, controlled trial of its kind to directly test whether improving diet quality can actually treat clinical depression. The trial collectively involved 67 men and women with moderate to severe depression, all of whom reported eating a relatively unhealthy diet before joining the study. Researchers divided the participants into two groups for a three-month intervention: One group was put on a modified Mediterranean diet, while the other group continued eating the way they did prior to the study, though they were instructed to attend social support groups that have been shown to help with depression. After the trial's three months were over, the researchers found that about a third of those following the modified Mediterranean diet showed "significantly greater improvement" in their depression symptoms compared to those who were not following a specific diet, according to the study. (Related: Is Junk Food Making You Depressed?)
Having said that, this doesn't mean you should switch from an antidepressant to a healthy diet to treat your depression-certainly not without consulting your doctor first, at least. However, it does mean that you have more control over your mental health-and how it relates to your physical well-being-than you might think. Antidepressants clearly aren't the only way to treat depression, but that doesn't make them any less effective, nor does it make it okay to write them off as just some pill that's making you gain weight without offering any significant benefits.
Remember, it's going to take time to find what works for you
One of the trickiest things about finding the best antidepressant for an individual is that it's extremely difficult to predict how well a specific medication will work, according to the Institute for Quality and Efficiency in Health Care. Plus, once you do begin taking one of these medications, it can take as long as six weeks (if not more) to determine its effectiveness, according to Mayo Clinic. Translation: Finding a treatment plan that works for you isn't going to happen overnight; you have to be patient with the process, and with yourself, as your brain and body work to adjust to the changes.
If it proves to be a difficult adjustment for you, Fenkel suggests carving out time for activities that make you genuinely happy, whether it's cooking, exercise, or even just being outside in nature. Additionally, she recommends steering clear of social media as much as you can, as she says it can "make people feel down on themselves because they are comparing themselves to others who may seem 'perfect' when it is entirely not true." (Related: Why It's Important to Schedule More Downtime for Your Brain)
Above all, don't hesitate to bring up these concerns with your doctor. You can always try a new medication; you can always try a new diet plan; you can always experiment with a different type of therapy. Consider the pros and cons of your treatment plan with your doctor, and be real with yourself about what's truly helping you feel balanced. As Ariel Winter wrote on Instagram of her own experience with antidepressants, "it's a journey." So even when a treatment feels challenging, remind yourself that you're doing something positive for your well-being. "We are doing something to better our own lives," Winter wrote. "Always take care of yourself."