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Why does treating depression cause rapid weight gain?

Updated on April 16, 2013

In short, no one seems to know. The consensus seems to be that as many as 25% of people who take certain antidepressants gain quite a bit of weight – up to 100 pounds!

That number doesn’t quite do the phenomenon justice; USA Today reported last year that 1 in 10 people take antidepressants, and that this number is nearly 400% of what it was in 1988. In fact, says the USA Today article (which cites the Center for Disease Control and Prevention), this makes antidepressants the medication most frequently used by people between the ages of 18 and 44.

Why do so many people take antidepressants?

While many people take antidepressants to treat depression, the same medication can also be used to treat anxiety disorders and other conditions. There are a number of possible reasons for the soaring numbers:

  • The economy: There’ve been a record number of layoffs and foreclosures in recent years; people should expect to be depressed after getting laid off, says a psychologist and public educator for the American Psychological Association. However, usually this type of depression is short lived, and people should not be placed on medication unless it becomes a serious problem.
  • Advertising campaigns: Believe it or not, mental-health professionals cite ad campaigns which name the benefits of antidepressants as a possible reason for the increase in usage.
  • Health insurance: Some families may be reimbursed by their health insurance company for prescription antidepressants almost immediately, and thus skip the visit to a mental-health professional all together.
  • Being a woman: I threw this one in there; being a woman is rough sometimes! Surveys have shown again and again that women are more likely to take antidepressants. I heard it said, just the other day, that to think like a woman is like having 30,000 internet browsers open all at once, and to think like a man is to have just one open at a time! It’s no wonder we get anxious and depressed more often!

What makes it worse? Weight gain.

Most antidepressants can cause weight gain, although some will affect an individual differently than others. Whether or not an antidepressant causes weight gain depends on the person’s metabolism and response to the drug; I’ve seen cases in which weight gain is a direct side effect of the antidepressant (having to do with changes in metabolism), as well as cases in which the individual is unsatisfied after a meal and continues to crave carbohydrates.

In either case, weight gain while taking antidepressants appears to be fairly common.

SSRIs (Selective Serotonin Reuptake Inhibitor)

Selective Serotonin Reuptake Inhibitors, or SSRIs, are a category of antidepressants that work to counteract depression by inhibiting the reuptake of the neurotransmitter serotonin, which contributes to one’s feelings of happiness, in the brain.

Why does this work?

The current model is that the longer that serotonin remains extracellular, essentially, the greater the stimulation of “good feelings”. It is thought that low levels of extracellular serotonin are primarily responsible for depression. Thus, a great deal of antidepressants fall into this category; however, these are also the drugs which are seen to result in weight gain.

Why, you ask? It’s a catch-22, really. While the antidepressant itself may cause changes in metabolism, lifting depression may cause the person to fell pleasure from eating, so, they eat more than usual. However, weight gain can have negative effects on one’s health and also contribute to a negative self-image. Coming full circle now, this lower self-esteem may contribute to feelings of depression.

Don’t get too discouraged; sometimes gaining the weight is better than living with depression. Again, while weight gain is often associated with antidepressants, a low dosage along with a healthy lifestyle could prevent this side effect entirely.

An Alternative, or Two

Losing those extra pounds you’ve gained while taking the medication isn’t easy; in some cases, switching medications may be your best bet. However, exercising at least 30 minutes a day is an effective way to combat mild depression.

Guess why? Not only is improved self-esteem a key factor, but exercising actually releases endorphins, which are molecules produced by the brain (as is serotonin) that diminish the perception of pain and trigger positive feelings in the body.

The take home? Antidepressants should be reserved for severe cases, since weight gain could be a factor in some individuals, and lead to further feelings of depression.

If you are in the market for an antidepressant, Mayo Clinic psychiatrist Daniel K. Hall-Flavin, M.D. suggests that Effexor and Serzone are the two of the drugs least likely to cause weight gain, and Paxil, an SSRI, tends to cause weight gain.

What about you?

Have you, or has someone you know, experienced weight gain while taking an antidepressant?

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