ASK THE ANXIETY SISTERS

Anxiety meds and weight gain? Anyone have issues?

Note: We believe this person was asking about SSRIs (the anti-depressants commonly prescribed for anxiety disorders, namely Prozac, Lexapro, Celexa, Zoloft, Paxil, and Cymbalta, among others). These meds are taken everyday (as opposed to some drugs which are on an as-needed basis).

The short answer: Absolutely!

The long answer:

If you ask your MD (and, believe me, we have many times) he/she will probably tell you two things: 1) SSRIs don’t cause weight gain—or, at least, not a significant amount and 2) if someone is gaining weight it is because she feels better and, consequently, has recovered her appetite (eating can be hard with intense anxiety or depression).

As Anxiety Sisters who have battled with the disorder for 30+ years, we respectfully disagree. Ok, maybe not so respectfully. Here’s the deal:

The first studies of side effects (including weight gain) were sponsored by Big Pharma. Let’s face it, if their studies had shown a connection between America’s “biggest sin” and their incredibly profitable drugs, it would have been a PR nightmare. Big Pharma thus conducted studies with very small samples and over a very short period of time—typically 8 to 12 weeks. As you may know, SSRIs take a month or two to get into your system, so not many people reported weight gain in the first 2 or 3 months. Therefore, the data did not support the idea that people on SSRIs gained weight.

In 2014, Harvard Medical School and Massachusetts General Hospital conducted a study of 19,000 people on SSRIs over the course of one year. The researchers found that the average weight gain was 1 to 2 pounds (“not significant”). This was a big headline in JAMA (Journal of the American Medical Association), where many MDs get the latest research information. The headline in the publication of the Harvard Medical School was: “Antidepressants Cause Minimal Weight Gain.”

But the authors of the Mass General study suggest in their conclusion that one year may still be too small a time period in which to see significant weight gain.

WebMD researchers, on the other hand, state that upwards of 25% of people on SSRIs gain 10 pounds or more. This is fairly in line with reports of significant weight gain that we heard from 86 of the more than 300 women we have interviewed. We even heard from Sisters that never had weight/food issues (hard for us to imagine) until they started taking SSRIs.

So, what can you do about this? The decision is a very personal one as so many other factors are involved in the equation (such as the existence of an eating disorder, the causes of the anxiety, physical capabilities, etc.), but here are some ideas:

  • Use the SSRI for only a short stint—six months or less—during which you should find other treatments that work (e.g., therapy, acupuncture, meditation, exercise, herbal supplements, etc.). That way you will have gotten on your feet without packing on the pounds.

 

  • Switch SSRIs. Often just changing from one SSRI to another—for example, from Prozac to Zoloft—does the trick. There are subtle differences in each of the drugs within the SSRI class, and these can affect your metabolism in different ways.

 

  • Stay on your SSRI—particularly, if it has really changed the quality of your life—and add exercise while cutting a few calories out of your daily menu. (This may not work, but, if you don’t have weight/eating issues in general, you may want to give it a try.)

 

  • Stay on your SSRI and accept the plumper but calmer and more able-to-function you. (This is what Mags and I chose—we’re not always pleased when we look in the mirror, but we are thrilled to be living fulfilling and mostly happy lives. The tradeoff is worth it to us; however, we completely understand and respect that others may view such a tradeoff as a deal-breaker.)

Finally, 2 Don’ts:

  • DO NOT take any weight loss medications (over-the-counter, herbal, or otherwise) while taking SSRIs. Drug interactions are serious business!

 

  • DO NOT let anyone, especially in the medical field, shame you for your weight issues. Fire any health care professional (or anyone else, for that matter) who makes you feel bad about your body size.

If you are willing to share your experiences with weight gain and SSRIs, we would really love to hear from you!

 

28 thoughts on “Anxiety Meds and Weight Gain

  1. I have gained 20 pounds due to SSRI. I am not giving it up, so I count my calories so I maintain my current weight. It is what it is. I feel so much better that I am just going to deal with the extra pounds.

    1. We have gained at least that much–each! Like you, we work hard not to gain any more weight, but it is always a challenge. When we lament the toll our meds have taken on our bodies, we remind each other that living with debilitating anxiety is much much worse. We are not giving up our SSRIs!

      Thank you for your response,
      Abs & Mags

    1. I also gained close to 80 lbs since I’ve been on lexapro. Since this past march I’ve been doing low carb diet & have lost 30 lbs to date. I really needed to get the sugar out of my system. I am highly addicted to sweets. After a few days I didn’t crave it anymore. I was scared I couldn’t lose wt while taking the lexapro but it’s slowly coming off!

  2. Gained 60 pounds in last 10 years while on, at different times, Effexor, Zoloft, Citalopram. Mentioned several times to my nurse practitioner how distressed I was about weight gain but she really downplayed the meds’ involvement. Off all meds now for a couple months but weight not changing.

    1. Hi Leigh,
      We often find medical professionals downplaying the very real weight gain from SSRI’s. Here is the unfortunate thing, after a while our bodies adjust to the weight and it becomes very difficult to lose it…even off the meds. We would say to focus on treating your body well and focusing less on the weight (although we both really struggle with this so we don’t want to be hypocritical). Let us know how your are doing. Mags and Abs

  3. I have been on and off zoloft (mostly on) since age 14, I’m now 35. I always gain weight on it and the amount of weight depends on how high the dosage is. It doesn’t matter what I eat or how much I exercise. I can’t lose it, I also retain salt and water. I’ve also tried Lexapro and I gained 50 pounds in 5 months on it, no diet or activity changes. Went back to zoloft and immediately stopped gaining any more, but unable to lose. Paxil caused visual problems. I’m fed up, (ha) but I have a severe anxiety disorder and don’t feel I can function without zoloft. But at the same time, obesity is slowly killing me.

    1. Elizabeth,
      It sounds like your body has extreme reactions to these meds but I also get the feeling that they really help. Zoloft is a life-saver for me too! Even if you are dealing with extra weight, obesity is not killing you because you can be healthy at any weight. It is the food choices themselves that support our health and the exercise itself that makes our body stronger. I am not preaching to you because I struggle with these issues myself (taking care of my physical health). But I know that even if Zoloft causes weight gain, I can still choose to keep myself healthy and taking Zoloft is part of that choice…without brain health the rest of my life just doesn’t work. Let us know your thoughts. Much love, Mags and Abs

  4. I have gained 50 pounds over the last three years while taking Effexor and Buproprion. During this time I have under gone 6 rounds of chemotherapy, watched my calorie intake, no more than 1100 a day and exercised. My doctor keeps saying cut more carbs and exercise more. Most days it is good if I get 800 calories in due to no appetite.

  5. Hi Beverly,
    Wow it sounds like there is a lot going on for your body and that you are trying to be very responsive in taking care of yourself. It also sounds like you really have lost your appetite and that whatever you can eat (whether it is carbs or not) is important for you. Right now your focus needs to be on taking care of yourself rather than worrying about carbs…and it sounds like you are really doing the very best you can. Much love, Mags and Abs

  6. Hello! I’ve been on Paxil a year and I have gained 20. Mentally I feel better, but physically I’m horrible. I started weight watchers today. I just hope I’m able to loose being on medication.

    1. Hi Stacy,
      Go easy on yourself. You sound really good at taking the steps to help yourself in whatever way you need. Good luck and let us know how you are doing.
      Mags and Abs

      1. Be patient with yourself. Losing weight is so hard. I never put weight on from psych meds, but early menopause has caused me to pack it on. And even with watching what I eat and regular exercise, it’s so slow to come off.

  7. I have gained 40lbs this year on Effexor. Also counting calories and exercising. I used to be able to eat whatever I wanted and stay 135. However, I have seen a significant improvement in my anxiety disorder. So at this point I’m embracing my plump.

  8. Hi Sara,
    Yes, sometimes we have to put our health first and living with anxiety disorder is really excruciating. Thanks for your note.
    Mags and Abs

  9. I gained a total of 50 lbs since being on Paxil. I’ve been it on now, for almost 2 years. It has helped tremendously with my anxiety, the trade off was the weight gain though. I definitely believe it caused weight gain, although I do feel much lazier on the medication than ever before, so that could be a contributing factor as well.

  10. I gained a ton of weight from SSRIs, mood stabilizers, etc. I am now doing Weight Watchers and am down 60 pounds. It is harder to lose the weight on the meds, but it CAN be done!

  11. I am currently on celexa and have gained 30 pounds in 6 months. One doctor told me that was normal of celexa because it affects the part of your brain that tells you when you are full. Which makes sense because I’m thinking of my next meal while eating a current meal.

  12. My son has gained 20lbs in close to 2 yrs of Fluvoxamine. He’s a very active 10 yr old. We took him off for a couple of months per his doc’s request because of the weight gain and it was awful. He was suffering so I put him back on. Even at 10 he told me he feels so much better on the medicine and will work hard to be more active in order to stay on it. 😔

  13. I’m so glad I’m not the only one! I gained 50lbs in total over the first year of taking Paxil. But I had lost a bunch of weight before taking because I was unable to eat or when I did I would have instant diarrhea. My husband says who cares at least your healthy now! Gotta love that man. So glad to hear I’m not the only one. Makes me feel a little better to know we all have that same struggle.

  14. I recently went off of lexapro because I was gaining too much weight on it. It really helped with my anxiety/depression, but I gained roughly 50 lbs in 8 months. I have struggled with obesity my whole life and have worked really hard to get my weight down to a more “reasonable” level. It’s really disheartening to look down at the scale and see that a lot of the hard work I’ve put in has been counteracted by the medicine. I’m currently at a much higher weight than I’ve been at in years. Ultimately, I decided that the emotional toll of the weight gain was no better than the original anxiety/depression I had experienced without the medicine. It was a difficult decision, but I think it was probably the right one for me. Anyway, thanks for posting this. It’s nice to know that I’m not alone in these experiences!

  15. Almost 40lbs on lexapro in a year. I have never struggled with weight, and actually enjoyed eating healthy and exercising before this. I’ve taught fitness classes off and on for over 17 years! Now most days I can hardly pull myself out of bed or off the couch, and I crave sugar like my life depends on it… I’ve tried to wean myself off the meds, but about a week or so into the weaning the anxious thoughts take back over. I’ve talked to my healthcare professionals, and they just suggest diet and exercise.

    1. Hi Krissy–

      Unfortunately, many healthcare professionals don’t understand how hard it is for us to deal with weight gain on top of the mental health issues. This is especially difficult since our culture doesn’t treat larger female bodies very well. We haven’t yet figured out how to stop the weight gain resulting from taking antidepressants, but we do know that living with extreme anxiety is far worse than being “overweight.” At least it is for us. So, for now, we are embracing the low-anxiety life and all the sugar that seems to come with it!

      With love,
      Abs & Mags

  16. I am currently on Cymbalta and gained about 6kg (13ish pounds) over 12 months. I gained most of it over the middle period but have miraculously managed to lose 2kg (6 pounds) over the last month.

    Previously however I was on effexor An whoa nelly! I gained 20kg (44 pounds) over about 6 months. This compounded my situation so my GP took me off them. I managed to lose half of that weight and then had a baby, and 4 years later started the cymbalta.

    Whilst I am pudgier than I’d like, it’s a means to an end to get my dodgy brain back on track and totally worth it. I always drop the weight, or at least a good portion once I’m off meds again. It’s been a long journey on and off meds and the weight gain is shit, but not the end of the world.

  17. I gained a lot of weight when my depression and anxiety was at its worst. I’ve been on almost all the SSRIs and none seemed to work for me. I’m finally on one that helps a little. I’ve not gained any more weight, but haven’t lost it either. It’s a terrible cycle.

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