Antidepressants and Weight: What to Expect

The way we feel about our bodies can impact our emotional wellbeing. If you're considering antidepressants or already taking them, you may have questions about how they affect weight. At Next Step Psychiatry in Lilburn, Georgia, we help patients throughout Gwinnett County and Metro Atlanta make informed decisions about their psychiatric medications.

How Do Antidepressants Affect Weight?

Antidepressants affect everyone differently, and for most people, any weight changes are small. Effects can differ based on:

• Your genetics
• Lifestyle factors
• Other health conditions
• The specific medication

Some people experience weight gain from increased appetite or metabolism changes, while others lose weight from decreased appetite—even when taking the same medication.

Research shows that initial weight changes often level out over time. A meta-analysis found that patients on certain SSRIs experienced slight weight loss (about one pound) in the short term compared to placebo, but this effect diminished over several months.

Antidepressants Less Likely to Cause Weight Gain

Wellbutrin (bupropion) is the one antidepressant known for not causing weight gain—and some people actually lose weight on it. One study showed participants lost as much as seven pounds.

Wellbutrin is an atypical antidepressant that works by stimulating norepinephrine and dopamine—neurotransmitters affecting appetite, energy, and pleasure. This may contribute to its weight-neutral or weight-loss effects.

Sometimes weight loss on any antidepressant occurs because:

• Improved mood leads to increased activity
• Depression-related overeating stops
• Switching from a weight-gaining medication allows weight to normalize

Important note: Wellbutrin can reduce seizure thresholds in some people and is not prescribed to people with eating disorders or seizure history. Always discuss your medical history with your psychiatrist.

Antidepressants More Likely to Cause Weight Gain

As many as 65% of people on antidepressants report some weight gain. Medications more strongly linked to weight gain include:

• Paroxetine (Paxil): Studies show patients may gain as much as 7% of their body weight
• Mirtazapine (Remeron): Can cause significant weight gain, with some studies showing up to 11 pounds over two years (though lower doses may have less effect)

Antipsychotics and mood stabilizers sometimes prescribed for depression—like olanzapine and clozapine—are more strongly linked to weight gain and metabolic changes.

Why Does This Happen?

Different mechanisms may contribute to weight changes on antidepressants:

• Changes in appetite and food cravings
• Metabolic changes
• Effects on energy levels and activity
• Improved mood leading to lifestyle changes

What Should You Do?

If you're concerned about weight changes on antidepressants:

• Talk to your psychiatrist about your concerns before starting medication
• Monitor your weight and report significant changes
• Maintain healthy habits including regular exercise and balanced nutrition
• Consider medication options—your psychiatrist can help you choose a medication with a profile that works for your goals

Remember: the FDA has not approved any antidepressant for weight loss alone. The primary goal of antidepressant treatment is to improve your mental health.

Finding the Right Medication

Every person responds differently to medications. Working with a psychiatrist allows you to find the right antidepressant that effectively treats your symptoms while minimizing unwanted side effects.

This article is for educational purposes only. If you or someone you know is experiencing a mental health crisis, call 911 or the National Suicide Prevention Lifeline at 988.