Is It Hard to Lose Weight After Antidepressants?

Antidepressant medications are a popular choice for addressing moderate to severe major depressive disorder. Nonetheless, a considerable number of these drugs are associated with documented adverse events, including gastrointestinal side effects as well as weight gain. Sometimes, this potential side effect plays a role in people's decision not to use antidepressants even if they need them.

How do antidepressants work?

To better understand antidepressants' adverse effects, first, it is beneficial to understand how they work. In the brain, we have specific molecules to transmit signals through the neurons and the body. These molecules are called neurotransmitters. They have special names regarding their structure and main effects, such as dopamine, serotonin, and norepinephrine.

Due to the lack or excess of one or a couple of them, people may have different types of brain-related disorders, such as depression, attention deficit hyperactivity disorder, or even schizophrenia. And the goal of physicians is to diagnose and correct changes in neurotransmitter signalling by using specific medications.

Among antidepressant agents, there are varying risks of weight gain, with notable differences within the same class. For example, sertraline is linked to significant weight gain, whereas bupropion exhibits effects leading to weight loss, particularly in non-smokers. Let’s delve into the topic and learn more details about antidepressants and their side effects.

Antidepressants and weight complications

Differences in how antidepressant medications work can affect how likely someone is to gain weight or have problems with their metabolism. It mainly depends on the pharmacological target of the medication.

Histamine

It is not yet fully understood how and why is histamine signalling involved in depression, however, it is believed that many of the currently available antidepressants also interact with histamines. The way certain medications affect histamine and other chemicals in the body is hypothesized to play a big role in whether someone gains or loses weight. When a medication blocks a receptor called H1, it often leads to lower feelings of fullness and more cravings for carbohydrates, which may result in eating more calories and gaining weight.

Serotonin

As serotonin is hypothesized to be one of the neurotransmitters implicated in depressive disorder, some drugs that directly target serotonin signalling, called selective serotonin reuptake inhibitors or SSRIs, can modify serotonin levels in the central nervous system. It is believed that in depression, serotonin, which leaves one neuron, cannot sufficiently reach other neurons as it is often reabsorbed back. When reabsorption is inhibited by SSRIs, serotonin can successfully reach other neurons, thus increasing serotonin signalling in the brain.

It is reported that short-term use of SSRIs tends to reduce impulsive eating and increase the feeling of being full by boosting metabolism. However, using these medications for a longer time, like 12 months or more, may lead to weight gain due to increased cravings for carbohydrates.

Dopamine

Dopamine, a chemical that affects reward and motivation, also is hypothesized to play a role in depression. Medications such as tricyclic or atypical antidepressants can affect dopamine levels in the brain. While the relationship between dopamine and weight is not fully understood, changes in dopamine levels or sensitivity may potentially affect eating behavior and cravings, and, consequently, may lead to weight gain.

Norepinephrine

Norepinephrine, another chemical in the body, influences mood and weight. Medications that block both serotonin and norepinephrine reuptake may cause a small amount of weight loss initially, but over time, they may lead to weight gain. However, compared to medications that only block serotonin reuptake, the combined blockers are believed to be less likely to cause weight gain. This might be because norepinephrine stimulates a process in fat tissue that converts fat into heat and energy, promoting weight neutrality or loss.

Post-antidepressant weight issues

The post-antidepressant health effects and possible weight issues can depend on a variety of factors which may be related to the antidepressant that was used, the duration of treatment, the method employed to introduce medication discontinuation, and the presence of depressive symptoms after treatment termination.

If treatment is discontinued before complete recovery, emotional eating problems may lead to weight gain, as eating is often seen as a coping mechanism to suppress negative feelings. For this reason, individuals should go through this process with regular consultations with their doctor, psychologist, and dietitian to address weight struggles post-medication to ensure a smooth transition and healthy recovery.

Is exercise really the most powerful tool?

In all these stages, exercise plays a significantly crucial role. Numerous studies indicate that exercise may be even more effective than pharmaceutical antidepressant treatments. Moreover, it is a method that can enhance your physical health without any side effects. Therefore, supporting both your treatment process and the post-treatment period with exercise can be highly beneficial and may help prevent antidepressant-related weight gain.

An expert's advice on post-antidepressant weight journey

Reach out to your doctor, psychologist, and dietitian to discuss your unique situation. They can provide tailored insights based on your health history, medication specifics, and individual needs.

If you realize that you feel emotionally better when you eat, you may consult with a nutritionist, who may help you have a better relationship with foods and help you look for healthier and comfortable options for intuitive eating.

Developing an exercise routine will benefit both physiological and physical health for managing antidepressant-related weight gain. If you do not exercise regularly, it is better to start with achievable goals, like two times per week, and increase the frequency step by step. Also, socializing with people by exercising in the gym or some sports communities may have healing power for depression management.