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Will You Gain Weight on an Antidepressant?

Some people who take an antidepressant may gain weight. The risk is higher for those taking duloxetine, paroxetine or escitalopram.

Antidepressant medications are among the most widely prescribed drugs in the United States. People who take antidepressant medications for many years often complain that they gain weight. Several years ago, researchers presented evidence to support this common complaint. Recent research demonstrates that not all antidepressants are equal with respect to weight gain.

Do People Gain Weight When They Take Antidepressants?

An epidemiological study published in the BMJ tracked nearly 300,000 people for more than a decade (BMJ, May 23, 2018). Those taking antidepressant medications were more likely to put on pounds than matched controls who were not taking antidepressants.

People who started at normal weight were more likely to become overweight if they took an antidepressant, while those who were overweight at the outset were more likely to become obese. This risk became apparent during the second and third year on the medications.

The authors suggest that “the widespread use of antidepressants might be an important factor contributing to increasing body weight.”

The Risk Is Not High, But It Is Wide:

An editorial in the same issue points out that the increased risk that a person will put on pounds is modest: 11.2 per 100 person-years of follow-up among people taking antidepressants compared to 8.1 per 100 person-years for people not taking the drugs. The difference is only about 3 people who gain weight out of 100 people followed up for a year. However, because so many people take antidepressants, this could add up to extra pounds for thousands of individuals.

Knowledge about the possibility of weight gain should not keep people from taking antidepressant medications, but it should make both doctors and patients vigilant about this potential adverse reaction.

Which Antidepressants Are Most Likely to Lead to Weight Gain?

At last count, nearly 50 million Americans took medications such as sertraline, citalopram, fluoxetine and duloxetine. A new study in the Annals of Internal Medicine shows that such drugs frequently contribute to increased weight (Annals of Internal Medicine, July 2, 2024). There is, however, significant variability among them.

The authors analyzed medical records between 2010 and 2019. They were looking for people who experienced a minimum 5 percent weight gain within six months of starting an antidepressant. Their findings suggest that duloxetine, paroxetine and escitalopram are more likely to promote weight gain than sertraline. Bupropion, on the other hand, was the least likely of the commonly prescribed antidepressants to lead to extra weight.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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  • Gafoor R et al, "Antidepressant utilisation and incidence of weight gain during 10 years’ follow-up: population based cohort study." BMJ, May 23, 2018. doi: https://doi.org/10.1136/bmj.k1951
  • Petimar J et al, "Medication-induced weight change across common antidepressant treatments : A target trial emulation study." Annals of Internal Medicine, July 2, 2024. DOI: 10.7326/M23-2742
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