What Doctors Want You to Know About Lexapro and Weight Gain
The antidepressant medication Lexapro has been linked to weight gain.
A recent study links antidepressants to weight changes.
Doctors say there are a few things you can do if you gain weight on an antidepressant and it bothers you.
Antidepressant Lexapro (escitalopram) has been linked to weight gain in the past. In fact, for years, reports have swirled of some people experiencing changing weight while taking certain antidepressants. Now, new research aims to break down which antidepressants are linked to the most weight gain.
The study, which was published in the journal Annals of Internal Medicine, analyzed electronic health records from more than 183,000 patients who used antidepressants for the first time. The researchers tracked the patients’ weight for two years, doing regular check-ins to see if there were any changes in their weight.
After six months, those who took Lexapro, Paxil, or Cymbalta had a 10% to 15% higher risk of gaining weight (which was defined as at least 5% of their baseline weight), compared with those who took Zoloft, the study found.
Meet the experts: Joshua Petimar, Sc.D., an assistant professor of population medicine at Harvard Medical School; Thea Gallagher, Psy.D., a clinical assistant professor at NYU Langone Health and a cohost of the Mind in View podcast; Mir Ali, M.D., board certified bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA; Hillary Ammon, Psy.D., a clinical psychologist at the Center for Anxiety & Women’s Emotional Wellness; Gail Saltz, M.D., associate professor of psychiatry at the NY Presbyterian Hospital Weill-Cornell School of Medicine and host of the How Can I Help? podcast.
But, of course, taking an antidepressant doesn’t guarantee you’ll gain weight. So, what’s behind Lexapro weight gain, specifically, and what can you do to lower the risk of gaining weight on an antidepressant? Doctors break it down.
How depression and anxiety affect weight
The link between depression or anxiety and weight is “complex and hard to predict” for each person, says Joshua Petimar, Sc.D., lead author of the recent study and an assistant professor of population medicine at Harvard Medical School. “Some people who experience depression or anxiety may gain weight, while others may lose weight or not experience any major changes in weight,” he says.
A lot comes down to a person’s relationship with food, as well as their history with stress management, says Thea Gallagher, Psy.D., a clinical assistant professor at NYU Langone Health and a cohost of the Mind in View podcast.
“Stress can lead to weight gain, but it can also lead to weight loss,” she says. “Sometimes people are depressed and anxious, and they just can’t eat.” But Gallagher also notes that most people have weight fluctuations that just happen as part of life. “There’s a lot of stigma around weight gain, but the weight gain might not be a bad thing,” she says. “It just might be different from what you were used to.”
What may cause Lexapro weight gain?
It’s important to stress that not everyone who takes Lexapro gains weight. Still, some patients note weight gain while taking the medication.
Lexapro is in a popular class of antidepressants called selective serotonin reuptake inhibitors (SSRIs), which work to increase a chemical called serotonin in your body. Serotonin is often called a “feel-good chemical” and taking an SSRI can help boost some people’s overall feelings of happiness, Gallagher says.
But serotonin is also involved in your appetite and weight control—and that may cause some people to gain weight when they take an SSRI. “There are a lot of serotonin receptors in the gut,” Gallagher says. “There is a huge relationship between mood and your GI system.”
Mir Ali, M.D., board-certified bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, says he’s seen some patients gain weight after taking an antidepressant—but, again, it’s not a given. “They may start eating more and therefore gain weight,” he says. “It’s often because their depression... is better and they’re feeling better.”
It’s important to point out that this isn’t just a Lexapro thing. One study of SSRI side effects in 100 people found that 49% gained weight on Zoloft and 37.5% gained weight on Prozac (while 41% gained weight on Lexapro).
How to avoid gaining weight on an antidepressant
Everyone is different when it comes to taking an antidepressant, says Hillary Ammon, Psy.D., a clinical psychologist at the Center for Anxiety & Women’s Emotional Wellness. “I’ve worked with many clients who have been prescribed Lexapro. Some were more prone to gaining weight, while others did not experience any significant weight gain while taking it,” she says.
Doctors say there are a few things to consider, and it all starts with talking to your doctor. “Our research shows that some antidepressants raise a person’s risk of gaining a clinically significant amount of weight more than others, so it is possible that they can find a medication that works best for their overall health needs—both treating their symptoms as well as avoiding unwanted weight gain,” Petimar says.
If you’re already on an antidepressant and have started gaining weight (and it bothers you), he also suggests talking to your doctor about changing up your treatment or lifestyle to avoid gaining more weight.
Ammon agrees. “I’ve worked with clients who experience side effects, such as weight gain, on one SSRI, and then did not experience that side effect on a different SSRI,” she says. Prozac and Wellbutrin are often linked to less weight gain and may be a good options to consider, says Gail Saltz, M.D., associate professor of psychiatry at the NY Presbyterian Hospital Weill-Cornell School of Medicine and host of the How Can I Help? podcast. “Speak to your doctor about dosage,” she says. “A lower, but still high enough to be clinically effective dose, can reduce weight gain.”
Dr. Ali cautions against making “drastic changes” to your diet. “Instead, continue to follow a healthy diet—that should help,” he says.
Gallagher suggests focusing on making healthy lifestyle choices, including trying to get in the recommended 150 minutes of moderate-intensity exercise a week. “If this is impacting you in a negative way, it can be important to get a nutritionist involved,” she adds.
Other potential side effects of Lexapro
Like all medications, there is a risk of potential side effects with antidepressants, and these can vary by medication. “These include sexual side effects, such as diminished sexual interest, gastrointestinal side effects, and others,” Petimar says.
Lexapro in particular may cause a list of side effects. According to Medline Plus, those include:
nausea
diarrhea
constipation
sexual problems
drowsiness
yawning
shaking
trouble falling asleep or staying asleep
increased sweating
dizziness
heartburn
stomach pain
excessive tiredness
dry mouth
decreased appetite
weight loss
flu-like symptoms
runny nose
sneezing
“Side effects may go away after a few weeks on medication, changing the time of day it’s taken, or reducing a dose,” Dr. Saltz says.
Ultimately, Petimar stresses the importance of good communication with your doctor. “It’s very important that people maintain clear lines of communication with their prescribing doctor about the side effects they experience due to antidepressants,” he says. “It’s possible that their doctor will have suggestions for other options that could manage their symptoms while decreasing the risk of unwanted weight gain.”
You Might Also Like
