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Judith J. Wurtman, PhD

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10 Tips to Prevent Weight Gain on Antidepressants

Posted: 06/30/10 09:00 AM ET

Weight gain as a side effect of antidepressants is very common and distressing. Patients may even stop their medication because they have gained so much weight. No one has a good explanation for how these drugs increase eating. Nonetheless, people report never feeling satisfied after a meal and continually craving carbohydrates. Sometimes they find themselves binging.

Our research at MIT, and at a Harvard University hospital weight-management center, helped us develop an effective way of preventing or reversing this weight gain. We know that serotonin, the chemical in the brain that regulates mood, also regulates appetite. Antidepressants work only on the mood function of serotonin and may in some way interfere with the appetite function. The solution to this, based on our research, is to increase the ability of serotonin to turn off the need to eat.

Here are simple tips that will work to prevent antidepressant weight gain. Before you take the medication, learn about the drug and how much weight people typically gain on it. If the medication suggested by your doctor is associated with substantial weight gain, ask if you can switch to another one. This seems obvious, but your doctor may not be thinking of the weight gain side effect when prescribing the drug.

  1. Before starting on the medication, get weighed and report the number to your physician. Most psychiatrists do NOT have scales in their offices. Be sure your weight is recorded so when you return for follow-up visits and claim that you have gained weight, there is no dispute.
  2. Learn to tell the difference between being hungry and having an appetite. Hunger is when you must eat immediately and just about any food will satisfy you. Appetite is when you feel like eating but without the urgency of hunger. Your medication will increase your appetite and leave you with the nagging feeling that you want to eat more but won't really make you hungry. A good test of the difference between hunger and appetite is whether you are willing to eat something you really don't like that much. If the answer is yes, you are hungry. If the answer is no, then it is your appetite calling to you. My test food is a protein bar. When I am really hungry, I will gobble it down. When I only have an appetite, I won't even nibble on one.
  3. Does the medication cause your stomach to produce too much acid? Some medications will do this and the feeling is similar to being hungry. A simple test is to take Tums, or some other over-the-counter preparation, to reduce stomach acidity. If the hungry feeling goes away, then you will know it is a side effect of the medicine on your stomach. Speak to your physician about long-term treatment of this.
  4. Make more serotonin. This will immediately turn off your appetite, vanquish your cravings and leave you feeling satisfied. The feeling is similar to having your thirst vanish after you drink enough water.
  5. Serotonin is made after you eat any carbohydrate except the sugar in fruit (fructose). When a starchy or sweet food is digested, the brain receives tryptophan, an amino acid that is used by the brain to make serotonin. Eat about 30 grams of a sweet or starchy food such as breakfast cereal, pretzels, popcorn, rice or soy crackers, graham crackers or Twizzlers.
  6. Eat the carbohydrate on an empty stomach or at least two hours after you have eaten protein. Protein foods like turkey, chicken, beef, fish, cheese, yogurt and eggs interfere with the ability of tryptophan to get into the brain. If you combine protein foods with carbohydrate, as in a turkey sandwich, no serotonin will be made.
  7. Choose carbohydrates that contain very little fat. Fat slows digestion and adds unnecessary calories. Chocolate, cookies, ice cream, cake, pie crust, French fries, and chips are NOT good serotonin-producing snacks.
  8. Avoid eating protein at dinner time if your medications make you snack all evening. By eating only a starchy carbohydrate, like pasta or a large baked potato along with vegetables for dinner, your brain will make enough serotonin to keep you satisfied and full until bedtime.
  9. Do not, under any circumstance, go on a high protein, low carbohydrate diet. This is a diet for disaster as it prevents serotonin from being made and will only increase your urge to eat and maybe binge.
  10. Exercise. The increase in serotonin brought about by eating serotonin-producing carbohydrates will increase your energy. Take advantage of this and increase your physical activity, even by a few minutes each day. The combination of no longer feeling an urge to eat and the exercise will allow you to lose weight easily or prevent you from gaining it at all.

 

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Weight gain as a side effect of antidepressants is very common and distressing. Patients may even stop their medication because they have gained so much weight. No one has a good explanation for how t...
Weight gain as a side effect of antidepressants is very common and distressing. Patients may even stop their medication because they have gained so much weight. No one has a good explanation for how t...
 
 
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04:07 AM on 07/06/2010
You got more to worry about then weight gain when taking antidepressants. How about suicide? There are some antidepressants that will push you over the edge but this is not talked about because the health care industry wants you to keep buying those drugs.

So many drugs are on the market that have not been thoroughly tested. They want the fast money and now use the public as their testing lab. Watch the tv ads, they list some of the side effects. They may cure what ills you but gives you 4 or 5 side effects you didn't bargain for.
06:10 PM on 07/03/2010
Please cite evidenced based references to your recommendations. I am an RD and some of your advice does not make sense. To start, not all proteins sources have the same amino acid composition, the amount that you are consuming is also relevant, and separating CHO's from protein -that will create differing insulin responses.
04:12 PM on 07/03/2010
Depression can be measured by varying degree's, I suppose the more serious it becomes you need to take prescription medication. But for the more milder forms, then one can use natural supplements and if they work for you then all well and good.

www.vitaminsforlife.co.uk/Supplements_for_Depression
07:13 PM on 07/01/2010
How about the number one way.... stop taking poisons!
12:00 PM on 07/01/2010
my mom was on antidepressants for about two years and it screwed up her metabolism permanently (not to mention did absolutely nothing for the depression...). some people benefit from antidepressants, yes, but in the vast majority of cases there are other natural remedies that work 100% better. try dietary changes (food allergies and unhealthy diet can cause or worsen symptoms of depression), exercise, meditation. I started meditating a few months ago and cannot believe how much better I feel. I was going through one of the worst bouts of depression I've experienced, and now I feel like a totally different person.
10:11 AM on 07/01/2010
HUFFPOST SUPER USER
topkatnc 58 minutes ago (8:57 AM)

I believe what you say ... I am always open for learning something new from another poster ... Myself ... I have been on antideepressants for years ... and I hate them .. I have cut the dose in half a few years ago ... and I wish I could get off of the for good ................................

Thanks for all the great info ...
_________________________________________________

You're so welcome! I have a cousin who also took antidepressants for severe chronic pain, for about three years. It took her a while to get off them, but she did it and now gets just as much relief from OTC pain medication, without the emotional flatlining and chronic IBS and a host of other side effects.

Do check out the website http://www.breggin.com/ Lots of information and support there. I wish you all the luck in the world.
(fanned).
01:57 AM on 07/01/2010
An excellent source of information:

Psychiatric Drug Facts with Dr. Peter Breggin
http://www.breggin.com/

Dr. Breggin is the Psychiatrist who wrote "Talking Back to Prozac", in 1994. He is still the best source of information about all the things that Big Pharma doesn't want you to know and that most doctors don't take the time to research.

He is NOT Tom Cruise or a Scientologist, nor am I.
10:51 PM on 06/30/2010
How about Ten Tips to avoid *taking* anti-depressants in the first place, since about 90% of those taking them, don't really need them. These toxic drugs are destroying people's minds, bodies and lives.
Obviously, there are some cases of extreme psychiatric disorders where the necessity outweighs the damage done, as the damage to the individual's mind, body and life without them, is even worse than what they cause. Again, maybe 10% of those actually taking them.

SEE:

Are Prozac and Other Psychiatric Drugs Causing the Astonishing Rise of Mental Illness in America?
www.alternet.org

The specific link has probably expired. Do some Googlong, people. Your life, or the life of someone you care for, could depend on it.
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MJinCanada
Safe from zombies until my 2nd cup of coffee
12:41 AM on 07/01/2010
Taking antidepressants beats walking in front of a bus, sweetie.
01:12 AM on 07/01/2010
Do you have any idea how many people have committed suicide *because* of antidepressants?
First we had he warning "may cause suicidal thoughts *or actions* in children under eighteen".
Then it was "young adults under age twenty-five".

Not to mention the long term, extreme physical and mental side effects that cause it to be almost impossible to get off these drugs, once you've been on them for a while (length of time varies, but any way you look it, this FACT should cause these drugs to be classified as ADDICTIVE.)

See Psychiatric Drug facts with Dr. Peter Breggin
http://www.breggin .com/

Dr. Breggin, a psychiatrist, wrote "Talking Back to Prozac" in 1994. Since then the devastation wrought by these drugs has exploded a hundred fold. Especially the horrendous and increasingly acceptable practice of medicating children with psychiatric drugs because they're over-active and difficult to control. Rowdy kids are now diagnosed with psychiatric conditions and medicated into being compliant little robots.

And Big Pharm gets richer and richer. It's now common practice to "create" a "disorder" for their new drugs to treat.

Several years ago, Serzone (Nefazadone) was VERY QUIETLY taken off the market, because of associated suicides and suicide attempts. The lawsuit attempting to get Paxil off the market has been ongoing for years.
Big Pharma's pockets are endlessly deep, and they learn from experience.
05:30 PM on 06/30/2010
"Antidepressants work only on the mood function of serotonin and may in some way interfere with the appetite function."

This is another way of saying that she has no idea whether or not SSRI's "interfere with the appetite function". She's simply making an assumption based on faulty logic: "If SSRI's increase serotonin, and serotonin suppresses appetite, SSRI's MUST "interfere with the appetite function". It's faulty because SSRI's have effects other than increasing serotonin, and it could just as easily be one of those effects as any other. If SSRI's increase insulin secretion, for example, it would increase appetite in a way totally unrelated to their effects on serotonin.
12:23 PM on 07/01/2010
I'm also inclined to doubt the science behind the advice, and am very curious about the "research" mentioned in the article. Were their ideas based on any studies, and if so, which ones? Did they conduct any studies on actual humans?

Plus, asserting that antidepressants only work on the mood function of serotonin is pretty questionable, considering that something like 80% of the body's serotonin is in the gut. When I first started taking SSRIs, the most noticeable effects were actually digestive.
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lynzyluhu
Something clever and smart goes here: _____
05:17 PM on 06/30/2010
I actually LOST weight on Lexapro- those final 5 stubborn lbs. It just kicked my appetite's arse. Perhaps I was eating to calm my anxiety?? I don't know..but I heard I'm lucky and that most people gain.
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MJinCanada
Safe from zombies until my 2nd cup of coffee
12:47 AM on 07/01/2010
My sister also found it easier to control her weight on antidepressants because anxiety made her crave sweet stuff. Since her depression was due to a series of stressful events, including surgery that kept her housebound for the winter, she's hoping she can quit them this summer.
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bluize
Let's Stay Together, 4 more years Obama/Biden2012
01:03 AM on 07/01/2010
Back in the late 80's, after suffering chronic pain for several years, I went to pain management clinic. Was very depressed, of course, and wanted to get off of heavy pain meds. I was prescribed this " new ", antidepressant called Prozac. Lost over 20 pounds, just did not feel like eating. Took Prozac for about 3 years. Did wonders for me. If I ever find myself going back to that "dark place ", I will not hesitate to take the drug again. People do need to realize that you do suffer "burn out" on some of these meds and need to adjust and couple the meds with counseling.
04:31 PM on 06/30/2010
I gained about 20 lbs on an SSRI, and subsequently lost over 40 lbs, while still on the medication. My secrets? I ate a little less and moved a little more. I started making better food choices. I even counted calories for a while so I could learn what a proper portion size looked like and make sure I was getting proper nutrition. Crazy, huh?

That being said, suggestions 5 - 9 are simply absurd. Eating all that sugar and flour is poor nutritional advice for anyone, especially someone with the carb craziness that can come along with SSRIs. Fat and protein are both incredibly important for satiety, not to mention overall health.

If I ate nothing for dinner but a baked potato and some veggies, I would be hungry again within an hour, regardless of my serotonin levels. What ever happened to a nice, wholesome, balanced meal? Baked sweat potato, some veggies sauteed in garlic and olive oil, and a nice cut of wild salmon - now that will keep you full!
05:32 PM on 06/30/2010
Agreed, except that I'm not too sure about the "sweat" potato...
10:21 PM on 06/30/2010
Ewwwww. That must be one of those side effects they keep warning me about...
KristenfromMA
I hate platform shoes.
03:52 PM on 06/30/2010
Very interesting information, but I don't think it's the whole picture, at least in my case. I am always hungry (or 'have an appetite,' as you put it). I have been this way since I was a kid, long before I started taking SSRIs. I've read a little bit about Leptin, and its affect on appetite. I'd be curious to know how Leptin and Serotonin interact.
03:51 PM on 06/30/2010
TIP 1: Read the Blackbox warnings and decide not to take them in the first place. - There are alternatives to drugs folks. I'm not just saying that.
KristenfromMA
I hate platform shoes.
04:00 PM on 06/30/2010
as someone else said down thread, thank you tom cruise. (just curious, do you also tell diabetics to 'just say no' to insulin?)
04:58 PM on 06/30/2010
You're welcome. Just and fyi, MOST diabetes can be handled permanently without any use of insulin and ALL depression can be handled without drugs. You've obvioulsy made your choice and hope you don't suffer the consequences of the known side effects. It's like Russian Roullette with these drugs my friend.

http://www.ssristories.com/index.php - Great site. Bookmark it.
08:03 AM on 07/01/2010
Actually, for many Type II Diabetics, strictly following a satisfying, nutritious, balanced "diabetic" diet rich in natural sources of fiber, combined with moderate daily exercise and careful blood monitoring, often eliminates the need for insulin and diabetes meds. And sugar substitutes.

Many people find that they lose weight on such a diet, and the weight loss alone changes their metabolism. They also find that their "sweet tooth" resets itself, and sugary foods which they once craved taste repulsively sweet, while foods rich in complex sugars----whole grain breads, dried fruit, nuts, now satisfy the need for something sweet.
02:09 PM on 06/30/2010
Actually it is antipsychotics such as Seroquel and Zyprexa that are associated with weight gain. SSRIs are really not associated with weight gain. Plus, Wellbutrin, which is a unique antidepressant not involving serotonin, is actually associated with weight loss. No psychiatrist would ever prescribe a high carb diet. The antipsychotics actually increase the risk of diabetes so a low carb diet is the way to go. If your diet to increase serotonin method had any validity, don't you think we would be prescribing high carb diets to all our depressed patients? This just sounds like nonsense to me. Anyone knows that eating a high carb meal with low protein is a surefire way to increase appetite! Just have your jelly doughnut for breakfast and see what happens an hour or two later!
KristenfromMA
I hate platform shoes.
03:55 PM on 06/30/2010
I've been taking SSRIs for a while now. My doctors told me that they can cause weight gain. Not as much as the old tricyclates (sp?), but they do cause some gain.
04:00 PM on 06/30/2010
Actually SSRI's do cause weight gain:

http://www.depression-guide.com/ssri-weight-gain.htm
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serz4u
GOP: Because, hey, survival of the fittest! â„¢
01:41 PM on 06/30/2010
Low-carb/high-protein diets do work for a lot of people, depressed and not. Specifically atypical depression is associated with blood sugar dysregulation and a feeling of constant hunger (with or without weight gain), and especially carbohydrate cravings. A high protein diet can be helpful.

Also, Twizzlers (and graham crackers and some cereals) contain a lot of corn syrup and sugar. Aren't these good bets to boost, rather than reduce, hunger, especially for people who have "hypoglycemic" symptoms (again, atypical depressives)?
02:06 PM on 06/30/2010
Fanned for being so well informed. Low GI is the way to live.
KristenfromMA
I hate platform shoes.
03:56 PM on 06/30/2010
But this person is talking about atypical depression. I suffer from chronic clinical depression, so some opf the tips may help. (I agree about corn syrup, though. Bad stuff.)