Which antidepressants are less likely to cause weight gain?

[Picklemeyellow]

I need antidepressants.
I have suffered for decades with anxiety, depression, ocd , issues with weight and food, intrusive thoughts, bad dreams and basically unbalanced thinking etc.
My mental health has never been great but I’ve limped on by with endless cbt, exercise, healthy eating, no alcohol and caffeine and just ‘trying my best’.

But I’ve got to face up to the fact that it’s not working. I have some health issues (IBS, endometriosis and adenomyosis). The latter two will need more investigating and operations this year which is already raising my anxiety levels. Add into the fact I am in peri and caring for a parent with dementia and needless to say I’m ready to break.

However, many people I know have gained so much weight on antidepressants including my sister who has gone from a size 10 to 16. I know people will say they’d rather be bigger and happy than slim and miserable and I understand this as I long to feel happier but for most of my life I’ve been dealing with food issues and I love being slim, it’s my identity. The thought of weight gain makes me feel so miserable. I know that is hard for some people to understand but the possibility of any weight gain as a side effect to medication very much holds me back.

I have tried Citalopram, nortriptyline (Was told this has less digestive side effects so wouldn’t exacerbate my daily gut issues) and sertraline but I’ve never gotten past the initial side effect weeks and the fear or weight gain.

Are there anxiety/depression meds which are less likely to cause weight gain? And if the weight gain is due to increased appetite how do you deal with that (I have never had much of an appetite)?

3 weeks into Prozac and I’ve lost weight. I’ve heard this is an initial side effect but also heard it causes less weight gain than most.
Antidepressants work differently for everyone and some ppl actually lose weight on them it all depends how your body responds to them.
Was on paroxetine before and definitely gained weight on them .

I’m on 10mg Escitalopram ( for about three years) and it hadn’t affected my weight. I also have an underactive thyroid that I take Levothyroxine for, so I technically “should” be prone to weight gain, but I’m a size 10.

I was originally on 20mcg and that didn’t affect my weight either.

Thanks Ilovemycatalot & HamBone I’ve been offered both Fluoxetine and Escitalopram and am weighing up the pros and cons for both meds. Good to hear neither of you have experienced any weight gain yet.

I've never gained weight on any of them other than when I've not been eating because I've been too depressed to eat. Once I feel better, and start eating properly, I might put on a bit but only what I lost through being unwell.

I had escitalopram
And piled on the weight. No issues with sertraline.

Generally medication doesn't cause weight gain because calories do. What medication can do is dull feelings of being sated meaning you eat more or for longer.

Dishing up normal portions and typical eating and exercise habits, and also drinking a glass of water 20 minutes before eating can resolve this.

I imagine the dosage makes a difference as well. 10 or 20 mcg is low so I’d be surprised if that caused significant weight gain.

I've been on escitalopram for years and years, when I came off it briefly, the weight dropped off

20mg for me and it makes a big difference to my weight, I hate it. But I have to weigh up not being on it and the crippling anxiety and being on it and being less anxious but bigger. No amount of diet and exercise has helped whilst being on it either.

However it may be different for others, I'm not sure, I can only offer my experience.

Best of luck with whatever you choose

Sadly Sertraline really upsets my gut issues.

Venlafaxine for me was weight neutral. But everyone responds differently

My daughter put on a lot of weight with Sertraline. She has changed to something else now (I don't actually know what) and the weight has disappeared.

Fluoxetine I lost weight and stayed off, but I massively struggled with the side effects the first few weeks and was considering giving up when thankfully they eased off

I did not gain weight on Duloxetine - though I was on it for just a few months

Thanks everyone.
It does look as though these medications affect everyone differently. I’m either going to just have to leap straight in and try one or except antidepressants may not be for me.
Will have to think hard over the next few weeks.

I’ve been on fluoxetine for 10 years for PMDD and it’s never caused any weight gain. I’m also perimenopausal.

I’ve gained weight on both sertraline and now citalopram. I was on 200mg of sertraline and now 40mg of citalopram. For me though I’m suicidal without them so I’d rather be fat than alive but I really am horrifically fat and that is starting to affect my mood too.

My Gp has resisted the idea that SSRIs cause weight gain and I guess technically they don’t but what they do do is make me feel very hungry and with my mental health being poor I don’t have the will power to deal with it.

I've gained a good couple of stones both times I've had sertraline. Citalopram seemed to be ok for me Weight wise. Currently on Prozac but hard to tell as already have the weight from the sertraline!

I can recommend escitalopram. Didn't cause weight gain but did impact my depression symptoms.

I've put on 3 stone on Setraline 😩

I mean, I've put on weight because I eat and drink too much and don't exercise enough, but since I started taking Setraline I never feel full and I'm more tired/less motivated to exercise (which I used to do regularly)

I am on sertraline low dose and have lost nearly 3 stone in 2023

I was on Fluoexetine(Prozac) for three years and gained four stone. Since stopping them the weight has been slowly coming off. What makes one person gain weight though will be totally different for someone else.

Although I miss being the size I was they were absolutely worth it though, honestly changed my life for the better.

Fluoexetine is prescribed for binge eating disorder because it reduces appetite

Another vote for fluoxetine, it reduces appetite, at least initially.

Duloxetine causes weight loss.

Sertraline doesn't cause much weight gain.

It's possible to just not eat more as well.

I got very underweight on duloxetine actually. Anorexia is a side effect.