How to lose weight gained as SSRI side effect?
August 1, 2010 8:42 AM   Subscribe

Has anyone here lost weight successfully while on an SSRI? How did you do it?

I chunked on 25 pounds after starting Lexapro for anxiety a few years ago. The drug works great for me otherwise. I have healthful habits--count calories, no sugar, few refined grains, no junk food, exercise vigorously 3-4 times a week--still the scale will not budge downward except a pound or two, and then it goes back up. Thyroid checks out fine; in fact, I'm very healthy according to all lab-measurable parameters. I do not want to spend my life in the gym, but am willing to spend some more time if necessary. Bonus points if, like me, you're a 40+ woman, but all input welcome. Thanks!
posted by sister nunchaku of love and mercy to Health & Fitness (16 answers total) 5 users marked this as a favorite
On Zoloft, I lost 30+ pounds on Weight Watchers and have (pretty much) kept it off. A little has crept back on, but that's since I'm ten years older, have had a kid and a more sedentary lifestyle (switch from subway commute to car commute.) I lost the weight in my early 20s
posted by chesty_a_arthur at 8:57 AM on August 1, 2010

Yes, I was over 40 YO (substantially) and when I started Paxil I made a commitment to myself to maintain my weight during the first 2 months and then lose 7-8 lbs. I can report both were successful. It was a matter of calories--200 less in and 200 more out. As a life long jogger I added 20 minutes to my daily routine and cut down intake by 200 calories. That is roughly 3-4 lbs. weight loss per month. I should note I was not particularly over weight when I started--BMI was 25.5 after weight loss it was 24.6. As has been said many many times--calorie reduction is essential for weight loss and exercise is essential to maintain weight loss. Yes, you absolutely can do it as long as you see it as a long term plan and a commitment.
posted by rmhsinc at 9:42 AM on August 1, 2010 [1 favorite]

While on Paxil, I lost weight on eDiets, and, more dramatically, on the Carbohydrate Addicts' Diet. I really don't recommend the latter -- it makes you NEEEED your dinner, in a creepy way.
posted by Countess Elena at 10:40 AM on August 1, 2010

I have a friend who also had success with Weight Watchers. I'm not exactly sure how much weight she lost but the difference was noticeable. She was in her early 20s at the time. As long as she was doing Weight Watchers, she kept steadily losing weight, but when she stopped she gained it back.
posted by Lobster Garden at 12:27 PM on August 1, 2010

Best answer: Yes. I actually can't tell you what my 'adult weight' was before SSRIs: I don't know, because I started high-dose SSRIs for OCD at 14. (100-120mg of Prozac, for example.)

I peaked around 190, which doesn't sound high, especially for my height (5'9")--but it's not my 'natural' set point, and I have a very small frame. I looked kind of like I was on prednisone. The lowest I ever reached on SSRIs (I think I was on 20mg of Celexa, plus two other non-SSRIs) was 145, and although that's a bit higher than my current weight, it got rid of the pseudo-prednisone look. Honestly, it was exercising 4-5 times a week for at least an hour, switching to a lower-carb diet (the Zone and South Beach were new at the time, and that's what I did), and being very rigid about these two practices. Although exercising became more fun, the inflexibility sucked, and anxiety about it was not necessarily a step up, mental health-wise.

Anyway, the lower proportion of carbohydrates--at least for me--seemed to be as key as the regular exercise when I was on SSRIs. This is less true now that I no longer take them. I was a hockey player in college, on a huge campus where I walked everywhere, and didn't drop anything until I cut down on carbohydrates. I suspect that--like beta-blockers, though I'm sure the mechanism is totally different--SSRIs alter metabolism in general and carbohydrates particularly, especially with serotonin's high activity in the gastrointestinal tract.*

Caveat: I was never able to lose all of the extra weight I gained, and that last 15lbs stayed and would always creep upward if I slipped a little, until I stopped SSRIs completely. I think SSRIs raised the lower limit of my set point. When I came off of Celexa, 35lbs (145lbs + 20 gained because I wasn't watching carbs or exercising as often) nearly fell off of me, and five years later I have to try to push my weight over 140.

*if someone more knowledgeable about pharmacology and metabolism corrects me on any part of this, I will happily accept the corrections. I am speculating based on personal anecdote and a few studies I read years back.
posted by Uniformitarianism Now! at 12:49 PM on August 1, 2010

On Lexapro... frankly, the same way that I lost weight not on an SSRI: Not binge eating or self-treating for depression by eating high calorie foods, exercising a lot, integrating physical activity into my day (ex: Taking the stairs), and making sure whatever I do eat is healthy.
posted by SpecialK at 1:14 PM on August 1, 2010

Best answer: I do not want to spend my life in the gym, but am willing to spend some more time if necessary.

That's sort of backwards. Exercise is great and necessary to be healthy but it isn't a great way to lose weight for the amount of effort you put in. You lose weight by reducing your caloric intake. So if you aren't losing weight right now by far the most effective way is to eat slightly less per day and see if the weight starts dropping off.

Most people grossly overestimate the amount of calories burned by typical workouts. I mean, if you're training for the Olympics by doing swimming sprints for 8 hours a day you're going to burn thousands of calories. But adding 20 minutes to a moderate cardio workout might burn the calories from one cookie.
posted by Justinian at 1:31 PM on August 1, 2010

Best answer: Yes, I lost 11 pounds over about 6 months while on Zoloft. I kept track of my diet using I did not try to lose weight, just tracked what I ate and ate what I wanted. I did not exercise. I hate to exercise. And you do not have to exercise to lose weight. I just kept track of calories.
posted by fifilaru at 4:55 PM on August 1, 2010

To literally answer your question instead of necessarily proposing an approach to the problem, at one point I lost weight while on Lexapro because I was also prescribed Adderall for ADD.
posted by XMLicious at 5:39 PM on August 1, 2010

Ugh, I gained about 40 lbs being on Paxil for about 6-8 months. To be fair, I was quite thin when I started (which was very unusual for me, since I've always been a little chunky) but I didn't really change my habits much. If anything, I had more energy and was more active on paxil but the weight increased. After getting off paxil (a horrible experience for me), I then became addicted to carbs (yes, addicted!) and gained another 20-40 lbs over the course of a year. I haven't been on any medications, nor needed them for many years thankfully, but I still need to lose the weight I gained.

I did have some luck with Weight Watchers (I bought a kit and did it at home) but wasn't able to maintain it (I think their caloric/"points" estimates for men are way too low, and it is too easy to "cheat" and use your points for junky food). I have had the most luck losing weight by just walking a lot, though it was much easier when I lived downtown and didn't really think of it as exercise. It's a lot more difficult (boring) to walk around the suburbs where I now live.

Best of luck!
posted by 1000monkeys at 6:58 PM on August 1, 2010

Response by poster: Thanks for the helpful answers so far. There seems to be quite the range of experiences.

I did Weight Watchers for a while and lost 20 pounds, kept 12 of it off, but am still well over what I'd like to be. I wasn't skinny to start with! For now I think I'll monitor calories more carefully with the Daily Plate and see what happens. Will still check back here to see if anybody wants to add anything. Thanks again!
posted by sister nunchaku of love and mercy at 9:02 PM on August 1, 2010

Another anecdote: Adderall XR/Ritalin/Adderall Instant-Release/Concerta had little effect on my weight when I was on SSRIs.
posted by Uniformitarianism Now! at 9:06 PM on August 1, 2010

If you feel like your SSRI has serious weight-gain side effects, you can talk with your psychiatrist about trying a different pill. I was on Celexa, which didn't work out for me at all (face-planting sleepy all the time!!) so I changed to Welbutrin (not SSRI family), whose side effects are more likely to be weight-loss than weight-gain. I'm not suggesting that you use depression meds as weight regulators, I'm just wanting to underscore that if your current meds are working against you, it might be worth talking to your doc.
posted by aimedwander at 7:20 AM on August 2, 2010

Response by poster: Thanks, aimedwander, for the suggestion. I've been talking to pdoc about it for a while. Current drug works so well for me otherwise that we're loath to change it. I have no other side effects at all! We've talked about adding Wellbutrin, but I have hypertension (medicated), so it's not a good choice for me. Oh, well!

Helloooo, Daily Plate ;)

Thanks again to all.
posted by sister nunchaku of love and mercy at 10:58 AM on August 2, 2010

If you have an iPhone, the "Lose It" app is also excellent - esp. since you can enter your foods right as you're eating them.
posted by media_itoku at 2:59 PM on August 2, 2010

Yes... but that's because they made me really, really nauseous for the first several weeks. This is an effective but unpleasant method of losing weight.

Seriously, though, I'm guessing that you're also in therapy. You're probably making some changes to your life. Now is the absolute best time to start good habits like excercise. It will make you happier, healthier, and it's more likely to work this time. Best of luck.
posted by honeydew at 1:46 PM on August 10, 2010

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