On antidepressants. Need to lose weight. How to get started?
January 15, 2008 4:28 PM   Subscribe

I'm taking SSRIs. I've experienced significant weight gain while on them and am now trying to work it off. How to get started?

I need assistance with physical fitness and getting back into optimal shape while on Celexa/SSRIs.

I'm male, 28, 6'3 and currently 255 lbs. I started taking Celexa in June 2007 (started on Lexapro, switched over to Celexa over cost issues) to help treat severe anxiety and regular panic attacks.

On the mental front, the combination of SSRIs and therapy have worked wonders. I feel like a new person. But before I started taking Celexa, I weighed 220 lbs. That means I gained 35 lbs. in a little over six months.

The problem is that, once I started taking SSRIs, I lost interest in working out. While before I'd go running on 3 mile runs at least 4x a week and go to the gym 3x weekly, I simply stopped working out for six months or so. In addition, Celexa really f'd with my head in regard to hunger. I could eat a huge meal - a footlong sub, a few slices of pizza, a Chipotle burrito and be hungry two hours later.
Combine the lack of exercise, the overeating and the metabolic changes that came with going on SSRIs and, bam, I gained a ton of weight.

Now I want to work on losing it and getting back to where I was before (and, hopefully, lose even more weight and build more muscle). I'm consciously eating healthily and forcing myself to work out daily. Accepting my current weight isn't an option; I looked damn good before and don't want to resign myself to looking like a premature John Goodman.

But the big question... has anyone been in this situation and managed to do it successfully? Or if you haven't, if advice can be offered?
posted by anonymous to Health & Fitness (13 answers total) 5 users marked this as a favorite
Actually I am kinda surprised you needed an ssri if you were doing all that exercise to begin with...oh, I see it was anxiety. Well, then, what the deal is is you were using the anxiety to fuel your exercise. So take heart-if you continue to just work out it will become a habit and it will reinforce itself.

(I have been on meds before and I presently work out now.)
posted by konolia at 5:01 PM on January 15, 2008

well, is it possible that you might want to try a different SSRI? if you've lost interest in something you used to do a lot before, then maybe it's not doing what it's supposed to. perhaps you should discuss tweaking your meds with your doctor.

i know it's not typical, but i went on lexapro and lost 10 pounds. ymmv.
posted by thinkingwoman at 5:21 PM on January 15, 2008

Increase your protein intake, decrease your carb intake.

IANAD, of course, but in my research I've found that SSRIs can increase carb cravings and insulin resistance - eating more protein will make you feel fuller longer. Your description of what you would eat (pizza, burrito, sandwich) without feeling full is good evidence that what you're experiencing is the rebound hunger that comes from high carb intake, which leads to a rapid rise, then crash, of your blood sugar. When the blood sugar crashes, you get hungry.

Skip the bread, pizza, rice, etc. and replace it with protein and veggies.
posted by chez shoes at 5:28 PM on January 15, 2008

SSRIs can increase carb cravings, as was mentioned. In my experience, they can also make you lose interest in some things you used to do. I would not recommend changing meds if they are working for you. It can be difficult to find a good med; I had to try several to find the right one for my stuff. Obviously up to you, but in my experience you're going to have side effects to any med you take, and so if a med is working, it's best to find out how to work with its side effects if they are tolerable.

I have gained some weight on the med I'm on now. Cutting out carbs won't work completely, because you'll still crave them. It's better imo to balance your diet with some carbs included, but try not to snack on them. Portion them out. Keep a food diary. I managed to lose weight while on meds, but I had to get sort of obsessive about it. I kept a spreadsheet with the foods I ate, the calories in everything, and calories lost through exercise.

I don't know what that might do to your anxiety however. I'd advise working with your therapist on what actions you could take. They might have experience helping others to control their weight while on meds. I read medical journals as part of my job (and personal interest), and there is a lot out there now about controlling patients' weight while on meds, as it has become a concern for a lot of people.
posted by veronitron at 6:21 PM on January 15, 2008

Wellbutrin actually helped me lose 20 lbs. But I don't know if that's right for you.

Dietary extremes are usually a bad idea. May I suggest talking to a nutritionist and perhaps meeting with a trainer? The only way to keep weight off is to make permanent changes in your diet. I know it's expensive, but talk to a pro who can counsel you in both areas. Endorphins kick in, even when you're on and SSRI, and eating well will help your mood, though not in the same way as medication.

Good luck. I've been there/ am still there. Keep in mind, it's not easy for anyone to keep in shape. Not being anxious is also helping your health.
posted by gesamtkunstwerk at 6:48 PM on January 15, 2008

This is a significant weight gain here. I think your best bet is to try a different SSRI without such nasty side-effects. Talk to your doctor. This is pretty unhealthy stuff, 255 at your height is not good.

On preview, Wellbutrin is a powerful stimulant. Be wary if you get prescribed this.
posted by damn dirty ape at 7:07 PM on January 15, 2008

I went through a similar arc, complete with the reduction in anxiety leaving me with no reason to go work out.

I still haven't solved the gym issue, but I've addressed the food issues through simple calorie counting. Nothing severe, but keeping track of what I'm eating tends to help me eat reasonable amounts.

Of course that discipline slipped a bit during the holiday season. Time to start keeping track again...
posted by tkolar at 7:29 PM on January 15, 2008

oh, and to chime in again--i also tend toward the anxious, and wellbutrin made me batshit crazy. you might want to go back to the lexapro--even if it does cost more, it may be worth it because the side effects are supposed to be fewer.

so, i don't know how much more you had to pay for the lexapro, but is the difference equivalent to the gym membership, nutritionist's fees, and the self-loathing you feel about your weight right now? i mean, it might be worth it to go back.
posted by thinkingwoman at 7:30 PM on January 15, 2008

I experienced the same thing. I was a new person on Celexa. This was a person I'd never known before...calm, equanimous, positive, likable...and fat. Yes, the skinny one in the family finally gained a bit of weight...then a bit more...then more and more and ....... !!!

I tried to exercise; I tried to eat less. Nothing worked. I had to go off the medication. I since lost all of the weight.

What did Celexa do to my life? I lost the best relationship I've ever had due to the weight gain (say what you want about true love but I guess I can understand how a guy who signed up for a size 4 wasn't pleased to suddenly be with a 14). I spent a small fortune buying clothes in all different sizes. And although my body looks pretty damn good it never quite got back to what it was before (it's rather like weight gain due to childbirth).

I am not trying to be negative. This was my honest experience. The only thing that worked for me was going off the medication. Wellbutrin doesn't cause weight gain OR sexual side effects (but it doesn't work nearly as well as Celexa for me). I have slowly come to accept that I have to manage in other ways.

My advice is:
1. Don't let people tell you that you can just have willpower or exercise more. The drug is messing with your metabolism and your appetite. It's not in your head. If you're vulnerable to this side effect mere "willpower" is unlikely to help.
2. Keep in mind that no matter how happy the drug makes you, you aren't going to be happy if you develop diabetes. Weight gain is a side effect that can have serious consequences.
3. The most important thing is to LOSE THE WEIGHT SLOWLY. This minimizes the damage done to your body and helps your skin to bounce back. It's also healthier. If you lose the weight very quickly you risk developing very loose, flabby skin.
4. EXERCISE. Lift weights for tone.

Good luck :)
posted by mintchip at 7:57 PM on January 15, 2008 [1 favorite]

P.S. I found no difference between Lexapro and Celexa for side effects. Interestingly enough, I found Lexapro to be a less effective medication even though there isn't any reason it should be.
posted by mintchip at 8:02 PM on January 15, 2008

Celexa / Citalopram is what's called a 'clean' ssri in that it has very few side effects. Work more on controlling your food intake... you might be surprised at what you're eating every day.

Before I started on anti-anxiety medications, I ate like a pig and never gained weight. Part of it I later found was because I 'jiggled' all day -- I literally sat there and visibly VIBRATED with anxiety and tension in my chair. When that stopped after I started taking antidepressants, my food/calorie intake (esp. soda) needed to drop too because I was no longer burning all that energy.
posted by SpecialK at 9:40 PM on January 15, 2008

I went through this exact same situation. Took Paxil, gained 30 lbs. (which is a lot at five foot tall!). Same thing, panic attacks. Same thing, stopped working out (and before that I worked out an hour a day, every day, minimum).

What I did: gave up all alcohol; it helped with calories. Gave up sodas, coffee, and candy/sweets. Bought a stairmaster. Forced myself to do it for an hour a day unless I was sick. After a year, I had FINALLY worked it off.

I cried in frustration during the 4th month cause I'd basically lost a pound and thought I was going to freak the fuck out because the weight wasn't budging.

Then all of a sudden, boom, I get back down like 28 lbs. and I can bear life again! Oh hello old clothes that fit again!

It took me probably another 6-8 months to get the last 2 or 3 pounds off. I finally just gave up and eventually went to the doctor and oo neat, last 2 lbs. gone.

You're a dude so it will probably take less time; weight training and swimming would probably help, and I do understand the lethargy. It's hard to shake; may take awhile if you're still on the drugs, not sure if you are, but it will be harder unless you get off them and get your workout groove back slowly.
posted by Unicorn on the cob at 9:41 PM on January 15, 2008

Fourthing the idea of cutting back on carbs. The more you eat them, the more you crave. They also affect brain chemistry in ways I'm not knowledgeable enough to understand.
posted by callmejay at 6:58 PM on January 16, 2008

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