Are There Any Antidepressants That Cause Weight Loss?

If you’ve been diagnosed with a type of depression or anxiety, your healthcare provider may prescribe an antidepressant to help manage your symptoms. 

While we don’t fully understand how every type of antidepressant works, we do know they help get certain brain chemicals back in balance, which can stabilize mood and emotions. 

As with other prescription medications, antidepressants come with their share of potential side effects, including body weight changes. 

Are there antidepressants that cause weight loss? Not directly, but some are less likely to set you up for unwanted weight gain, particularly bupropion. 

We’ve examined how various types of antidepressants can influence weight and why bupropion is your best bet if preventing weight gain is a top priority while treating depression.

How antidepressants affect you depends entirely on how your body responds to them. 

Some people might develop an increased appetite that can lead to weight gain over time, while others may not notice a difference in their food intake after starting antidepressant treatments. Some may even find their appetite reduced. 

How much weight gain are we talking about? 

A large-scale 2019 systematic review found that most studies of antidepressants and changes in body mass show an average weight increase of approximately five percent in people who use antidepressants. Most of the patients in these studies were followed up for at least 10 years. So, for a 140-pound person taking antidepressants long term, this could be around seven pounds. Those who took antidepressants for only a few years gained much less - only a pound or two.

Let’s look at the different types of antidepressants and what the research says about how they’re most likely to influence weight changes. 

Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) work by blocking the reabsorption (reuptake) of the brain chemical serotonin into your neurons — specialized brain cells that transmit information. This increases the serotonin levels available in your brain. 

Having more serotonin present helps improve mood and can alleviate symptoms of depression.

Here are some of the most common SSRIs and how they tend to influence weight changes: 

• Prozac^® (fluoxetine) may lead to weight loss initially, but long-term use can result in weight gain.

• Zoloft^® (sertraline) is generally neutral for weight but can cause weight gain in some individuals.

• Paxil^® (paroxetine) is most likely to be associated with weight gain compared to the other SSRIs.

• Celexa^® (citalopram) and Lexapro^® (escitalopram) tend to have a neutral effect on weight, though some cases of weight gain have been reported.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Like SSRIs, SNRIs work by blocking the reabsorption of serotonin, but they also act on norepinephrine in the brain, as well, improving your mood and alleviating anxiety.

Common SNRIs and their most likely impacts on weight changes include: 

• Effexor^® (venlafaxine) is generally neutral for weight but may cause weight gain or loss in different individuals.

• Cymbalta^® (duloxetine) may cause weight loss during short-term use and modest weight gain over longer-term use.

• Pristiq^® (desvenlafaxine) is generally considered weight-neutral, but data is limited.

Tricyclic Antidepressants (TCAs)

TCAs also work by preventing the reuptake of serotonin and norepinephrine in your brain to improve mood. However, they can also affect other neurotransmitters, which increases the risk of potential side effects.

Here are the most common TCAs and their expected influences on weight: 

• Elavil^® (amitriptyline) and Silenor^® (doxepin) are known to cause significant weight gain.

• Aventyl^® (nortriptyline) and Tofranil^® (imipramine) can also cause weight gain, though to a lesser extent than the others. 

Monoamine Oxidase Inhibitors (MAOIs)

MAOIs work by inhibiting the enzyme monoamine oxidase, which breaks down neurotransmitters like serotonin, norepinephrine, and dopamine. This helps increase the amounts and availability of these neurotransmitters in your brain, which can improve your mood and reduce symptoms of depression.

The most widely used MAOIs and likely weight-related effects include: 

• Nardil^® (phenelzine) often causes weight gain.

• Parnate^® (tranylcypromine) and Marplan^® (isocarboxazid) have a varied impact on weight; some people may gain weight while others maintain or lose weight.

Noradrenergic and Specific Serotonergic Antidepressants (NaSSAs)

NaSSAs work to improve mood and alleviate feelings of depression by blocking specific serotonin and norepinephrine receptors and increasing their release into your brain. 

The most commonly prescribed NaSSa is called Remeron^® (mirtazapine), which is strongly associated with weight gain. 

Atypical Antidepressants

Atypical antidepressants are named as such because they’re kind of the misfits of antidepressants. They don’t fit into any of the other categories. The three most common are bupropion, trazodone, and nefazodone.

Bupropion works by inhibiting the reuptake of dopamine and norepinephrine and increasing their presence in your brain. 

Trazodone inhibits serotonin reuptake and acts as an antagonist at certain serotonin receptors in your brain. 

Nefazodone works by blocking serotonin receptors and inhibiting the reuptake of serotonin and norepinephrine.

Here’s how they tend to influence weight:

• Wellbutrin^® (bupropion) is often associated with weight loss. It may even be combined with another drug called naltrexone — together, they’re sold under the brand name Contrave^® — to enhance weight loss among people living with obesity.

• Desyrel^® (trazodone) may lead to some weight gain.

• Serzone^® (nefazodone) is generally weight-neutral but may lead to weight gain in some people.

Overall, weight gain appears to be more common when using TCAs, MAOIs, and mirtazapine compared to other types of antidepressants. Many SSRIs or SNRIs are more likely to have a neutral effect on your weight, while bupropion is generally a good choice for those who are concerned about weight gain.

Over the years, several theories have attempted to explain the connection between antidepressants and weight changes.

First, antidepressant drugs work primarily by increasing the levels of certain brain chemicals and hormones (which are often low among people with depression). Experts think these alterations may also be a root cause of appetite changes. 

One idea is that they also impact neurotransmitters involved in eating behaviors — like histamine and serotonin — leading to increased food intake and weight gain for some.

Another thought is that certain antidepressants attach to beta-3 adrenergic receptors in the brain. These receptors help convert fat into energy in response to certain neurotransmitters, which can lead to weight changes. 

Other theories involve the effects of antidepressants on receptor sites for acetylcholine, a neurotransmitter that may play a role in appetite stimulation.

Finally, depression itself can impact your appetite. Some people with depression may feel less interested in eating, while others may develop a stronger appetite and start to eat more food in response to cravings. 

These behaviors can result in changes in your body weight. If your depression causes you to eat less, any weight loss you had may start to reverse once you use antidepressants. Meanwhile, if your depression leads to weight gain, it could become more significant.

Still, there’s significant variability in how people respond to antidepressants. Try to have an open mind, communicate questions and concerns to your healthcare provider, and monitor any side effects you notice after starting a medication.

It’s important to remember that you won’t necessarily have to take the weight gain trade-off in order to treat your depression. However, there is one antidepressant that isn’t associated with weight gain at all. 

While it may not be marketed as “the depression medication that causes weight loss,” bupropion (sold as Wellbutrin) has a significantly stronger association with small amounts of weight loss than any increase in body weight and appetite.

Bupropion is approved by the Food and Drug Administration (FDA) for adult depression, seasonal affective disorder, and smoking cessation. It may be especially appealing to individuals with obesity who are also experiencing depression. Unfortunately, it doesn’t work as well for anxiety compared to medications that act on serotonin.

In fact, there’s an abundance of research showing that people who use bupropion to treat depression tend to gain less weight than their peers — and some people prescribed this medication even lose weight during treatment.

For example, a 2016 study found that bupropion users lost an average of 7.1 pounds over two years compared to people with depression who used fluoxetine, a common SSRI.

Additionally, a 2019 systematic review of 27 studies found that just about all of the widely used medications for depression resulted in long-term weight gain, except bupropion, which produced weight loss.

Bupropion XL is one of the many depression and anxiety medications offered through Hers Weight Loss and prescribed by a licensed healthcare provider.

Even if you’re prescribed an antidepressant that’s associated with weight gain, there are ways to limit its impact on body composition: 

Get Daily Movement

Regular physical activity helps burn calories, which can reduce the effects of overeating on your weight. It’s also a great way to stimulate the release of feel-good chemicals called endorphins, which may enhance your moods. 

Try to get at least 150 minutes of moderate-intensity physical activity each week, even if it’s just a short walk or bike ride around your neighborhood. Experts also recommend getting in at least two days of strength training, which could mean lifting dumbbells, doing bodyweight exercises, or using resistance bands. 

Optimize Your Nutrition 

It’s easy to accidentally overeat when recovering from depression. Try to prioritize naturally nutrient-dense foods, which are foods that provide abundant vitamins, minerals, and antioxidants without too much added sugar, salt, and saturated fat. 

In short, that means eating plenty of fruits, veggies, and other plant foods, which are always good, high-nutrition, lower-calorie choices. 

Practice Mindful Eating

We’re all often distracted when we eat — it’s just the nature of life. Mindful eating involves paying close attention to your hunger-fullness cues without judgment. 

It’s an aspect of living intentionally that may help you avoid overeating. During each meal, try to focus on the experience of your food. Avoid eating while watching TV or doing other things that may distract you.

Don’t Worry About Minor Weight Changes 

It’s normal for your weight to fluctuate by a small amount from day to day. You shouldn’t see minor changes in your weight as a sign that your antidepressant is causing you to gain weight. 

You can weigh more or less throughout the day based on factors like exercise, how much water you drink, and whether you recently went to the bathroom. So, if you weigh yourself regularly, do so weekly or monthly instead of every day — that way, these fluctuations don’t become important. 

Prioritize Sleep and Stress Management

Adequate sleep (experts recommend seven to eight hours) regulates leptin and ghrelin, hormones that control appetite and metabolism. Poor sleep can disrupt these hormones, leading to increased hunger and cravings. 

Follow a consistent sleep-wake schedule, create a calm and soothing environment in your bedroom, and avoid things that make it harder to fall asleep, like doom-scrolling social media, eating a heavy fat-rich meal, or engaging in vigorous exercise right before you lie down.

Stress management is also essential since stress hormones like cortisol can tell your body to hang onto more abdominal fat and influence eating behaviors. 

Better sleep can help with stress, but to reduce stress during the day, try to include practices like meditation, yoga, stretching, listening to calming music, or taking a nature walk. 

Hydrate 

Did you know that the adult body is made up of at least 60 percent water? And we need to replenish our fluid stores — ideally with water — when they’re lost through activities like using the bathroom or sweating it out at the gym. 

Staying hydrated supports healthy digestion and even the breakdown of fat, which is called lipolysis. Drinking water before and during meals can help reduce calorie intake by promoting a feeling of fullness.

Consider Weight Loss Medications 

If weight loss is one of your top health-related goals, but lifestyle changes don’t seem to be moving the scale, you may be a candidate for prescription weight loss medications. 

These work through various mechanisms: some suppress appetite and reduce the urge to eat, while others inhibit fat absorption from your diet or boost your metabolism. 

Some of the common options include: 

• Contrave. When bupropion is combined with naltrexone, it’s sold under this brand name. Together, they act on your brain's reward system to decrease hunger and control cravings, aiding in weight loss.

• Glucagon-like peptide 1 (GLP-1s) receptor agonists. GLP-1s like Ozempic^® and Wegovy^® work by mimicking the hormone GLP-1, which increases insulin secretion, reduces glucagon release, and slows gastric emptying. This increases satiety, decreases appetite, and leads to better blood sugar control, all leading to weight loss.

• Metformin. Metformin is a diabetes drug that helps lower blood sugar levels and reduce insulin resistance. Additionally, it may alter your gut microbiome, decrease appetite, and reduce the absorption of glucose from the intestines, contributing to weight loss.

• Topiramate. Topiramate is an anti-seizure drug but also reduces appetite and increases feelings of fullness. It may also boost calorie burning and alter taste perception to reduce the desire for high-calorie foods.

Whether used alone or with cognitive behavioral therapy, antidepressants have helped many people recover from depression and improve their lives.

Like all prescription medications, antidepressants can cause side effects, and weight changes are a common concern.

Do antidepressants make you lose weight? If you’re concerned about weight gain as a side effect of antidepressants or are looking for antidepressants that cause weight loss, keep these tips in mind: 

• Not everyone responds the same way. Your friend or colleague’s experience with antidepressants and weight gain doesn’t necessarily translate to yours. Make sure to follow all your prescriber’s recommendations and tell them about any side effects that concern you, including weight changes. 

• Other lifestyle habits help. If you’re taking an antidepressant that tends to encourage overeating, remember that your weight results from a whole slew of lifestyle factors. Your diet's nutritional quality, stress management practices, hydration status, and even sleep habits can help support healthy weight management regardless of which medication you’re on.

• Don’t stop taking it. Don’t stop antidepressant treatment suddenly. Doing so can increase your risk of antidepressant discontinuation syndrome and other side effects of withdrawal. 

• You can change medications. If you’d like to switch to a new antidepressant medication, follow up with your mental health provider. If you currently use an older antidepressant, such as aTCA, a newer type may reduce the severity of appetite changes. Or, you might find that bupropion is the best depression medication to align with weight loss goals. 

Your well-being matters. If you think you may have depression and need medical advice, Hers provides access to online mental health services.

You can also learn more about depression treatment options with our free online mental health resources and complete guide to the best medications for depression.