The Link Between Lexapro^® and Weight

Many antidepressants are associated with changes in weight, and Lexapro^® is no exception. But does Lexapro cause weight gain, or can Lexapro cause weight loss? 

It depends. For some people, Lexapro can cause weight loss, while for others, it may result in unintentional weight gain.

Below, we’ve covered how Lexapro works, why your mental health provider may suggest it, and how to navigate potential Lexapro weight gain or loss.

Lexapro is an antidepressant that belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). It is available as a brand-name medication and in generic form as escitalopram, which is also the name of the active ingredient it contains.

As an SSRI, Lexapro works to treat symptoms of depression and other mood disorders by modifying levels of the neurotransmitter (brain chemical) serotonin in your brain and body. Serotonin plays a key role in regulating your moods, including feelings of happiness and anxiety. Research suggests that low serotonin levels are associated with depression, hence the use of SSRIs to enhance mood.

As is the case with most antidepressant use, Lexapro doesn’t act immediately. It can take several weeks to begin working, and it may take one month or longer to experience its full mental health benefits.

Currently, Lexapro is approved by the FDA as a treatment for major depressive disorder (MDD) and generalized anxiety disorder (GAD) in adults. 

But like many other medications, Lexapro is also used off-label. This means many healthcare providers are prescribing it for purposes other than what it is FDA-approved for, including: 

• Social anxiety disorder

• Panic disorder

• Obsessive-compulsive disorder (OCD)

• Premenstrual dysphoric disorder (PMDD)

• Post-traumatic stress disorder (PTSD)

Lexapro also may be used to treat some vasomotor symptoms, which are caused by fluctuations in the diameter of your blood vessels. These symptoms, many of which may develop during menopause, can include hot flashes, night sweats, and changes in blood pressure.

Although Lexapro and other SSRIs are usually less likely to cause side effects than other types of antidepressants like monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs), they still can cause issues for some. Among those potential issues are changes in your appetite and weight.

But does Lexapro make you gain weight? In general, antidepressants are more commonly associated with an elevated risk of weight gain than undesired weight loss. 

In fact, a large-scale cohort study from the UK found that the risk of weight gain was slightly higher among people who used antidepressants than their peers.

However, not all antidepressants are equally likely to cause weight gain, and some are linked to weight loss in certain groups of people. 

For instance, another study compared the effects of Lexapro and nortriptyline, a TCA, on the body weight of people undergoing treatment for moderate to severe major depression. The researchers found that while nortriptyline was associated with moderate weight gain over a six-month period, those who were treated with escitalopram only gained 0.14kg (under a third of a pound) over the same period.

Because of its mild effects on weight, the researchers concluded that escitalopram is a suitable option for people with depression at risk of or concerned about  weight gain.

A separate study of escitalopram even found that it helped to reduce weight and lower the severity of symptoms in people with binge-eating disorder (BED) and obesity. However, it’s not clear if the same effects occur in people without eating disorders.

The overall takeaway here is that escitalopram’s effects on body weight appear to be mild. In some research, it’s linked to a small increase in average body weight in people with depression, while other research suggests that it may help to promote weight loss in those who are overweight or obese. 

In addition to potentially affecting your appetite, eating habits, and weight, Lexapro and similar antidepressants may also cause other side effects. Most potential side effects of Lexapro are mild, and many will gradually improve as your body adjusts to the medication. 

Possible side effects of Lexapro include:

• Insomnia

• Nausea

• Fatigue

• Drowsiness

• Increased sweating, including night sweats

There are potential sexual side effects of Lexapro as well, such as: 

• Diminished interest in having sex

• Difficulty reaching orgasm or delayed orgasm during sexual activity

• Difficulty ejaculating even with significant sexual stimulation

Lexapro may also cause other adverse effects, including some that could affect your well-being and quality of life. 

Additionally, Lexapro can interact with other medications, potentially resulting in symptoms such as serotonin syndrome. This is a potentially life-threatening condition caused by an excess of serotonin in the brain, typically as a result of using certain medications or drug interactions. Symptoms may include agitation, confusion, rapid heart rate, dilated pupils, and muscle rigidity.

To reduce your risk of side effects or interactions when taking Lexapro, it is important to inform your healthcare provider about your medical history, including any health conditions you may have, and your current or recent use of any drugs or dietary supplements.

Why does Lexapro cause weight gain or loss? Well, it doesn’t necessarily. The main reason certain medications may set you up for unintentional weight changes is because of how they can influence your appetite. 

As such, although antidepressants like Lexapro are linked to changes in weight, it is still possible to mitigate any unwanted decrease or increase in weight while taking them. The key is maintaining the right habits.

1. Remember Small Weight Fluctuations Are Normal.

If you’ve recently started taking Lexapro, it’s easy to get concerned when you step on the scale and see that you’re several pounds lighter or heavier than usual. But remember that it’s normal for your weight to fluctuate by a few pounds on a daily basis — whether or not you’re using Lexapro. 

Weight fluctuations can happen because of food intake, differences in hydration levels, and hormonal changes. Rather than getting discouraged by one day or week, focus on the long term instead.

We don’t recommend weighing yourself every day, either. If you’re keeping track of your weight trends, consider switching to a once-a-week weight check instead. 

2. Stay Active.

If you’re concerned about weight gain while using Lexapro to treat depression or any other condition, make sure to prioritize moving your body regularly.

Regular exercise helps you burn more calories. It can also reduce the severity of depression symptoms by promoting the release of endorphins (i.e., “happy hormones”) and even improve brain function.

Aim to get in some physical activity most days of the week. Mix it up with a variety of movements you enjoy, such as:

• Jogging

• Brisk walking

• Practicing martial arts

• Biking

• Playing tennis or pickleball

• Weightlifting

• Swimming

• Doing yoga or pilates

3. Eat a Healthy, Balanced Diet.

Both depression itself and the effects of antidepressants can change your appetite and eating habits, causing you to eat less and lose weight, or eat more and gain weight. If you lost weight because depression took away your appetite, it’s to be expected that effective treatment with a medication like Lexapro will bring it back to its usual baseline.

Even when you’re feeling depressed or anxious, try to maintain a balanced, healthy diet most of the time. While less healthy eating on occasion isn’t going to make or break you, do what you can to build most of your diet around nutrient-rich foods, including plenty of plant-based foods. Aim to incorporate foods such as:

• Fruits

• Vegetables

• Whole grains

• Nuts and seeds

• Legumes and other lean proteins

And don’t forget about your snacks either. Consider swapping out your usual afternoon bag of chips for a healthy snack for weight loss instead.

4. Adjust Food Intake to Maintain Target Weight.

If you’re beginning to lose or gain too much weight while using Lexapro, try adjusting your calorie intake to bring your body weight either up or down toward your optimal weight.

The National Institutes of Health (NIH) has a body weight planner that you can use to calculate your target food intake based on your optimal weight, age, height, and activity level. 

It can also be helpful to meet with a registered dietitian nutritionist who can provide personalized guidance on calorie needs and how to satisfy hunger with nutrient-dense foods you enjoy.

5. Get Enough Sleep.

Sleep is your body’s designated time to rest, repair, and recharge. Getting enough sleep (experts recommend 7-8 hours per night for adults) helps regulate the hormones that control hunger and appetite, such as ghrelin and leptin, which in turn maintains a balanced metabolism. 

Poor sleep can disrupt these hormones, throwing off your hunger-fullness cues and potentially contributing to changes in your weight. 

Plus, when we get enough quality sleep, we’re more likely to experience better emotional well-being and less stress, factors that can otherwise lead to cravings or poor dietary choices. 

If you’re not sleeping well, consider these tips to improve your sleep hygiene: 

• Design a consistent sleep-wake schedule and stick to it.

• Avoid alcohol, caffeine, heavy meals, vigorous exercise, and blue light-emitting technology close to bedtime, as these things can make it harder to fall asleep.

• Create a sleep-promoting environment in your bedroom, such as layered bedding, comfy pajamas, and white noise or blackout curtains if needed.

6. Follow Up With Your Healthcare Provider.

It’s important to stay in contact with your provider regarding any side effects of Lexapro you’re experiencing, which include any changes in weight that are bothering you. 

Many people with depression experience unwanted changes in appetite and weight, and unfortunately, some medications for depression may also contribute to these issues.

If you find it difficult to eat a normal amount while using Lexapro, don’t hesitate to talk to a healthcare professional. They may recommend adjusting your dosage or switching to a different treatment option for depression.

Fluctuations in weight aren’t uncommon throughout various seasons of life, regardless of whether you’re experiencing depression or using an antidepressant medication like Lexapro. Still, that doesn’t mean it’s not frustrating when your pants don’t fit quite how you’d like them to. 

Because of the various factors involved in weight changes, there’s limited strong research on this topic. Most studies comparing the weight change side effects of antidepressants have not been able to appropriately control for all of the variables among the samples.

With that in mind, here’s what we can say when it comes to Lexapro and weight gain (or loss):

• Lexapro can affect appetite. Do you gain weight on Lexapro? For the most part, research suggests that any changes in your body composition or weight loss from Lexapro are mild, especially when compared to older antidepressants. However, that doesn’t mean that Lexapro weight gain or weight loss can’t happen, as we all respond to medications differently. 

• Prioritize healthy habits. Steps like improving your diet, staying physically active, and getting enough sleep can help keep your appetite in check and support a healthy weight. Plus, these things are just good for your overall well-being and mental health, too.

• Express concerns to your provider. If you think you’re experiencing Lexapro weight gain or loss, it’s best to get medical advice from your mental health provider.

Need more help overcoming depression? Our guide to dealing with depression goes over your options for seeking help and feeling better.

You can also connect with a licensed provider online for an evaluation and, if appropriate, get prescribed depression medication online.