We might live in the Lucky Country and the Land of the Long Weekend but that doesn’t stop large numbers of us battling mental health woes.
Around 1 in 7 Australians take antidepressants, reflecting one of the highest prescribing rates in the world. There are many possible reasons for that, including stressful life circumstances, weak support networks, overwhelmed GPs and poor access to psychologists.
And antidepressants aren’t only used for depression and anxiety. They’re sometimes prescribed to help patients with chronic pain or migraines too.
About half of patients who start taking antidepressants stop within weeks because they don’t like the medication. The other half, though, take them for many months or years, even indefinitely. Often such patients begin to wonder if antidepressant use is contributing to weight gain.
Do Antidepressants Make You Fat?
It’s too simplistic to say that antidepressants cause weight gain. Your mental health and your weight are closely intertwined.
Depression may lead to weight gain if you comfort eat or feel too flat to exercise. Taking an antidepressant may ease your symptoms and help you to live a healthier, more active life which helps you maintain a healthy weight.
Equally, if depression meant that you lost your appetite or couldn’t be bothered to eat, taking an antidepressant may improve your appetite along with your mood. You could gain weight but it’s not directly due to the medication – it’s due to being in a healthier mental state.
Your age is a factor too. We all tend to gain weight as we get older, irrespective of which medicines we take (or don’t take).
Then there’s the duration of usage. Antidepressants work by increasing serotonin levels in the brain, which affects your mood and appetite. In the short-term, that can reduce impulsivity and keep you feeling full, reducing your food intake and helping you manage your weight.
Keep taking it for more than a year, though, and you may find your serotonin receptors change. As a result, you may start to crave carbohydrate-rich foods like bread, pasta and sweets, which can push your weight up.
It is true that nearly all antidepressants list weight gain as a potential – but not guaranteed – side effect. Certain antidepressants are thought to be more likely to cause weight gain than others. If that’s a concern for you, you can always talk to your doctor to see if there’s a better alternative.
Antidepressants And Surgery
If you need surgery for any reason, tell your surgeon and anaesthetist that you’re on antidepressants. That’s important because antidepressants can have implications for your metabolic health, affecting things like your blood sugar and cholesterol levels as well as your weight.
As with other medications (like those for blood pressure or diabetes), we need to know about antidepressant usage so we can monitor and manage these aspects of your health before and after surgery. Dose adjustments may be required before or after surgery.
Bariatric Surgery And Antidepressants
Bariatric surgery is associated with significant improvements in anxiety and depression scores. That may reduce reliance on antidepressants for some patients.
Bariatric surgery changes your anatomy and alters the way you digest food. It also alters the way you digest medication.
Some patients find that they need a different dose of their antidepressant after bariatric surgery in order to maintain control of their symptoms. Others find they need to take their medication in a different format, such as a wafer that’s absorbed under the tongue rather than a tablet that’s digested in the gut.
How Can Dr Lockie Help?
Dr Lockie takes a multi-disciplinary approach to weight loss. Our team includes a skilled psychologist, exercise physiologist, nurse and dietitian.
Their combined skills alongside Dr Lockie’s medical and surgical expertise help you to address all the factors contributing to your weight gain. Sometimes, this also touches on factors that have affected your mental health.
It also enables us to consider all aspects of your care, including aspects like medication management, to ensure best outcomes.
If you’d like to explore how we could help you, book an appointment.
Disclaimer
All information is general and is not intended to be a substitute for professional medical advice. Dr Phil Lockie can consult with you to confirm if a particular procedure or treatment is right for you. All surgery carries risks.
References
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The Conversation, Why are so many Australians taking antidepressants? https://theconversation.com/why-are-so-many-australians-taking-antidepressants-221857, [Accessed 30 August 2024]
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Mayo Clinic, Antidepressants and weight gain: What causes it? https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressants-and-weight-gain/faq-20058127#, [Accessed 30 August 2024]
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Harvard Health, Managing weight gain from psychiatric medications, https://www.health.harvard.edu/blog/managing-weight-gain-from-psychiatric-medications-202207182781, [Accessed 30 August 2024]
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Cambridge University Press, Metabolic effects of antidepressants; Is it time to change the conversation? https://www.cambridge.org/core/journals/bjpsych-open/article/metabolic-effects-of-antidepressants-is-it-time-to-change-the-conversation/1F31D01C35E7D8BECDC8324D4B255930, [Accessed 30 August 2024]
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Law S, Dong S, Zhou F, Zheng D, Wang C, Dong Z. Bariatric surgery and mental health outcomes: an umbrella review. Front Endocrinol (Lausanne). 2023 Nov 2;14:1283621. doi: 10.3389/fendo.2023.1283621. PMID: 38027159; PMCID: PMC10653334. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10653334/, [Accessed 30 August 2024]