Does Depression Cause Weight Loss, or Weight Gain?

By Dr. David Woo - January 29, 2021

When you search for the symptoms of depression, you’ll likely see both weight loss and weight gain. So, which is it? The answer is: it depends on the person. While some people with depression will gain weight, others will lose weight. Below we’ll explore the role of depression in weight changes.

Why Does Depression Make You Gain Weight, and Vice Versa?

Researchers know that depression can lead to weight gain, and that weight gain can also contribute to depression. 

The CARDIA study revealed that patients with depressive symptoms are more likely to experience an increase in BMI (body mass index) and waist circumference over subsequent years, compared to people who do not have depressive symptoms.(1)

Weight gain can happen when a person is depressed because:

• They lose interest in activities and are less physically active
• They tend to eat a diet higher in fat due to poor food choices
• Certain depression treatments, such as antidepressants, may cause weight gain

Researchers and doctors also know that weight gain increases the risk of developing depression. A study published in 2010 found that obese patients were 55% more likely to develop depression, compared to patients who were not obese.(2)

Loss of Appetite Caused by Depression Can Lead to Weight Loss

Weight loss caused by depression can be brought on by decreased:

• Appetite
• Interest in eating well or eating nutritious foods
• Sensation of the taste buds (3)

When patients with depression skip meals or eat meals that are high in sugar or grease, this can lead to malnourishment and weight loss, which can also contribute to depression. (4)

Depression is also commonly seen among patients with other health conditions, like anorexia and other eating disorders.(5)

Depression Treatment and Weight Management

Depression treatment often involves combining multiple treatments, like talk therapy and antidepressants as well as lifestyle changes, like increasing exercise and altering one’s diet. Lifestyle changes specifically, such as walking and incorporating more fruits and vegetables into one’s diet, can help patients return to their normal weight.

Depression Medication that May Cause Weight Loss and Weight Gain

Certain medications are commonly known to affect body weight more than others. Below is a list of medications that have been found most likely to cause weight changes.    

Antidepressants that may cause weight gain:(6,7,8,9)

• Mirtazapine (Remeron)
• Amitriptyline (Elavil)
• Paroxetine (Paxil, Brisdelle, Pexeva)
• Escitalopram (Lexapro)
• Sertraline (Zoloft)
• Duloxetine (Cymbalta)
• Citalopram (Celexa)
• Fluoxetine (Prozac)

Antidepressants that may cause weight loss:(9)

• Bupropion (Aplenzin, Forfivo, Wellbutrin)
• Fluoxetine (Prozac)
• Duloxetine (Cymbalta)

Of the above medications associated with weight loss, Bupropion is the most linked to weight loss. Fluoxetine has been connected to weight loss in some cases, but may then lead to weight gain in the long term. The link between Duloxetine and weight loss is inconsistent.(9)

Not all patients who take antidepressants will gain weight. However, weight gain is a possible side effect of certain antidepressants. For patients who are looking for an alternative to antidepressants, TMS (transcranial magnetic stimulation) is a medication-free, noninvasive procedure that provides relief from depression symptoms without the side effects associated with antidepressants.  

Resources:

1. Needham BL, Epel ES, Adler NE, and Kiefe C. Trajectories of change in obesity and symptoms of depression: the CARDIA study. Am J Public Health. 2010;100(6):1040-1046. https://pubmed.ncbi.nlm.nih.gov/20395582/. Accessed December 27, 2020.

2. Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BWJH, Zitman FG. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010 Mar;67(3):220-229. https://pubmed.ncbi.nlm.nih.gov/20194822/. Accessed December 27, 2020.

3. Hur K, Choi JS, Zheng M, Shen J, Wrobel B. Association of alterations in smell and taste with depression in older adults. Laryngoscope Investig Otolaryngol. 2018;3(2):94-99. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5915822/. Accessed December 28, 2020.

4. Rao TS, Asha MR, Ramesh BN, Rao KS. Understanding nutrition, depression and mental illnesses. Indian J Psychiatry. 2008;50(2):77-82. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738337. Accessed December 28, 2020.

5. Understanding the Facts: Eating Disorders. Anxiety and Depression Association of America. Publication Date Unavailable. https://adaa.org/understanding-anxiety/related-illnesses/eating-disorders. Accessed December 28, 2020.

6. Serretti A, Mandelli L. Antidepressants and body weight: A comprehensive review and meta-analysis. Journal of Clinical Psychiatry. 2010; 71(10): 1259-1272. https://pubmed.ncbi.nlm.nih.gov/21062615/. Accessed May 12, 2022.

7. Uguz F, Sahingoz M, Gungor B, Aksoy F, Askin R. Weight gain and associated factors in patients using newer antidepressant drugs. Gen Hosp Psychiatry. 2015; 37 (1): 46-48. https://pubmed.ncbi.nlm.nih.gov/25467076/. Accessed May 12, 2022.

8. Salvi V, Mencacci C, Barones-Adesi F. H1-histamine receptor affinity predicts weight gain with antidepressants. European Neuropsychopharmacology. 2016; 26(10): 1673-1677. https://pubmed.ncbi.nlm.nih.gov/27593622/. Accessed May 12, 2022.

9. Antidepressants that Cause Weight Loss. Khealth. Published August 18, 2021. https://khealth.com/learn/medication/antidepressants-that-cause-weight-loss/. Accessed May 4, 2022.

Dr. David Woo

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.