How Much Weight Gain Do Antidepressants Cause?
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There’s a lot of talk in the news lately about antidepressants and weight gain, so let’s look at some numbers.
Here’s a study from July 2024 that compared the weight gain of eight popular antidepressants, and pop-science outlets have reported it with such snippets as:
❝Bupropion users were approximately 15–20% less likely to gain a clinically significant amount of weight than those taking the most common medication, sertraline.
The researchers considered weight gain of 5% or more as clinically significant.❞
Read in full: Study compares weight gain across eight common antidepressants
At this point, you might (especially if you or a loved one is on sertraline) be grabbing a calculator and seeing what 5% of your weight is, and might be concerned at the implications.
However, this is a little like if, in our This or That section, we were to report that food A has 17x more potassium than food B, without mentioning that food A has 0.01mg/100g and food A has 0.17mg/100g, and thus that, while technically “17x more”, the difference is trivial.
As a quick aside: we do, by the way, try to note when things like that might skew the stats and either wipe them out by not mentioning that they contain potassium at all (as they barely do), or if it’s a bit more, describing them as being “approximately equal in potassium” or else draw attention to the “but the amounts are trivial in both cases”.
Back to the antidepressants: in fact, for those two antidepressants compared in that snippet, the truth is (when we go looking in the actual research paper and the data within):
- sertraline was associated with an average weight change of +1.5kg (just over 3lb) over the course of 24 months
- bupropion was associated with an average weight change of +0.5kg (just under 1lb) over the course of 24 months
Sertraline being the most weight-gain-inducing of the 8 drugs compared, and bupropion being the least, this means (with them both having fairly even curves):
- sertraline being associated with an average weight change of 0.06kg (about 2oz) per month
- bupropion being associated with an average weight change of 0.02kg (less than 1oz) per month
For all eight, see the chart here in the paper itself:
Medication-Induced Weight Change Across Common Antidepressant Treatments ← we’ve made the link go straight to the chart, for your convenience, but you can also read the whole paper there
While you’re there, you might also see that for some antidepressants, such as duloxetine, fluoxetine, and venlafaxine, there’s an initial weight gain, but then it clearly hits a plateau and weight ceases to change after a certain point, which is worth considering too, since “you’ll gain a little bit of weight and then stay at that weight” is a very different prognosis from “you’ll gain a bit of weight and keep gaining it forever until you die”.
But then again, consider this:
Most adults will gain half a kilo this year – and every year. Here’s how to stop “weight creep”
That’s more weight gain than one gets on sertraline, the most weight-gain-inducing antidepressant tested!
What about over longer-term use?
Here’s a more recent study (December 2024) that looked at antidepressant use over 6 years, and found an average 2% weight gain over those 6 years, but it didn’t break it down by antidepressant type, sadly:
…which seems like quite a wasted opportunity, since some of the medications considered are very different, working on completely different systems (for example, SSRIs vs NDRIs, working on serotonin or norepinephrine+dopamine, respectively—see our Neurotransmitter Cheatsheet for more about those) and having often quite different side effects. Nevertheless, the study (despite collecting this information) didn’t then tabulate the data, and instead considered them all to be the same factor, “antidepressants”.
What this study did do that was useful was included a control group not on antidepressants so we know that on average:
- never-users of antidepressants gained an average of 1% of their bodyweight over those 6 years
- users-and-desisters of antidepressants gained an average of 1.8% of their bodyweight over those 6 years*
- continuing users of antidepressants gained an average of 2% of their bodyweight over those 6 years
*for this group, weight gain was a commonly cited reason for stopping taking the antidepressants in question
Writer’s anecdote: I’ve been on mirtazapine (a presynaptic alpha2-adrenoreceptor antagonist which increases central noradrenergic and serotonergic neurotransmission) for some years and can only say that I wish I’d been on it decades previously. I requested mirtazapine specifically, because I’m me and I know my stuff and considered it would most likely be by far the best fit for me out of the options available. Starting at a low dose, the only meaningful side effect was mild sedation (expected, and associated only with low-dose use); increasing after a couple of weeks to a moderate dose, that side effect disappeared and now the only remaining side effect is a slight dryness of the mouth, which is fine, as it ensures I remember to stay hydrated 🙂 anyway, my weight hasn’t changed (beyond very small temporary fluctuations) in the time I’ve been on mirtazapine. Disclaimer: the plural of anecdote is not data, and I can only speak for my own experience, and am not making any particular recommendation here. Your personal physiology will be different from mine, and may respond well or badly to any given treatment according to your own physiology.
Further considerations
This is touched on in the “Discussion” section of the latter paper (so do check that out if you want all the details, more than we can reasonably put here), but there are other factors to consider, for example:
- whether people were underweight/healthy weight/overweight at baseline (sometimes, a weight gain can be a good thing, recovering from an illness, and in the case of the illness that is depression, weight can swing either way)
- antidepressants changing eating and exercise habits (generally speaking: more likely to eat more and exercise more)
- body composition! How did they not cover this (neither paper did)?! Muscle weighs more than fat, and improvements in exercise can result in an increase in muscle and thus an increase in overall weight.
As researchers like to say, “this highlights the need for more high-quality studies to look into…” (and then the various things that went unexamined).
Want to know more?
Check out our previous main feature:
Antidepressants: Personalization Is Key!
Take care!
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Surviving with Beans And Rice – by Eliza Whool
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If you’d like to be well-set the next time a crisis shuts down supply lines, this is one of those books you’ll want to have read.
Superficially, “have in a large quantity of dried beans and rice” is good advice, but obvious. Why a book?
Whool gives a lot of advice on keeping your nutrition balanced while subsisting on the same quite few ingredients, which is handy.
More than that, she offers 100 recipes using the ingredients that will be in your long-term pantry. That’s over three months without repeating a meal! And if you don’t think rice and beans can be tasty and exciting and varied, then most of the chefs of the Global South might want to have a word about that.
Anyway, we’re not here to sell you rice and beans (we’re just enthusiastic and correct). What we are here to do is to give you a fair overview of this book.
The recipes are just-the-recipes, very simple clear instructions, one two-page spread per recipe. Most of the book is devoted to these. As a quick note, it does cover making things gluten-free if necessary, and other similar adjustments for medical reasons.
The planning-and-storage section of the book is helpful too though, especially as it covers common mistakes to avoid.
Bottom line: this is a great book, and remember what we said about doing the things now that future you will thank you for!
Get yourself a copy of Surviving with Beans And Rice from Amazon today!
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Finding Geriatric Doctors for Seniors
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝[Can you write about] the availability of geriatric doctors Sometimes I feel my primary isn’t really up on my 70 year old health issues. I would love to find a doctor that understands my issues and is able to explain them to me. Ie; my worsening arthritis in regards to food I eat; in regards to meds vs homeopathic solutions.! Thanks!❞
That’s a great topic, worthy of a main feature! Because in many cases, it’s not just about specialization of skills, but also about empathy, and the gap between studying a condition and living with a condition.
About arthritis, we’re going to do a main feature specifically on that quite soon, but meanwhile, you might like our previous article:
Keep Inflammation At Bay (arthritis being an inflammatory condition)
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Why are tall people more likely to get cancer? What we know, don’t know and suspect
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People who are taller are at greater risk of developing cancer. The World Cancer Research Fund reports there is strong evidence taller people have a higher chance of of developing cancer of the:
- pancreas
- large bowel
- uterus (endometrium)
- ovary
- prostate
- kidney
- skin (melanoma) and
- breast (pre- and post-menopausal).
But why? Here’s what we know, don’t know and suspect.
Pexels/Andrea Piacquadio Height does increase your cancer risk – but only by a very small amount. Christian Vinces/Shutterstock A well established pattern
The UK Million Women Study found that for 15 of the 17 cancers they investigated, the taller you are the more likely you are to have them.
It found that overall, each ten-centimetre increase in height increased the risk of developing a cancer by about 16%. A similar increase has been found in men.
Let’s put that in perspective. If about 45 in every 10,000 women of average height (about 165 centimetres) develop cancer each year, then about 52 in each 10,000 women who are 175 centimetres tall would get cancer. That’s only an extra seven cancers.
So, it’s actually a pretty small increase in risk.
Another study found 22 of 23 cancers occurred more commonly in taller than in shorter people.
Why?
The relationship between height and cancer risk occurs across ethnicities and income levels, as well as in studies that have looked at genes that predict height.
These results suggest there is a biological reason for the link between cancer and height.
While it is not completely clear why, there are a couple of strong theories.
The first is linked to the fact a taller person will have more cells. For example, a tall person probably has a longer large bowel with more cells and thus more entries in the large bowel cancer lottery than a shorter person.
Scientists think cancer develops through an accumulation of damage to genes that can occur in a cell when it divides to create new cells.
The more times a cell divides, the more likely it is that genetic damage will occur and be passed onto the new cells.
The more damage that accumulates, the more likely it is that a cancer will develop.
A person with more cells in their body will have more cell divisions and thus potentially more chance that a cancer will develop in one of them.
Some research supports the idea having more cells is the reason tall people develop cancer more and may explain to some extent why men are more likely to get cancer than women (because they are, on average, taller than women).
However, it’s not clear height is related to the size of all organs (for example, do taller women have bigger breasts or bigger ovaries?).
One study tried to assess this. It found that while organ mass explained the height-cancer relationship in eight of 15 cancers assessed, there were seven others where organ mass did not explain the relationship with height.
It is worth noting this study was quite limited by the amount of data they had on organ mass.
Is it because tall people have more cells? Halfpoint/Shutterstock Another theory is that there is a common factor that makes people taller as well as increasing their cancer risk.
One possibility is a hormone called insulin-like growth factor 1 (IGF-1). This hormone helps children grow and then continues to have an important role in driving cell growth and cell division in adults.
This is an important function. Our bodies need to produce new cells when old ones are damaged or get old. Think of all the skin cells that come off when you use a good body scrub. Those cells need to be replaced so our skin doesn’t wear out.
However, we can get too much of a good thing. Some studies have found people who have higher IGF-1 levels than average have a higher risk of developing breast or prostate cancer.
But again, this has not been a consistent finding for all cancer types.
It is likely that both explanations (more cells and more IGF-1) play a role.
But more research is needed to really understand why taller people get cancer and whether this information could be used to prevent or even treat cancers.
I’m tall. What should I do?
If you are more LeBron James than Lionel Messi when it comes to height, what can you do?
Firstly, remember height only increases cancer risk by a very small amount.
Secondly, there are many things all of us can do to reduce our cancer risk, and those things have a much, much greater effect on cancer risk than height.
We can take a look at our lifestyle. Try to:
- eat a healthy diet
- exercise regularly
- maintain a healthy weight
- be careful in the sun
- limit alcohol consumption.
And, most importantly, don’t smoke!
If we all did these things we could vastly reduce the amount of cancer.
You can also take part in cancer screening programs that help pick up cancers of the breast, cervix and bowel early so they can be treated successfully.
Finally, take heart! Research also tells us that being taller might just reduce your chance of having a heart attack or stroke.
Susan Jordan, Associate Professor of Epidemiology, The University of Queensland and Karen Tuesley, Postdoctoral Research Fellow, School of Public Health, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Guava vs Pineapple – Which is Healthier?
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Our Verdict
When comparing guava to pineapple, we picked the guava.
Why?
Pineapple is great, but guava just beats it in most ways:
In terms of macros, guava has nearly 4x the fiber and nearly 5x the protein, for the same carbs, giving it the notably lower glycemic index. An easy win for guava in this category.
In the category of vitamins, guava has a lot more of vitamins A, B2, B3, B5, B9, C, E, K, and choline, while pineapple has marginally more vitamin B1. Another clear win for guava.
When it comes to minerals, guava has more calcium, copper, magnesium, phosphorus, potassium, selenium, and zinc, while pineapple has more iron and manganese. One more win for guava.
One big thing in pineapple’s favor is that it contains bromelain, which is an enzyme* found in pineapple (and only in pineapple), that has many very healthful properties, some of them unique to bromelain (and thus: unique to pineapple)
*actually a combination of enzymes, but most often referred to collectively in the singular. But when you do see it referred to as “they”, that’s what that means.
However cool that is, we think it unfair to weight it against guava winning in every other category, so we still say guava gets the overall win.
Of course, enjoy either or both; diversity is good!
Want to learn more?
You might like:
Let’s Get Fruity: Bromelain vs Inflammation & Much More
Enjoy!
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Beetroot Juice & Caffeine Work Better Than Either Alone
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Beetroot has many beneficial properties, which we’ve written about before:
Beetroot For More Than Just Your Blood Pressure
…and as for caffeine, it’s a mixed bag but for most people, the benefits of moderate caffeine use outweigh the risks:
Caffeine: Cognitive Enhancer Or Brain-Wrecker?
Now, caffeine’s less desirable effects can be mitigated somewhat by pairing it with l-theanine, as we’ve also discussed before:
L-Theanine: What’s The Tea? ← l-theanine also has many wonderful properties of its own, aside from its complementary effects when taken alongside caffeine
So, what’s the deal with caffeine and beetroot juice?
A performance-enhancing balancing act
Caffeine raises blood pressure, while beetroot lowers it, but there’s a lot more to it than that.
Researchers looked into the effects of caffeine and beetroot juice, together or separately, on athletic performance (in a 1000m run) in non-athletes.
They found:
- Caffeine alone enhanced second-run performance but not the first.
- Beetroot juice alone improved first-run performance but led to a performance decline after recovery.
- The caffeine + BJ combo resulted in the best initial and repeated 1000m run performances.
Specifically, they also noted:
- Caffeine alone caused higher blood lactate levels post-exercise.
- Beetroot juice increased muscle oxygenation by 25% during runs.
- The caffeine + BJ combo led to the highest post-exercise heart rate improvements.
You can read the paper in full here:
Caffeine and Beetroot Juice Optimize 1,000-m Performance: Shapley Additive Explanations Analysis
Now, maybe you don’t have a 1000m run to do, let alone multiple ones back-to-back, but most of us could sometimes do with an energy boost during the day, and this seems like an excellent way to get it.
That said, caffeine timing can be important too; midday is generally the best time for it, because:
- of course it should not be too late in the day, because the elimination half-life of caffeine (4–8 hours to eliminate just half of the caffeine, depending on genes, call it 6 hours as an average though honestly for most people it will either be 4 or 8, not 6) is such that it can easily interfere with sleep for most people
- because caffeine is an adenosine blocker, not an adenosine inhibitor, taking caffeine in the morning means either there’s no adenosine to block, or it’ll just “save” that adenosine for later, i.e. when the caffeine is eliminated, then the adenosine will kick in, meaning that your morning sleepiness has now been deferred to the afternoon, rather than eliminated.
Another reminder that caffeine is the “payday loan” of energy. So, midday it is. No morning sleepiness to defer, and yet also not so late as to interfere with sleep.
See also: Calculate (And Enjoy) The Perfect Night’s Sleep
Want to learn more?
Check out:
The Best Form Of Sugar For Energy During Exercise
Enjoy!
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Pelvic Floor Exercises (Not Kegels!) To Prevent Urinary Incontinence
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It’s a common threat, and if you think it couldn’t happen to you, then well, just wait. Happily, Dr. Christine Pieton, PT, DPT, a sport & women’s health physical therapist, has advice:
On the ball!
Or rather, we’re going to be doing ball-squeezing here, if you’ll pardon the expression. You will need a soccer-ball sized ball to squeeze.
Ball-squeeze breathing: lie on your back, ball between your knees, and inhale deeply, expanding your torso. Exhale, pressing your knees into the ball, engaging your abdominal muscles from lower to upper. Try to keep your spine long and avoid your pelvis tucking under during the exhalation.
Ball-squeeze bridge: lie on your back, ball between your knees, inhale to prepare, and then exhale, pressing up into a bridge, maintaining a firm pressure on the ball. Inhale as you lower yourself back down.
Ball-squeeze side plank: lie on your side this time, ball between your knees, supporting forearm under your shoulder, as in the video thumbnail. Inhale to prepare, and then exhale, lifting your hip a few inches off the mat. Inhale as you lower yourself back down.
Ball-squeeze bear plank: get on your hands and knees, ball between your thighs. Lengthen your spine, inhale to prepare, and exhale as you bring your knees just a little off the floor. Inhale as you lower yourself back down.
For more details and tips on each of these, plus a visual demonstration, plus an optional part 2 video with more exercises that aren’t ball-squeezes this time, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Psst… A Word To The Wise About UTIs
Take care!
Don’t Forget…
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