Long-term use of antidepressants can lead to weight gain and an increased risk of obesity. A study in Spain followed adults for six years and found that those who used these medications continuously gained more weight and were twice as likely to become obese. Even those who started or stopped treatment experienced some weight gain. Researchers warn of the importance of monitoring health while taking antidepressants and adopting strategies to reduce these effects.
Depression is the most common psychiatric disorder in the world, affecting approximately 280 million people. Studies indicate that approximately 5% of the adult population suffers from the disease, with women being almost twice as likely to develop it compared to men.
Depression can be extremely debilitating and is among the leading causes of disability in the world. The most commonly used treatment for this disorder includes psychological therapies and the use of antidepressant medications, which are widely prescribed globally.
The duration of use of these medications can vary from one year to a lifetime, depending on the patient's needs. Data from international studies show that the use of antidepressants has increased significantly over the years, being more common among women.
Despite advances in the development of antidepressant medications, all of them can cause side effects. The most commonly reported include insomnia, drowsiness, dizziness, restlessness, excessive sweating, changes in the digestive system, sexual problems and, most importantly, changes in body weight.
Weight gain, in particular, has been identified as one of the main reasons for patients to discontinue treatment.
Obesity is a global problem that affects approximately 650 million people and is associated with several health complications. Research suggests that there is a two-way relationship between obesity and depression: obese people are at greater risk of developing depression, and individuals with depression are more likely to gain weight and become obese.
Several biological factors may explain this connection, including genetic predisposition, hormonal and metabolic changes, and the influence of antidepressant use.
Some of these medications can cause weight gain as a side effect, although this varies according to the class of antidepressant. For example, some selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) are associated with weight gain, while others, such as bupropion, may even contribute to weight loss.
However, most available studies only assess short-term effects, and there is still little research that analyzes the impact of long-term use of antidepressants on weight over the years.
To investigate this issue, a study was conducted in Spain with more than 3,000 middle-aged adults (1,701 women) (average age 55), monitoring their use of antidepressants and changes in weight over six years.
Participants were divided into four groups:
Those who had never used antidepressants
Those who started using them during the follow-up period
Those who stopped using them
Those who used them continuously at both times evaluated
The results showed that all categories associated with the use of antidepressants presented greater weight gain compared to those who had never used these medications. The average increase was 1% of body weight over six years, with about a quarter of the participants gaining more than 5% of their initial weight.
Furthermore, individuals who used antidepressants continuously over the six years had a two-fold increased risk of becoming obese compared to those who never used them. Those who started or stopped taking them had weight gain, but there was no statistically significant association with the development of obesity.
These findings reinforce the importance of monitoring weight and metabolic health during antidepressant treatment. Given the increasing prevalence of obesity and the widespread use of these medications, it is essential that health professionals include weight control strategies in the guidelines for monitoring patients with depression.
This may involve dietary changes, encouraging physical activity, and choosing antidepressants with a lower impact on body weight, always considering the individual needs of each patient.
READ MORE:
Trajectories of antidepressant use and 6-year change in body weight: a prospective population-based cohort study
Camille Lassale, Gabriela Lugon, Álvaro Hernáez, Philipp Frank, Jaume Marrugat, Rafael Ramos, Josep Garre-Olmo and Roberto Elosua
Frontiers in Psychiatry. Volume 15 - 2024. 22 November 2024
DOI: 10.3389/fpsyt.2024.1464898
Abstract:
Antidepressant drug treatment may be associated with weight gain, but long-term studies are lacking. We included 3,127 adults (1,701 women) from the REGICOR study, aged 55.6 (SD = 11.6) years on average in 2003–2006, living in the northeast of Spain. They had data at two time points (baseline and a median of 6.3 years later) on self-reported antidepressant use, body weight and height, and on baseline smoking, physical activity, diet quality, education, civil status, and depressive symptoms assessed with the Patient Health Questionnaire (PHQ-9) at follow-up. We defined four trajectories of antidepressant use as follows: never use, new use at follow-up, initial use discontinued, repeated use at both time points. We used multivariable linear models to estimate the association of these trajectories with the percentage of weight change. In people without obesity at baseline (n = 2,404), we also estimated the association with obesity incidence at follow-up. The average 6-year weight gain was 0.53 kg (1.01% body weight), and 24.5% of the participants gained >5% of body weight. The majority (83.6%) of participants did not report any use of antidepressants, 6.2% initiated during follow-up, 5.1% discontinued it, and 5.1% reported their use at both time points. In multivariable analyses, compared to never users, all trajectories were associated with greater weight gain: +1.78% (0.57, 2.98) for initial use discontinued, +2.08% (0.97, 3.19) for new use at follow-up, and +1.98% (95% CI: 0.75, 3.20) for repeated use. In non-obese participants at baseline (n = 2,404), the odds ratio for becoming obese was 2.06 (1.03, 3.96) for repeated use and non-statistically significant for the other trajectories. In a population-based adult cohort, repeated use of antidepressants was strongly associated with weight gain. New and discontinued use was associated with weight gain, but non-significantly to obesity incidence. Given the global obesity epidemic and the widespread use of antidepressants, weight management and metabolic monitoring should be encouraged and integrated into depression follow-up guidelines alongside antidepressant prescriptions.
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