Lexapro and Weight Gain: Why it Happens & What You Can Do

Many individuals who are prescribed Lexapro (escitalopram) report undesired weight gain that not only increases their risk for various health problems, but is also one of the main reasons some people discontinue this particular treatment [1].

According to research, approximately half of the people who take Lexapro may experience weight gain of 7% or more while taking this medication [2]. Gaining weight unexpectedly and struggling to lose it can worsen self-esteem, anxiety, and depression [3], which ultimately defeats the purpose of taking Lexapro. 

Read on to learn more about the possible causes of Lexapro weight gain and beneficial strategies that can help you target this issue.

Why Does Lexapro Cause Weight Gain?

Research consistently shows a link between Lexapro and weight gain, which is a major concern as this issue increases the risk of potential health consequences. More specifically, becoming overweight makes people more susceptible to heart disease, high blood pressure (hypertension), type 2 diabetes, stroke, joint problems (e.g., osteoarthritis), abnormal fat or cholesterol levels, and even certain cancers [2, 4].

Whether it’s a few pounds or a substantial amount of weight, realizing that your treatment for depression is causing undesirable physical changes can reduce your self-esteem and quality of life – making it that much harder to address your mental health. Now the burning question is “How does Lexapro make you gain weight?

Medical experts are not exactly sure why taking certain antidepressants, including Lexapro, leads to weight gain, but most believe that this type of medication may alter metabolism or appetite. According to research, Lexapro treatment may cause your body to burn less calories by slowing down your metabolism or affect your appetite by causing you to crave certain foods (e.g., carbohydrates) and overeat [5].To better understand this process, let’s take a closer look at how Lexapro works.

This particular antidepressant or SSRI influences serotonin levels by blocking the activity of a specific serotonin transporter [6]. Typically, when serotonin levels in the brain begin to rise, the serotonin transporter rapidly starts shuttling serotonin back out of the brain – causing the levels to drop. For people who suffer from anxiety or depression, low serotonin levels tend to worsen symptoms [6].

SSRIs such as Lexapro block the serotonin transporter and this allows more serotonin to remain in the brain – a process that helps improve mental health for those who are taking it. However, research indicates that blocking the activity of the serotonin transporter decreases metabolism, while increasing appetite because serotonin and its transporter influence appetite [5,6]. Therefore, the risk of gaining weight should be discussed with your doctor before beginning Lexapro, especially if you have any pre-existing conditions.

Would Stopping Lexapro Reverse the Weight Gain? 

Long-term antidepressant studies regarding weight gain show that weight fluctuations may persist for years during and following treatment [78]. This may be due to ongoing mood, appetite, and metabolic changes as well as other factors such as age, gender, or race. It also means that discontinuing Lexapro treatment for the sole purpose of returning to your original size is not recommended as it may not be an effective way to reverse weight gain.

If this side effect becomes burdensome, it is always best to speak with your mental health provider and physician to discuss changing or discontinuing antidepressant treatment.

What Can You Do About Weight Gain Caused By Lexapro?

Although it may be hard to pinpoint the exact cause of Lexapro weight gain, there are several strategies that can help you achieve your desired weight.

Modify Your Diet And Exercise Routine

If you are concerned about possible weight gain, make sure to establish a more nutritious meal plan and increase the amount of exercise you do daily. This is an important strategy you can implement before taking Lexapro to help sustain a healthy body composition. You can also work with a healthcare professional who can create an optimized meal plan and fitness regime that may stop weight gain before it even starts.

If you already started to experience weight changes due to Lexapro, modifying your diet and workouts can help you gain more control over your weight. Speaking with a nutritionist is another good way to work towards meeting your goals.

Practice Mindful Eating

Practicing mindful eating involves paying close attention to feelings of hunger and fullness (satiety), while focusing less on external signals (e.g., fast food restaurants, bakeries) [12]. Slowing down during meals is another example of mindful eating. This strategy supports portion control as it gives your mind and body time to notice when you are getting full.

Research shows that mindful practices (e.g., breathing meditation, body scan meditation) can also reduce the severity of depression [13].

Consider Switching Medications And Alternative Treatment Options 

There are antidepressants that are less likely to cause weight changes such as Serzone, Effexor, and Wellbutrin [14]. For some people, switching to a different medication that works the same way can dramatically improve weight control. If you and your healthcare provider decide to switch medications, it is important to monitor your symptoms in case the new antidepressant is not as effective as Lexapro.

Alternative treatment options such as nutrition management, counseling, or other cutting-edge approaches may also offer support. The experts at Dr. TMS Therapy provide tailored treatment plans for depression and medication-related weight gain as well.

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How Likely Is Weight Gain From Lexapro?

There are a few different factors to consider when trying to determine whether using Lexapro will lead to weight gain. These include assessing your appetite and weight prior to taking this antidepressant and how long you may be taking it.

Did symptoms of anxiety or depression previously reduce your appetite?

If you started to lose your appetite due to depression, you may have also lost a few pounds. In this case, taking Lexapro may lead to improved emotion control and a heightened mood that may encourage you to begin eating properly again [1, 25]. This may lead to healthy weight gain that helps you return to your original size.

Has your doctor prescribed short-term or long-term Lexapro treatment?

In addition to considering your previous weight and appetite, it is also important to discuss how long your doctor would like you to take Lexapro. Several clinical studies suggest that the longer you take SSRI antidepressants (Lexapro), the more likely you are to gain weight – with some studies reporting that possible weight changes may occur following six months or more of treatment [789].

Increases in weight during Lexapro treatment may vary from 0.5% to more than 7% [210]. Furthermore, it is not uncommon for people whose body mass index (BMI) was low before starting treatment to experience significant gains. Individuals who were overweight or obese before taking Lexapro may also notice an increase in their BMI. This is why it is important to discuss your health status with a healthcare professional while determining your treatment options.

Another important point to remember is that not everyone who takes Lexapro will gain weight and some even lose weight while taking this antidepressant – especially those who take it for short periods [11]. This is because antidepressant use can help some people achieve better appetite control, which may lead to weight loss.

Consult The Dr. TMS Therapy Team about Treating Lexapro And Weight Gain

If you’re suffering from anxiety or depression that necessitates prescription medication, additional problems such as unexpected weight gain can make it even harder to cope emotionally. This means that it is important to be aware of the potential for weight gain prior to taking this type of antidepressant.

If you need additional assistance, Dr. TMS Therapy – Griffith Psychiatry offers a wide range of services that help target Lexapro weight gain such as medical weight loss, medication management, TMS therapy, and even telemedicine.

  • Medical Weight Loss – This approach involves establishing a customized weight loss program with the assistance and guidance of a medical professional. Our team of experts use their experience and knowledge to help individuals who desire to lose weight set realistic goals that meet their specific needs. This may include behavioral modification through diet and exercise guidance as well as the use of appetite suppressant medication. The most commonly used medications for appetite suppression are Phentermine and Phendimetrazine which are safe and affordable, but other options are also available [15].*
  • Medication Management – This management approach entails medical monitoring of prescriptions, a comprehensive medication assessment (medication reconciliation), and guidance that helps individuals achieve their desired outcomes. In addition to medication management, counseling and psychotherapy are also available. Counseling is a form of short-term therapy that focuses on mild to moderate symptoms of depression and behavior. Psychotherapy is a long-term mental health treatment approach with a licensed psychologist or psychiatrist.

    Dr. Griffith further mentions that “when weight gain from any cause happens Dr. TMS Therapy and Psychiatry is able to offer its own successful medical weight loss program called, ‘A Shape for Life’. A Shape for Life offers appetite suppressant medications and behavioral modification guidance and follow-up care to facilitate burning calories through activity and reducing calories consumed and shaping food and beverage choices to healthier ones.”
  • TMS Therapy – Transcranial magnetic stimulation (TMS) is an FDA approved, non-medication therapeutic approach that treats depression for people who are not responding well to antidepressants or experiencing agonizing side effects [16]. TMS therapy involves electromagnetic stimulation of the brain through brief magnetic pulses that stimulate a targeted brain region. The magnetic pulses excite specific neurons (nerve cells), which means symptoms of depression can be modified therapeutically without the need for medication. As TMS therapy is non-invasive and non-pharmaceutical, this form of treatment does not cause side effects that are typically observed with oral medication.

If you’d like to learn more about any of the services offered by Dr. TMS Therapy, contact our team today. 

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Medical Weight Loss may not be suitable for people who are taking antidepressants and currently struggling with severe depression due to the side effects, interactions, and precautions associated with certain antidepressant medications. However, this approach may be beneficial for individuals who have residual weight gain after gradually discontinuing Lexapro treatment.

Walter G. Griffith Jr., MD, PA

Dr. Griffith earned his Undergraduate Degree from Notre Dame University and his Medical Degree from Ohio State University’s College of Medicine. He then completed his Residency in Psychiatry at Ohio’s prestigious Cleveland Clinic, and ultimately became the Chief Resident at the Cleveland Clinic in his final year of residency. After completing his residency, Dr. Griffith moved with his family to sunny Florida in 1992, where he worked at several hospitals in the early days of his career, but, ultimately, he decided to start his own outpatient Psychiatric Private Practice in Florida, where he has been working and growing the practice over the last three decades. Dr. Griffith is the Medical Director for the medical practice and oversees all of the medical clinicians who work in the practice in order to help manage the growing patient caseload at both of the medical office locations.

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