Devastated! 9lbs gain from antidepressant after reaching my goal

joowelz

I have worked my butt off for six months and exercised self control to reach my goal weight of 158 lbs. I lost around 12 lbs from Sept to Feb .

Then in March I had a few very serious anxiety attacks that necessitated I go back on my antidepressant, eschitalopram. Within six weeks of being on the med, I have gained 9 lbs! I am devastated. The med has made me want to eat more, so I have been indulging in peanut butter a lot at night. All my other habits and routines are the same.

I really like eschitalopram for anxiety and regaining a feeling of wellbeing, but my heart and spirit are crushed from this sense of failure, feeling unattractive again, and the loss of time. Six months of effort and discipline wiped out in a matter of weeks!

Are there other antidepressants for general anxiety disorder that do not stimulate appetite?

Hollis100

That sounds like a question for your medical provider. Hopefully, they will have some answers.

As far as being hungry, can you change the peanut butter to something else? Vegetables? Many entire bags of frozen vegetables without sauce or seasoning have about 100 calories total and should stop hunger. Or you could try fresh vegetables, a simple salad, or cup of soup. The DASH company makes seasoning without salt that's low calorie and tastes fine.

AnnPT77

I completely understand why you would feel frustrated, even devastated. I sympathize, truly and strongly.

But can we step back for a moment, and look at this more mechanistically, setting aside the natural emotional impact for a few minutes?

Generically, if a medication leads to weight gain, the mechanism is one or a combination of these:

* Water retention increase, or perhaps unpredictable fluctuation. It may or may not feel "bloated", it depends on whether the retention is general (over the whole body) or localized (maybe in an internal/non-obvious place).

* Fatigue (perhaps subtle), so moving less (daily life and/or exercise intensity) therefore burning fewer calories. (Fidgeting alone can burn in the low hundreds of calories daily, and noticing reduced fidgeting in oneself is pretty hard.)

* Appetite increase, so maybe portion creep (if a person is calorie counting/logging carefully, they'd likely know if this is happening; if just "watching what one eats" or logging with some estimating and approximating in the mix, this also can be a pretty subtle effect).

* In rare circumstances, better absorption of nutrients and calories. This would tend to be in the narrow case where someone has a disease that interferes with digesting and metabolizing foods, which is a dangerous condition. Treating that disease would make them better absorb nutrients (and calories), which is good for health, but could still lead to frustrating weight gain, in some cases.

Overall, across all of this: CICO - the calorie balance formula - still applies. Get calories below calories burned, weight loss happens. With medication, calorie counting may experience some bumps in the road, if calories burned drop due to fatigue, or calories eaten increase due to portion creep. (A few meds could even cause peaks and valleys in fatigue or eating, make counting even more confusing, even those CICO still applies! But that's rare.)

If the issue is water retention, fat loss is still happening, just being masked on the scale by the extra water weight. Some (unusual) things can cause creeping increases in water retention, up to a surprising total amount. It's more common for water retention just to move a person from X pounds of water, to X plus a couple or so pounds of water, then stop increasing. In that common case, fat loss will eventually outpace that couple of pounds or so, and show up on the body weight scale.

In your case, it seems like your medication did what you wanted it to for your anxiety, which is great. But it brought along some side effects.

My best guess would be that if there was an initial pretty quick scale jump, without much change in eating or activity, it was water retention. That tends to be a limited amount (usually doesn't keep increasing and increasing), and is sometimes temporary - i.e., it can drop after the body adjusts to a new situation.

Maybe I'm reading you wrong, but it sounds like you then also started eating more - like the peanut butter - through some combination of increased appetite . . . plus maybe some stress-eating effect?

I also wonder if there could be some subtle fatigue in the picture. I tend to think of that when someone talks about evening appetite/cravings.

Briefly: Fatigue is a drop in energy. A drop in energy makes the body seek energy (calories), usually manifesting subjectively as appetite/cravings. Over the course of a day, fatigue tends to grow, for the common sense reason that we're better rested and de-stressed when we get up in the morning, then spend energy all day with activity (and maybe added stress), get depleted. So, evening can be when those cravings hit.

Hollis had some good thoughts about the appetite/cravings part. If there's any stress-eating in the picture - I don't know - then other stress management techniques might help. (People do all kinds of things, from mild, non-tiring exercise, to meditation, journaling, warm showers, prayer, aromatherapy, yoga, adult coloring books, . . . whatever works.)

If fatigue could be part of the situation, mild exercise might help that, too (counter-intuitively), or if sleep quality/quantity could be improved, then working on that might be beneficial for reducing evening cravings. Even timing nutrition or snacks differently during the day can help, sometimes.

I totally get why you're frustrated. What I'm trying to encourage is that you try to adopt a bit of an analysis and problem-solving orientation, past that very natural emotional reaction to the situation. I think you can get a handle on this, work your way through this . . . and if so, that may feel usefully empowering.

The only way in which you've wiped out your progress totally is if you stop trying to work at this. Every single one of us has probably had setbacks on the path. You've had a pretty big one, maybe more than most. It's probable that you can move beyond this, IMO . . . though I'm not saying it will be easy, just possible.

And, yes, ask your doctor about that "is there another med" question. We're just random idiots on the internet - at least I am - who don't know much about medications, but have some experience (our own!) with weight loss.

Best wishes, sincerely!

kshama2001

Only you and your doctor can decide if you should switch meds or come up with coping strategies that allow you to continue with this med.

My brother takes mood stabilizers and antipsychotics known to cause an increase in appetite. When he was in a hospital setting, he gained weight while eating hospital food and not getting much exercise. Now that he is home, eating Mom's cooking, helping her with extensive yard work, and walking several miles per day, he lost all the weight he gained in the hospital and has maintained a healthy weight for going on 7 years.

He doesn't count calories. He does eat lots of whole foods - fruits, veggies, legumes, whole grains, chicken, fish, etc. There's very little, if any, junk food in the house. Mom's natural way of eating is basically the Mediterranean diet.

joowelz

Thank you so much 💓

kjlahh

Could you try doing something to occupy your hands or mind in the evening to prevent you from snacking? For example if you're watching TV and thinking of snacking, pick up a pen and do some doodling instead, something that you can do whilst doing your usual routine.
Or if you're relaxing in bed and fancying a snack, how about trying some meditation or guided talk down. It will help your anxiety and hopefully take your mind off of food.
If you've had a hard day and want to reward yourself with something, instead of peanut butter, maybe put a facemask on or plait your hair. (It will keep your hands busy too).

siobhanaoife

I absolutely agree with the prior posters that only you and your doctor working together can determine what the best drug is for you. That said, another drug in the same class, bupropion (also known as Welbutrin), is not associated with weight gain. It may not be the right drug for you, and I am not suggesting that you ask your doctor to prescribe it! But I wanted to just give you the boost of knowing that there are some drugs to address anxiety and depression that do not have this particular side effect.

Also, a different evening ritual when you're craving things might serve you well. Either a non-food ritual, or one with a fancy drink, or a replacement food that fits in your calorie budget for the day - peanut butter adds up fast!