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Re: Do people LOSE weight while on an SSRI? Trepanist

Posted by Racer on September 23, 2008, at 11:02:59

In reply to Do people LOSE weight while on an SSRI?, posted by Trepanist on September 22, 2008, at 22:12:48

Welcome to Babble, Mark! It is a great place, and there are lots of great people here.

All the SSRIs potentially cause weight gain. Some people are more vulnerable to it than others -- I'm especially vulnerable to weight gain from meds, for example, in large part because I'm underweight to begin with. Serotonin is the main neurotransmitter involved in feeding behaviors, which includes the physical parts like gut motility and the signals your body gives that you've satisfied your hunger. For some people, diet and exercise just aren't going to make a lot of difference in that regard. If the Lexapro is a big contributor to your weight gain, I'd strongly urge you to get a referral to a good dietitian who has experience with weight gain related to psychotropic medications. Plan on working closely with him/her, probably at least twice a month.

The Risperdal, of course, is probably a much more active participant in your weight gain, so some will probably come off after stopping that. (I'm assuming you are, by the way. If not, that's moot.)

Some medications can mitigate the weight gain, and aid in losing the weight while on these meds. Topomax is probably the best choice these days, although Zelnorm -- no longer on the market -- was the only medication I know of which addressed the underlying issue with the SSRIs directly. Another option is to try one of the OTC acid reducers -- they help ease the GI discomfort which adds to the obesogenic effects for a lot of people. It's well worth a try.

Yxibow -- who knows I think he's a smart cookie -- had a great suggestion, and it's one that I make frequently: keep a food journal. Write down EVERYTHING you eat, and write it down accurately and completely. Measure portions, find out how much you're actually eating. You may find that you're eating more than you're aware. (Far more often the case than you might think...) Also look at your food choices and how often you eat: about 65% of your calories should come from carbs, for example, and you should be eating at least every 2.5 to 3 hours, because the idea is to stay between about 3 and 6 on a hunger scale where 1 is so hungry you feel weak and dizzy and 10 is so stuffed you literally cannot stand up. So, three meals, three snacks, and a very minimum of 1200 calories per day. (As in -- you probably need more like 1500 calories per day, but never, ever, ever go below 1200.) Five servings of veggies and two or three servings of fruits per day. And so on... (Yes, more than a year of nutritional counseling and college courses in nutritional sciences...)

I hope that helps, and best luck!




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