Ssri without weight gain

Antidepressants cause minimal weight gain

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Antidepressants have helped millions of people cut through the dark fog of depression. Many others try these medications but stop taking them, often because of side effects such as weight gain. A study from a Harvard-based team shows that the amount gained is usually small, and that it differs little from one antidepressant to another.

Earlier studies linking antidepressant use to weight gain were usually small and short. This one, led by researchers with Massachusetts General Hospital’s Center for Experimental Drugs and Diagnostics, included more than 19,000 men and women and lasted for a year.

Using electronic health records, the researchers identified men and women who took an antidepressant for at least three months. Medications used included amitriptyline (Elavil), bupropion (Wellbutrin), citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), mirtazapine (Remeron), nortriptyline (Pamelor), paroxetine (Paxil), venlafaxine (Effexor), or sertraline (Zoloft). They also identified another 3,400 people who took some other type of medication for a non-depression ailment. Each person’s weight was checked every three months for a year.

The researchers chose citalopram as a reference, because earlier studies suggested that it is “average” when it comes to weight gain. In this study, the weight gain experienced by people taking citalopram averaged one to two pounds. Compared to citalopram, the weight gain linked to other antidepressants was small.

Bupropion was associated with the least amount of weight gain, close to none. Two others that also appeared to have less weight gain were amitriptyline and nortriptyline. Amitriptyline and nortriptyline are older drugs. Because newer drugs tend to have fewer side effects, those two aren’t prescribed as frequently. At the other end of the spectrum, citalopram caused the most weight gain. Even so, the differences between the drugs were small. The results of the study were published in JAMA Psychiatry.

Not everyone taking antidepressants gained weight. Some actually lost a few pounds.

Tip for choosing an antidepressant

The results of this study indicate that worries about weight gain shouldn’t influence the choice of antidepressant for most people. One antidepressant is generally as effective as another. If you need to choose an antidepressant, let cost and potential side effects be your guide.

Many antidepressants are available as generics. Generics work as well as brand name drugs, but cost less.

Here are some tips for choosing a treatment based on common side effects:

Sexual side effects, such as difficulty having an orgasm. Bupropion may be less likely to cause this side effect. It’s also the one associated with the least amount of weight gain.
Sleepiness. Some antidepressants make you sleepy. If you have trouble falling asleep or staying asleep, taking one of these before bed, like trazodone, might be a good idea. Paroxetine is another good choice.
Decreased energy level. No antidepressant leads the pack in terms of being more stimulating. Perhaps bupropion or fluoxetine might be a good first choice.

If you start taking an antidepressant, don’t expect to see a major improvement right away. It often takes 6 to 8 weeks to see a response to an antidepressant. And don’t give up if the first one doesn’t work. Trying a different one may do the trick.

Another option to consider is psychotherapy, especially if the first drug doesn’t work. People who do not respond to the first antidepressant can often do as well with talk therapy as they would with another drug.

Keep in mind that a small number of people have a condition called atypical major depression. Instead of the more usual problems of decreased appetite and difficulty sleeping, their depression causes an increased appetite and sleeping too much. This leads to weight gain regardless of drug therapy. For them, it’s probably best to stay away from an antidepressant that causes even more weight gain.

Waiting for Antidepressants That Don’t Cause Weight Gain

When Prozac entered the market as the first serotonin reuptake blocker to treat depression, it was anticipated that in addition to reducing or eradicating the symptoms of depression, it might also prevent the weight gain seen with antidepressants being used at that time. The drug was approved by the FDA in December 1987 and launched the next month. Indeed, it seemed so promising in its ability to prevent weight gain that it was tested to see if it would be effective as a weight drug. And it worked, for about half a year; however, continued treatment after the mid-point in the year-long study resulted in the subjects who had lost weight gaining back all the weight they lost.

The hoped-for weight-neutral side effect of Prozac was not realized. And unfortunately, most antidepressants that entered the market subsequently also had weight gain as a potential side effect although one, bupropion, (Wellbutrin) seems to cause less weight gain than other SSRI medications. One antidepressant currently being prescribed, Mirtazapine (Remeron) has been associated with rapid and significant weight gain.

Some weight gained during treatment may be due to recovery from depression itself. Loss of appetite often accompanies depression and when normal eating is resumed, weight may return to pre-depression levels. However, weight gain as a side effect of the medication is unfortunately also common and may add unwelcome and unwanted pounds that alter body shape, energy levels, and satisfaction with one’s appearance. Social and work consequences may follow. A 10-pound weight gain is noticeable and may make a patient uncomfortable physically and emotionally. Does one tell family at a yearly gathering that the reason their clothes don’t fit very well is that the individual has been depressed, anxious, and on medication? Does one mention to co-workers who wonder about the increasing size of the patient that he or she has a mental illness and the treatment is causing weight gain? Or does the patient stand up at a Weight Watchers meeting and explain that her inability to lose weight is due to the medication she is taking for depression? Understandably, this information is probably generally not shared, but it leaves the patient with no way of explaining the unexpected addition of 5-20 or more pounds.

We established a weight-loss center at a university-affiliated psychiatric hospital more than 20 years ago to help patients from the hospital and community to lose weight they had gained or were gaining on their psychotropic medications. Few if any of the people coming to our clinic had been overweight or obese before being treated with antidepressants. Indeed, many did not know how to diet since they never had the need. Moreover, they enjoyed exercise and were upset because their increased weight made it hard for them to do so. And they all claimed that their weight gain was due to a new, unexpected craving for carbohydrate snacks and an absence of satiety after meals. These changes in their appetite made us suspect that the antidepressant medications might be interfering with serotoninergic activity, as one of serotonin’s functions is to produce a feeling of satisfaction after eating. A drug-free way of increasing serotonin levels and function; i.e. consuming a small amount of carbohydrates on an empty stomach, seemed a workable approach to helping our clients control their food intake. Perhaps we could make them feel slightly full and satiated before they started a meal by increasing serotonin.

Our approach seemed to work. The consumption of a carbohydrate-containing beverage about 90 minutes before eating lunch and dinner, and in tandem with an exercise regimen we developed for them, was effective in achieving significant weight loss. Presumably, the subsequent increase in serotonin diminished their appetite and increased their satiety, so they were content with diet-size meal portions.

Our results suggested a method for supporting weight-loss efforts even while patients are on medications that lead to weight gain. Eventually, we tried introducing our intervention as soon as individuals noticed changes in appetite and satiety. Coupled with an exercise program compatible with their level of fitness and energy, it seemed an effective approach to minimizing the amount of weight gained.

Unfortunately, there is evidence—admittedly, mostly anecdotal—of patients unable to lose weight even after discontinuing antidepressants, going on a calorie-restricted diet, and exercising. Very little data are available about whether certain antidepressants are more likely to cause resistance to weight loss than others. The difficulty people have in attaining their pre-medication weight status should not be explained as the difficulty many obese people have in losing weight, since many who have trouble returning to their pre-treatment weight were thin before starting on their medication.

All this could be avoided if antidepressants were available that did not have the potential to cause weight gain. The first antidepressants were discovered in the 1950s: iproniazid, a drug that had been used to treat tuberculosis, and imipramine, the first in a group of drugs known as the tricyclic antidepressant family. It has been a long wait.

How to gain weight for a very thin person: fast weight gain tips for thin people | 74.ru

The weight itself doesn't mean anything

Photo: Evgeniy Vdovin / 161. RU

While some people want to shed those extra pounds accumulated in their sides, others dream of at least a little weight gain. We will not talk about extreme cases and clinical stories - this is best told by narrow specialists. But if you do not have health problems, see how to improve the situation and get better yourself. nine0009

The most obvious thing about excessive thinness is a lack of nutrients, followed by a whole string of possible consequences, up to death.

“Firstly, the body does not receive the necessary amount of energy, which is necessary, among other things, to fight infections and diseases,” says nutritionist Marina Glebova. Therefore, people with low weight get sick more often and longer. Also, the bones do not receive the necessary trace elements, hence the decrease in bone density, an increased risk of osteoporosis, and tooth loss. The lack of nutrients is not for the better reflected in the quality and appearance of the skin and hair. nine0003

Due to excessive thinness, women have problems conceiving, men are at risk of dying too early from cardiovascular diseases. In old age, people with a low body mass index are 34% more likely to develop dementia.

Before registering yourself in the group of too thin people, calculate your body mass index (it must be at least 18.5). To do this, divide your weight in kilograms by the square of your height in meters. For example, if your height is 170 centimeters and your weight is 60 kilograms, the equation would look like this: 60 ∶ (1.7 × 1.7). The result is 20.7. This is a good indicator. But with a weight of 50 kilos, the indicator will be 17.3 - it's time to think about weight gain. But before proceeding with this, be sure to consult a doctor. Because there can be several reasons for thinness. nine0003

To understand if you need to get fat, calculate your body mass index

Photo: archive 74. RU

The most common reason is a lack of calories. Also of great importance is heredity, accelerated metabolism and nervous disorders. The body may not be able to absorb nutrients due to diabetes or strenuous exercise. If you started losing weight for no reason, your lifestyle has not changed, and the scales even showed minus five kilos in a couple of weeks - this is a sure sign that you need to go to a specialist. For starters, visit at least a therapist. The recommendations below apply to those people who do not have diseases that prevent them from gaining weight - those who are healthy and want to gain weight. nine0009

The most elementary way to gain weight is to simply eat everything indiscriminately at any time and in any quantities. With this approach to yourself, you will quickly acquire additional kilograms, but they will settle in ugly sides that you want to quickly remove. Gaining weight due to excess fat is not only wrong, but also dangerous. In any case, you need to add calories gradually.

- In order to get better, on average, men need to add at least 250 kcal per day to the required number of calories, women - 125, - explains Marina Glebova. - But it is important to remember that their exact number depends on many factors, such as: metabolism, age, initial weight, lifestyle, heredity, etc. At the same time, nutrition should be regular and correct. You should not eat too many calories - you need to gain body weight due to muscle, not fat. nine0009

Even if you want to get fat, you still shouldn't overeat

Photo: Elena Tulentseva

Daily calorie intake varies depending on lifestyle and age. For men, the run is from 2000 to 3000 kcal, for girls and women - from 1500 to 2500 kcal. A specialist will help you calculate the exact number of calories you need. If going to the doctor is too expensive and long for you, then use at least an online calculator. Calorie intake must be balanced with calorie expenditure so that weight gain does not become unhealthy. According to WHO recommendations, total fat intake should not exceed 30% of total energy intake, saturated fats (pork, beef and dairy products, fast food, chocolate) should be less than 10%, and trans fats should be less than 1% of total energy intake. nine0009

Popular foods that contain trans fats

Photo: Vitaliy Kalistratov / City Portal Network

etc.), and industrially produced trans fats are best eliminated from the diet.

Another calculator that you will need to gain weight, counts the consumed proteins, fats and carbohydrates. To maintain and increase the existing kilograms in the diet should be 1.6-1.8 grams of protein, 4-6 grams of carbohydrates and 0.5-1.5 grams of fat per kilo of weight. nine0009

— To ensure normal functioning, the body needs different sources of proteins, fats and carbohydrates in certain proportions. Everything is interconnected: you can drink pharmacy vitamins in handfuls, but they simply cannot reach the cells without carrier proteins (if you are malnourished of protein foods), and fat-soluble vitamins will not be absorbed without the proper amount of fat in the diet, says fitness trainer Victoria Yablokova.

Avocado is a good source of healthy fats

Photo: Alexandra Savelyeva / 76.RU

Products from which you can squeeze the maximum BJU are known to many. Protein sources are eggs, cottage cheese, cheese, fish, beans, nuts and meat. For carbohydrates, go to vegetables, fruits, oatmeal, whole grain bread and brown rice. Yes, carbohydrates are also found in white bread, cakes, cookies and pies, but these are simple carbohydrates - they give a feeling of fullness, but are not useful for the body. Getting fat is best from cheese, avocados, cottage cheese and nuts. Well, do not forget about fiber: for every thousand kcal of the diet, 10-15 grams are recommended. nine0009

Making the right diet is not so difficult

Photo: Vitaly Kalistratov / City Portals Network

was too light for you not to want to eat again after an hour. In the first case, you are unlikely to be able to fall asleep normally, in the second case, the “night watcher” will begin.

“Due to the fact that the body was engaged in digestion at night, as a result, not quite high-quality sleep, slight weakness, impaired digestion, you do not want to have breakfast in the morning,” says nutritionist Galina Bartashevich. - "Night Watcher" begins when a person has already used up energy, but did not compensate it with a food equivalent in time, as a result, the body requires the owner to return what was spent. It is easier for a person, without thinking about the waist, to quickly satisfy his hunger. There and cakes go, and nightly eating fruit, chocolate, a cup of coffee and everything else. nine0009

All these calculators are, of course, a useful thing, but there is one problem: underweight people usually fill up faster. Therefore, if you are used to eating three times a day, then even huge portions will not save you - you will not master them. The only way out is to eat more often. The WHO generally says that eating 5-6 times a day is the norm. Leave yourself a full breakfast, lunch and dinner and add about two snacks - profit!

But do not turn a snack into a second lunch

Photo: Ilya Barkhatov / 74.RU

If desired (and possible), the number of snacks can be increased (within reasonable limits). Do not forget to treat yourself to sweets, and if you do not feel like eating, you do not need to force yourself. This way you don't have to start all over again. The main thing is that you like the diet, and the body can comfortably tolerate it.

To achieve confident results in weight gain, you need to sleep at least eight hours a day. During sleep, the body recovers from daily stress and builds muscle mass. To understand how this works, scientists conducted a study where one group of people slept 5.5 hours a night, and the other 8.5. Three days was enough to come to a revealing conclusion: in those who did not get enough sleep, muscle mass decreased by 60% by the end of the study, and in those who slept normally, it increased by 40%. nine0003

Allow yourself more sleep and less stress

Photo: Daria Selenskaya / 74.RU

go to bed at the same time;

do not drink coffee or alcohol a few hours before bedtime;

do not eat much at night;

do not engage in excessive physical activity. nine0009

— Organs must have blood flow for their normal functioning and smooth muscle contraction. So you can't run. Do not forget that a person, if he is not an athlete, runs at a different pace, and if he is also out of breath, then the speed drops completely, - explains Igor Mormil, teacher of the Ural Institute of Fitness. - Thus, the energy supply of the muscles is always changing. And this can lead to a drop in blood sugar and pathological conditions such as hypoglycemia. nine0009

In the end, excessive physical activity will increase energy, significantly delay the time to fall asleep and generally ruin the quality of sleep. It is advisable to fall asleep on time, and not wait until your favorite show or the next episode of the series ends, and go to bed deep after midnight. This is where circadian rhythms (the "internal clock" if you will) come into play. The group of scientists who received the 2017 Nobel Prize for their research explains it this way: at night, the brain produces quite a lot of hormones, in particular melatonin and human growth hormone, and with a lack of sleep, growth hormone production drops sharply. (For children, such a decrease is dangerous in general with a developmental delay.)

You can replace your meal before bed with a protein shake. It's made up of protein in forms that break down quickly and easily, so eating it before bed will make that job much easier for the body.

Sport at least will not allow the mass to be deposited in the sides

Photo: Sofia Bogatkina / 29.RU

Physical activity for weight gain is just as important as proper nutrition. While others are losing weight on treadmills, focus on strength training and dilute their cardio. This will help build muscle mass. For the best effect, it is worth at least a few sessions with a trainer. He will at least tell you what to pay special attention to and explain how to approach the simulators. Be prepared to train at least three times a week. nine0009

Height and weight gain for children in their first year of life. Tables

Dear parents, your baby is growing and you are worried about whether he is gaining enough weight and height. For control, there are centile tables for assessing the physical development of children, weight and height indicators. At the same time, you must remember that each baby is individual, he cannot grow according to the textbook. These weight and height recommendations are based on an average number of children and 10% deviation is normal. In addition, the centile corridor from 25% to 75% is an average physical indicator. That is why they say: Physical development is mesosomatic, macrosomatic, microsomatic. nine0003

It is important that the weight and height indicators are in the same centile corridor, but no more than two adjacent ones. Then we can talk about harmonious development. If the gap is more than two centile corridors, the development is disharmonious. Then we can think either about an unbalanced diet or about a pathology associated with obesity (paratrophy), or protein-energy deficiency (hypotrophy). In addition, one should not forget about the constitutional characteristics of the child, about genetic predisposition. Therefore, in no case should you compare your child with a neighbor's. To talk about the health of a child, we evaluate his condition according to many criteria. This is neuropsychic development, laboratory examination data, anamnesis, heredity. How many times in my practice have I met children who gained 400-450 g in weight every month, by the year they barely gained 7.8-8 kg. But at the same time, children already at 10 months began to walk, pronounce syllables, and follow complex instructions. nine0003

We'll talk about weight and height gain for term babies. In preterm infants, rates of weight gain and height differ according to the degree of prematurity. In addition, children can be born with intrauterine malnutrition.

The tables for girls and boys are different in terms of numerical indicators, but at 1 year of age, these differences are quite minimal.

Centile tables for assessing the physical development of girls from 0 to 12 months. nine0003

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Body length (height), cm. Centiles in %							Age in months	Body weight, kg. Centiles in %
3	nine0002 10	25	fifty	75	90	97		3 nine0003	10	25	fifty	75	90	97
nine0002 45. 8	47.5	49.8	50.7	52.0	53.1	53.9 nine0158	0	2.6	2.8	3.0	3.3	3.7	3.9	4.1
48.5	50.3	52.1	53.5	55.0	57.3	one	3.3	3.6	3.8	4.2 nine0003	4.5	4.7	5.1
51.2	53.3	55.2	58.0	59.3	60.6	2	3.8	4.2 nine0003	4.5	4.8	5.2	5.5	5.9
54.0	56.2	57.6	59.3	67.7	61.8	63.6	3 nine0003	4.4	4.8	5.2	5.5	5.9	6.3	nine0002 6.7
56.7	58.4	60.0	61.2	62.8	64.0 nine0003	65. 7	4	5.0	5.4	5.8	6.2	nine0002 6.6	7.0	7.5
59.1	60.8	62.0	63.8 nine0003	65.1	66.0	68.0	five	5.5	5.9	nine0002 6.3	6.7	7.2	7.7	8.1
60.8	62.5 nine0003	64.1	65.5	67.1	68.8	70.0	6	nine0002 5.9	6. 3	6.8	7.3	7.8	8.3	8.7 nine0158
62.7	64.1	65.9	67.5	69.2	70.4	nine0002 71.9	7	6.4	6.8	7.3	7.7	8.4	9.3
64.5	66.0	67.5	69.0	70.5 nine0003	72.5	73.7	eight	6.7	7.2	7.6	nine0002 8.2	8. 8	9.3	9.7
66.0	67.5	69.1 nine0003	70.2	72.0	74.1	75.5	nine	7.1	nine0002 7.5	8.0	8.6	9.2	9.7	10.1
67.5 nine0003	69.0	70.3	71.9	73.2	75.3	76.8	nine0002 10	7.4	7.9	8.4	9.0	9.6	10.1 nine0158	10.5
68. 9	70.1	71.5	73.0	74.7	nine0002 76.5	78.1	eleven	7.7	8.3	8.7	9.3 nine0158	9.9	10.5	10.9
70.1	71.4	72.8	nine0002 74.1	75.8	78.0	79.6	12	8.0	8.5 nine0158	9.0	9.6	10.2	10.8	11.3

At the same time, until the age of three months, the child adds 20-30 grams per day daily, respectively, from 140 to 200 per week. If we talk about the average weight gain by months, then it is only 600 g per month, since the child after birth has physiological weight loss (with urine, feces, transition from intrauterine feeding to breastfeeding during the adaptation period), approximately 10% of the weight, which is 200-300 grams. nine0003

More often, by 3-4 days, the child restores its original weight, and then there is an increase. But I had a case in practice when the child began to gain weight from the 20th day of life, while the girl was active, reflexes were alive, her appetite was good, she could withstand the night interval, stool 4-5 times a day, urination was sufficient, developed according to age. Therefore, do not worry. Our indicator is the well-being of the child. If the baby is active, eats with appetite, sleep is calm, the skin is clean, physiological functions are not disturbed, be calm, your baby is healthy and not hungry. You see from the table the range of weight per year is from 8 to 13 kg. This is the norm. There is no reason to run to the endocrinologist, genetics, to examine the child. nine0003

Or the opposite situation: in the first months of life, a child gains 1-1.5 kg while breastfeeding. If the baby does not have colic, he does not spit up, there are no gastrointestinal manifestations, he is active, the skin is clean, physiological functions are not disturbed - this is also the norm. Remember, as often happens, premature babies quickly gain weight and catch up with their peers by the year. And large babies gain weight more slowly. In my entire thirty-year practice, only two children weighed 14-15 kg by the year, although their parents were large and tall. By the age of three, they weighed almost the same, added only in height, the rest of their peers caught up with them. nine0003

nine0169

Month	Weight gain in grams
one	600.0
2	800. 0 nine0003
3	800.0
4	750.0
five	700.0 nine0158
6	650.0
7	600.0
eight	550.0
nine	500.0
10	450.0
eleven	400.0
12	350.0

It is believed that by 4-4.5 months the child should double the weight, and triple by the end of the year.

It happens that the increase in height and weight goes in leaps, seasonality, unevenness, and sometimes asymmetry of growth are noted. Pediatricians are concerned about the circumference of the head and chest, by 2-3 months they should be equal. Further, the breast grows faster. This is important so as not to miss the pathology. nine0003

The younger the child, the faster his growth. In the first 3 months of life, body length increases by 3 cm monthly, in the second quarter by 2.5-2 cm monthly. In the third - 1.5-2 cm, in the fourth - 1 cm monthly. The total increase in height in the first year of life is about 25 cm.

Centile tables for assessing the physical development of boys from 0 to 12 months.

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Body length (height), cm. nine0003

Centiles in %

Age in months

Body weight, kg

Centiles in %

25 nine0003

fifty

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46. 5

48.0 nine0003

49.8

51.3

52.3

53.5

55.0

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2.9

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3.7

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4.4

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51.2

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54.5

55.6

56.5

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3.3

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4.0

4.3

4.7

5.4

53.6

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59.4

60.9

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5.6

6.0

6.4

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60.9

62.0

63.8

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68.9

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5.6

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8.3

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63.0

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