Lexapro (Escitalopram) is a drug classified as an SSRI (selective serotonin reuptake inhibitor). It functions by increasing extracellular levels of the neurotransmitter serotonin. The increase in serotonin is believed to be the mechanism by which this drug is capable of treating major depression and generalized anxiety disorder. It received FDA approval in 2002 for treating depression and 2003 for anxiety.
It is considered the successor to the drug Celexa in that it contains only the active S-stereoisomer. Some believe that Lexapro is superior in efficacy and tolerability due to the fact that it doesn’t contain the inactive stereoisomer. Others believe that both drugs are relatively equal in efficacy, but Lexapro makes more sense to prescribe simply because it is newer and a revised version of an older drug.
Lexapro and Weight Gain
Lexapro is a drug that may work extremely well to treat major depression and anxiety, but unfortunately it is not free of side effects. One common side effect that people dislike is that of weight gain. While not everyone will gain weight if they use the drug for a short period of time. Nearly everyone who uses the drug over a long-term is virtually guaranteed to gain some weight.
How Lexapro Causes Weight Gain: Possibilities to Consider
There are a variety of ways in which Lexapro may be causing you to gain weight. Many people buy-in to the theory that it slows your metabolism. However, others believe that it could be slowing metabolism and creating other hormonal changes as well as alter the way in which your body stores fat. Understand that while none of these possibilities have been scientifically proven, many are believed to be accurate.
- Appetite changes: Many people experience appetite changes when they take a psychotropic drug. Those who had a poor appetite as a result of depression or anxiety may notice their appetite increases during treatment with Lexapro. It is common for someone who previously ate poorly to begin eating regularly after the drug starts working. Although not everyone will experience an increased appetite from the drug, some people definitely do.
- Carb cravings: Have you noticed that you crave carbohydrates since you’ve been on Lexapro? The fact that this drug increases serotonin and carbohydrates are linked to serotonin, this could explain the increased cravings. Others may experience general food cravings for unhealthy things like refined sugars, artificial sweeteners, and pastas.
- Drug interaction: If you are taking another medication in addition to Lexapro, it is possible that the two medications could be interacting. The interaction effect could make it more likely that you’ll gain weight compared to if you were taking just one of the drugs. Be sure to always consider that the drugs could be working synergistically to cause weight gain.
- Fat storage: The mechanism by which your body stores fat may become altered when you take this medication. Some believe that after awhile on Lexapro, the way your body digests food and stores fat changes. This makes it more likely that fat will get stored in places you probably won’t like such as: stomach, chest, and hips.
- Hormone levels: Some speculate that over an extended period of being medicated, your hormone levels change. The change in certain hormones could account for any weight that you gain. An example would be if the hormone cortisol increased throughout your treatment – this results in increased fat storage. Other hormones that help burn fat may decrease, resulting in the weight gain.
- Laziness: After awhile of taking Lexapro, some people experience a drop in energy and motivation that leads to laziness. While it isn’t the person’s fault that the drug sapped their energy, it may explain why some people end up gaining weight after months of treatment. Not everyone will experience this energy drop, but it can be difficult to deal with for those that do.
- Side effects: Some individuals may be plagued by side effects such as sleepiness and increased fatigue. The increase in fatigue may make it very difficult to get proper exercise and burn calories. Those who feel fatigued may end up lying around more than usual and sleeping more frequently – which will lead to weight gain.
- Slow metabolism: One of the most common theories as to why people gain weight on Lexapro is that it causes metabolism to slow. The exact mechanism behind the slowed metabolism is unknown, but many people find out that if they keep their diet and exercise the same while taking the drug as they did prior to taking it, that they gain weight.
- Social eating: It’s always possible that a person is simply going out to eat with friends more frequently than when they were depressed. Going out to eat often is an easy way to over-eat, eat unhealthy, and gain weight. If you have been going out to eat more since taking Lexapro, understand that this aspect could be contributing to weight gain.
- Taste improves: Some people may notice that food starts to taste considerably better while taking Lexapro than it did prior to treatment. It is thought that the drug changes our neurochemistry, making certain foods taste better than they normally would.
Note: It is important to also consider that for each case of weight gain on Lexapro, it could result from an interplay between these factors. It is also likely subject to considerable variation in regards to whether someone experiences an appetite increase, engages in social eating, and/or experiences fatigue as a side effect.
Factors that influence weight gain on Lexapro
There are other factors that will influence the amount of weight you’ll gain from taking Lexapro. These include things like the dosage you’ve been taking, your lifestyle and habits, how long you’ve been medicated, and whether you’re taking other drugs.
In most cases, people are prescribed a dose ranging from 10 mg to 20 mg. It has been found that for most people, doses over 20 mg fail to offer any additional therapeutic effect. Those that are taking doses near the higher end of the spectrum (i.e. 20 mg) are more likely to gain weight than those taking 10 mg or less.
As a rule of thumb, keep in mind that the lower the dose, the better in terms of weight gain. Those that take high doses of a medication essentially are giving the drug more control over their physiology than at lower doses. At high doses the drug tends to make further alterations to your homeostatic functioning and may slow your metabolism to a greater extent than lower doses.
Note: This is why it is recommended to take the “minimal effective dose” of any drug. By taking the minimal effective amount, you decrease the likelihood of experiencing significant weight gain.
2. Individual factors
In most cases, it’s easy to make Lexapro the scapegoat that you blamed for any weight gain while taking the drug. That said, it is important to take responsibility for aspects of your life that you control. If you are eating an unhealthy diet, not getting much exercise, and aren’t getting enough sleep at night – this is a recipe for weight gain in and of itself.
Those that gain more weight than average while taking this medication may not be taking good care of themselves. Understand that everyone is different and will have differing physiological and genetic reactions to the Lexapro. Some people may have a more stressful job, others may have different hormone levels, and others may have a naturally slower metabolism that gets markedly slower while on this drug.
Take responsibility for the aspects of your functioning that you can and try not to place full blame on the drug for your weight gain. You can also consider getting a genetic test called “GeneSight” which may help predict how you’ll react (in terms of side effects) to this drug.
3. Time span
The longer you’ve been medicated, the more likely it is that you’ll gain weight. Those that have taken Lexapro for between 6 and 12 months are at the greatest risk for packing on weight. If you’ve only taken the drug for less than 6 months, you may not experience any weight gain (or you may even end up losing weight).
The longer the period of time over which you’ve taken Lexapro, the more changes it will have made to your physiology. Your nervous system becomes tolerant to its effects and accommodates its presence, sometimes at the expense of homeostatic processes that regulate weight. It should also be mentioned that when people take a drug for a long period of time, they often increase the dosage – which was already mentioned to increase weight gain.
4. Other medications/drugs
If you take other medications or drugs of any kind, it is important to realize that there could be a potential interaction effect. The Lexapro may be interacting with the other medication to amplify the amount of weight you gain throughout treatment. In other cases, the two drugs may not have a synergistic effect upon weight, but may both be contributing to small, incremental increases in weight. Other times only one drug is causing the weight gain and you’ll probably be able to pinpoint it (unless you started both drugs at the same time).
How much weight will you gain from Lexapro?
There’s no telling exactly how much weight you’ll gain from Lexapro. As was mentioned above, there are a number of individual factors that will be highly influential over your weight. Most researchers speculate that on average, only 25% of people who take antidepressants gain weight. Additionally they have stated that most people only gain about 10 lbs. throughout their entire course of treatment.
However, evidence suggests that those on the drug for a long term and/or at higher doses will gain greater amounts of weight. The amount of weight people gain from these medications is often underreported and not typically studied; drug companies and doctors want their patients to believe that they won’t gain much weight.
Does everyone gain weight while taking Lexapro?
Certainly not everyone will gain weight while taking this drug. Some people may experience weight loss and others may not notice any change in weight. Those who lose weight may have been lethargic as a result of their depression and this drug gives them extra energy to exercise and/or engage in some sort of physical activity. It is estimated that 1 out of 4 people gain weight from taking this drug and other SSRIs. The number of people who gain weight likely increases significantly among those who have been on the drug for a longer term.
Lexapro: Cost-Benefit Analysis
When taking any drug, you should always conduct some sort of cost-benefit analysis. Compare the severity of the costs (i.e. weight gain) with the benefits that you’ve gotten from taking the medication. If the costs associated with taking the drug are minor (e.g. a little weight gain), it may not be a big deal as long as the drug is working well.
If the Lexapro isn’t working very well though, and you are experiencing weight gain, it may be time to reevaluate this treatment. In some cases you may want to switch medications and/or consider Lexapro withdrawal if the costs significantly outweigh the benefits.
Did you gain weight while taking Lexapro?
Those that gained weight from taking Lexapro can share their experience in the comments section below. Sharing your experience may help someone else who is currently dealing with the weight that they’ve gained as a result of treatment. Be sure to mention how much weight you gained, the dosage you took, as well as how long you were taking it. If you can think of any other possible contributing factors such as increased stress, lack of sleep, poor diet, etc. – feel free to discuss them.