Lustral (sertraline) weight gain?

Hello,

My last experience of taking an ssri was about 9 years ago, when I took 20mg of citalopram for just over a year. It helped me feel better, but it made me gain about 20-30lbs. It then took a while for me to lose that weight. I’m not claiming to be one of these people who swear down that they were eating less and exercising more, yet still gaining... I do remember a fondness for potatoes and chocolate at that time (though not together!) and I was still carrying baby weight, so it was more likely an increase in appetite combined with not shifting baby weight I already had. The same thing happened when I was a teenager taking the birth control pill - I went from skinny to pretty curvy almost overnight.

I do have a sweet tooth, but I’m a bit afraid I may just be one of these people who put weight on when on medication of any kind. When not on medication, I can eat a lot of junk without really putting on much weight, still some - about 6lbs, which I’d rather not have, but not a massive amount. I’m still deemed to have a healthy bmi.

Now I’ve been prescribed 50mg of Lustral... but I’m very apprehensive about taking it, because I don’t want to put on any weight. I actually want to lose about 14lbs now (thanks lockdown!) to get myself in really good shape, and so really don’t want things to creep the other way!

I know it must sound so vain, and I suppose in a way it is. But I already have such low self esteem and disgust for myself, that I would feel worse than I do now. I’m a highly anxious person, but I can slip into depression easily and this would push me that way, I know it would. Plus, I have several family members have been diagnosed with type 2 diabetes, none of whom are very overweight, maybe slightly but not hugely, so I’m concerned it could be detrimental to my physical health.

I have searched the internet endlessly, and mostly all I can find are scare stories from people who say the weight gain was inevitable, despite them being really good about eating less and exercising etc. Can this really be true? If I were to keep using MyFitnessPal, or even start something like Slimming World, so I am keeping my eye on it and holding myself accountable on a weekly basis, am I still destined to put on weight??

I’m sorry if this question has been done to death, I just can’t find anything positive about Lustral and weight loss. And not knowing anyone in real life who has been on it, I have no one to ask.

Please help if you can. But if not, please don’t judge my reasons for worrying about it. I definitely want my mental health to improve, but it’s deflating to think I’m doomed to have another issue crop up because of it.

Thank you,

Letti xx

Bumping back up, for anyone who can help.

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Originally Posted by Letti1986

Now I’ve been prescribed 50mg of Lustral... but I’m very apprehensive about taking it, because I don’t want to put on any weight. I actually want to lose about 14lbs now (thanks lockdown!) to get myself in really good shape, and so really don’t want things to creep the other way!

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Most ADs may cause weight gain, but it is not a give and not all will trigger it in individuals. It could be that sertraline won't in your case.

There are several hypotheses to why ADs cause weight gain, but few definitive answers, however, affecting the metabolism is certainly one of them, possibly mediated by, among other factors, how ADs affect the enteric nervous system (ENS), the mini brain which controls the gut and the influence they could have on the gut biome. The ENS is by far the most serotonergic organ of the body, making about 95% of the serotonin produced compared to less than 2% for the brain, so it can be more affected by serotonergic ADs than the brain is. It is known that the gut bacteria can affect weight and the mix of gut flora may change due the the impact of ADs. Another factor seems to be that people simply enjoy eating more when they are no longer anxious and/or depressed.

You might find this useful: How to control weight gain when prescribing antidepressants

Wow, thank you. That’s really insightful. I guess I’m just expecting it, because I’ve experienced weight gain with both another ssri and the contraceptive pill. But I suppose I won’t know until I try, and if I stay aware of it and try to eat healthily with a calorie deficit, surely it can’t be that bad??

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Originally Posted by Letti1986

if I stay aware of it and try to eat healthily with a calorie deficit, surely it can’t be that bad??

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Exercise also helps, but in terms of weight loss, but also anxiety and depression as it triggers the same brain changes as antidepressants and therapy do, though to a milder degree.

I switched to a low carb diet a few years ago when I started getting modelling offers from Buddha statue sculptors :ohmy: and it worked wonders though it's slow, about a kilo/2.2 lb every couple of weeks. I just avoid anything which contains more than 4g carbohydrates per 100 gram.

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Originally Posted by panic_down_under

I switched to a low carb diet a few years ago when I started getting modelling offers from Buddha statue sculptors :ohmy: and it worked wonders though it's slow, about a kilo/2.2 lb every couple of weeks. I just avoid anything which contains more than 4g carbohydrates per 100 gram.

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😂 I’m sure that’s not true about the Buddha statues! But the low carb thing and losing a couple of pounds every couple of weeks sounds really good! Every bit of diet advice I’ve read or heard of (which is a lot, I’ve read an awful lot of women’s magazines over the years!) advocates losing 1-2lbs a week or it just won’t be sustainable long term, which makes sense. I’ll keep an eye on the carbs for sure, thanks for giving me a good number (g) to aim for.

I do exercise, running and Pilates with the odd bit of HIIT, not so much because I enjoy it (well, maybe the Pilates) but I love the feeling I get afterwards. I would definitely agree that it works wonders for anxiety and low mood. If I stop for only a week or so, it doesn’t take long for the sluggish, negative feelings and thoughts to return. So it’s definitely something I have to keep at consistently. I just hope the sertraline doesn’t take my willingness to exercise away, or if it does, for it to be a short term side effect!

Letti xx

I put on 16 kg in about 12 months on Sertraline 50mg without changing my diet or exercise routine.
I swapped to Lexapro 10mg again without changing anything else and lost the weight I'd gained.

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Originally Posted by Letti1986

�� I’m sure that’s not true about the Buddha statues!

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Well, much closer to the truth than I was willing to admit at the time, Letti. :sad: A case of enjoying sloth way to much after retirement from an active job+lifestyle.

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I’ll keep an eye on the carbs for sure, thanks for giving me a good number (g) to aim for.

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4% is a good number to aim for, but allow some leeway for the occasional pleasures in life.

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I just hope the sertraline doesn’t take my willingness to exercise away, or if it does, for it to be a short term side effect

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Side-effects are a very personal thing so defy prediction, but this isn't one that gets reported much so the chances are good that you'll be okay.