Weight Gain Related to Depression, Medication

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Weight Gain Related to Depression, Medication

Question:

I am a 50-year-old female with a long history of depression. In the last three months, I have had an uncontrollable craving for sweets. This has increased my weight. Could this craving be related to my depression or to the medications I take to treat it?

Answer:

You are right to wonder about the cause of your craving. The depression or the medication could be triggering it. Weight gain is a side effect of many of the medications used to treat depression. Changes in appetite and weight are common symptoms of depression as well. (Please note that the change in your weight may not be caused by the depression or the medication. More on that below.)

Let's talk about depression first. In depression, weight can go up or down. Some people lose their appetite completely. They can lose interest in food the way they lose interest in all pleasurable activities. People who are struggling with their weight may wish for just such a symptom! But be careful what you wish for — it can be a horrible feeling.

For others with depression, the opposite problem occurs — they can't stop eating. And often there is no pleasure in that either, because it's compulsive eating, followed by remorse.

Increased appetite and weight gain are probably more common in some types of depression. Seasonal (usually winter) depression is one example. But there are no rules about it. Any type of depression can be accompanied by weight gain or loss.

Medications can also induce cravings and weight gain. Any of the antidepressants can lead to a change in appetite and behavior.

Try to figure out what may have changed three months ago, when your craving for sweets got more intense. Here are a few questions I might ask:

• Did you start a new medication at that time? Or increase a dose?

• Did you decrease a dose or stop a medication? Lowering a dose or changing medications could lead to the return of depression symptoms.

• Was something going on in your life that could cause your depression to get worse?

• Did your activity level change?

• Could the change be related to perimenopause or menopause? Some women experience an increase in cravings and appetite during that time.

• Could there be some other medical problem causing you to experience a shift in your eating pattern?

You said you have a long history of depression. If you never experienced cravings or weight gain when you were depressed before, it's not very likely that depression is causing it now. On the other hand, if you had a change in your medications at the time your eating changed, you should tell the doctor who is prescribing your medication.

If this doctor can't come up with an obvious explanation for your weight change, talk to your primary care doctor. A general health review may provide more clues about the change in your eating. And it may help you get the problem back under control.

Michael Craig Miller, M.D., is editor-in-chief of the Harvard Mental Health Letter and an assistant professor of psychiatry at Harvard Medical School. Dr. Miller has an active clinical practice and has been on staff at Beth Israel Deaconess Medical Center for more than 25 years.

Last updated:	July 20, 2009