Does Sertraline (Zoloft) cause weight gain?

From the Guidelines

Zoloft (sertraline) is associated with weight gain in some individuals, but the risk is generally lower compared to other antidepressants, with approximately 1-5% of patients experiencing significant weight gain 1. The weight gain mechanism appears related to how Zoloft affects serotonin levels, which can influence appetite regulation and metabolism. Some patients report increased cravings for carbohydrates or changes in eating patterns. If weight gain becomes concerning while taking Zoloft, don't stop the medication abruptly, but instead discuss it with your healthcare provider. They might suggest lifestyle modifications like regular exercise and dietary changes, adjust your dosage, or consider switching to an alternative antidepressant less associated with weight gain, such as bupropion (Wellbutrin) 1. Key points to consider:

• Zoloft is a selective serotonin reuptake inhibitor (SSRI) that can cause weight gain, but the risk is generally lower compared to other antidepressants.
• The weight gain mechanism is related to the effect of Zoloft on serotonin levels, which can influence appetite regulation and metabolism.
• Lifestyle modifications, such as regular exercise and dietary changes, can help mitigate weight gain while taking Zoloft.
• Alternative antidepressants, such as bupropion (Wellbutrin), may be considered if weight gain becomes a significant concern. The benefits of treating depression or anxiety with Zoloft often outweigh the potential side effect of modest weight gain for many patients 1.

From the FDA Drug Label

As with other SSRIs, decreased appetite and weight loss have been observed in association with the use of sertraline In a pooled analysis of two 10-week, double-blind, placebo-controlled, flexible dose (50 to 200 mg) outpatient trials for major depressive disorder (n=373), there was a difference in weight change between sertraline and placebo of roughly 1 kilogram, for both children (ages 6 to 11) and adolescents (ages 12 to 17), in both cases representing a slight weight loss for sertraline compared to a slight gain for placebo. A subset of these patients who completed the randomized controlled trials (sertraline n=99, placebo n=122) were continued into a 24-week, flexible-dose, open-label, extension study. A mean weight loss of approximately 0. 5 kg was seen during the first eight weeks of treatment for subjects with first exposure to sertraline during the open-label extension study, similar to mean weight loss observed among sertraline treated subjects during the first eight weeks of the randomized controlled trials Those subjects who completed 34 weeks of sertraline treatment (10 weeks in a placebo controlled trial + 24 weeks open label, n=68), had weight gain that was similar to that expected using data from age-adjusted peers

Weight Gain with Zoloft (Sertraline)

• The FDA drug label reports that weight loss is more commonly associated with sertraline use, particularly in the initial stages of treatment.
• However, in a 24-week open-label extension study, subjects who completed 34 weeks of sertraline treatment had weight gain similar to that expected in age-adjusted peers 2.
• It is essential to note that weight changes can vary among individuals, and regular monitoring of weight and growth is recommended for pediatric patients on long-term sertraline treatment.

From the Research

Zoloft and Weight Gain

• Zoloft, also known as sertraline, is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression and other mental health conditions.
• Research on antidepressant use and weight change suggests that genetic and biological factors, including metabolizer phenotypes and inflammation, can help predict an individual's threshold for weight change among specific agents 3.
• Studies have shown that SSRIs, including sertraline, can be associated with weight gain, although the extent of this effect can vary depending on the individual and the specific medication 3.
• A review of 59 studies comparing sertraline to other antidepressants found that sertraline was generally well-tolerated, but was associated with a higher rate of participants experiencing diarrhea 4.
• Another study found that nefazodone, a different antidepressant, caused fewer complaints of nervousness and insomnia, but a higher incidence of confusion, dizziness, and vision disturbance compared to other advanced generation antidepressants, including sertraline 5.
• In terms of weight gain, research suggests that medications like bupropion, fluoxetine, and newer agents (e.g., gepirone) may be efficacious in improving depressive symptoms while concurrently reducing metabolic risks, including weight gain 3.
• For individuals experiencing weight gain due to antidepressant treatment, switching to a weight-neutral drug alternative, integrated behavioral interventions, and/or pharmacotherapy, including GLP-1 receptor agonists (e.g., metformin, liraglutide), may be effective strategies 3.