From the Research
Fluoxetine (Prozac) is the most suitable SSRI for obesity treatment, given its modest weight loss effects in some studies, typically at doses of 20-60mg daily. When considering the treatment of obesity, it's essential to prioritize medications that have shown efficacy in weight loss, even if they are not specifically approved for this indication. According to the study by 1, fluoxetine was found to be safe and effective in inducing weight loss over periods of up to 8 weeks, with patients losing an average of 4.5 kg.
Key Considerations
- The effects of SSRIs on weight vary significantly between individuals, and some patients may experience weight gain 2.
- For dedicated obesity treatment, FDA-approved medications like phentermine-topiramate, semaglutide, or orlistat would be more appropriate first-line options 3.
- Any medication for weight management should be used alongside lifestyle modifications, including diet and exercise, for optimal results.
- The use of psychotropic agents, such as SSRIs, in obesity treatment is supported by evidence, particularly for patients with comorbid conditions like depression or binge eating disorder 4.
Treatment Approach
- Fluoxetine may be considered for patients with both depression and weight concerns, as it tends to be weight-neutral or slightly weight-reducing compared to other antidepressants.
- The weight loss effects of fluoxetine are generally modest (1-3kg) and often temporary, diminishing after 6 months of treatment.
- It's crucial to monitor patients for potential side effects, such as asthenia, nausea, and diarrhea, which were reported more frequently in fluoxetine-treated patients 5.