What is the average weight gain associated with sertraline (Zoloft)?

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From the Guidelines

The average weight gain associated with sertraline (Zoloft) is typically minimal, with studies suggesting weight neutrality or even weight loss with long-term use, especially when compared to other antidepressants like paroxetine and mirtazapine 1. When considering the effects of sertraline on weight, it's essential to look at the broader context of antidepressant medications.

  • The selective serotonin reuptake inhibitors (SSRIs), which include sertraline, have been associated with weight loss in the short term and are generally considered weight-neutral in the long term 1.
  • In contrast, other antidepressants like lithium, mirtazapine, and monoamine oxidase inhibitors are more closely associated with weight gain 1.
  • Bupropion, another antidepressant, is unique in that it consistently promotes weight loss and is sometimes used off-label for weight management 1. The mechanism behind sertraline's effect on weight is not fully understood but may involve changes in appetite, metabolism, or fluid retention.
  • Some patients may experience increased carbohydrate cravings or reduced physical activity due to fatigue, which could contribute to weight gain 1.
  • However, these effects are not universal and may affect only a subset of patients taking the medication. If weight gain becomes a concern for patients taking sertraline, it's crucial not to stop the medication abruptly but instead to consult with a healthcare provider.
  • They may recommend dietary modifications, increased exercise, switching to a different antidepressant with less weight gain potential, or adjusting the dosage 1. Regular monitoring of weight while on sertraline is advisable, especially during the first few months of treatment, to catch any potential issues early on.
  • This approach allows for timely interventions and helps in managing the patient's overall health and well-being 1.

From the FDA Drug Label

Weight Loss Significant weight loss may be an undesirable result of treatment with sertraline for some patients, but on average, patients in controlled trials had minimal, 1 to 2 pound weight loss, versus smaller changes on placebo. 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.

The average weight gain associated with sertraline (Zoloft) is not reported, as the data indicates a weight loss of:

  • 1 to 2 pounds on average in controlled trials 2
  • A difference of roughly 1 kilogram compared to placebo in pediatric patients 2 Key points:
  • Weight loss is more common than weight gain
  • The exact amount of weight loss varies depending on the population and study
  • Regular monitoring of weight and growth is recommended for pediatric patients 2

From the Research

Average Weight Gain Associated with Sertraline (Zoloft)

  • The average weight gain associated with sertraline (Zoloft) is not explicitly stated in the provided studies 3, 4, 5, 6, 7.
  • However, study 3 mentions that selective serotonin reuptake inhibitors (SSRIs), which include sertraline, may be less likely to cause weight gain than tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs).
  • Study 6 found that some SSRIs, such as paroxetine, were associated with a greater risk of weight gain, while others, such as fluoxetine, may lead to weight loss, particularly in the acute phase of treatment.
  • Unfortunately, there is no specific information available on the average weight gain associated with sertraline in the provided studies.

Comparison with Other Antidepressants

  • Study 5 found that most antidepressants were associated with a 5% weight gain, while certain antipsychotics, such as Quetiapine, Haloperidol, and Olanzapine, led to a clinically significant weight gain of ≥7% from baseline.
  • Study 6 found that amitriptyline, mirtazapine, and paroxetine were associated with a greater risk of weight gain, while fluoxetine and bupropion may lead to weight loss.

Limitations

  • The provided studies do not offer specific information on the average weight gain associated with sertraline.
  • Further research is needed to determine the exact weight gain associated with sertraline compared to other antidepressants 3, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Weight gain and antidepressants.

The Journal of clinical psychiatry, 2000

Research

Effects of antidepressant and antipsychotic use on weight gain: A systematic review.

Obesity reviews : an official journal of the International Association for the Study of Obesity, 2019

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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