From the Guidelines
The expected weight loss with Bupropion (Wellbutrin) is approximately 2.8 kg at 6 to 12 months, as reported in a meta-analysis 1. This amount of weight loss is modest and may have a positive influence on obesity-associated cardiovascular risk factors, such as lipid levels and hypertension, although trials of weight loss drugs have not specifically looked at these outcomes 1. It's essential to note that Bupropion is not FDA-approved as a weight loss medication but is sometimes prescribed off-label for this purpose alongside its primary uses for depression and smoking cessation. The weight loss effect typically occurs during the first few months of treatment and may plateau over time. Bupropion works by affecting brain chemicals like dopamine and norepinephrine, which can reduce appetite and increase metabolism slightly. Common dosages range from 150-300mg daily, with the extended-release formulation often preferred. Some key points to consider when using Bupropion for weight loss include:
- The choice of agent will depend on the side effects profile of each drug and the patient's tolerance of those side effects 1.
- There are no data to determine whether one drug is more efficacious than another, and there is no evidence for increased weight loss with combination therapy 1.
- There are no data about weight regain after medications are withdrawn, underscoring the need for sustained lifestyle and behavioral modifications 1.
- The decision to continue treatment beyond 1 year should be a shared discussion between the physician and patient, considering the lack of long-term (>12 months) studies of efficacy or safety 1.
From the FDA Drug Label
Table 5: Incidence of Weight Gain or Weight Loss (≥5 lbs) in MDD Trials Using Bupropion HCl Sustained-Release Weight Change Bupropion HCl Sustained- Release 300 mg/day (n=339) Bupropion HCl Sustained- Release 400 mg/day (n=112) Placebo (n=347) Gained >5 lbs 3% 2% 4% Lost >5 lbs 14% 19% 6%
Table 6: Incidence of Weight Gain or Weight Loss (≥5 lbs) in SAD Trials Using Bupropion HCl Extended-Release Weight Change Bupropion HCl Extended-Release 150 to 300 mg/day (n=537) Placebo (n=511) Gained >5 lbs 11% 21% Lost >5 lbs 23% 11%
The expected weight loss with Bupropion (Wellbutrin) is not explicitly stated in terms of average weight loss, but the incidence of weight loss (≥5 lbs) is:
- 14% and 19% in the MDD trials using bupropion HCl sustained-release at 300 mg/day and 400 mg/day, respectively 2
- 23% in the SAD trials using bupropion HCl extended-release at 150 to 300 mg/day 2
From the Research
Expected Weight Loss with Bupropion (Wellbutrin)
- The expected weight loss with Bupropion (Wellbutrin) can be determined from several studies, including 3 and 4.
- In the study by 3, subjects receiving bupropion achieved a mean weight loss of 4.9% +/- 3.4% over the first 8 weeks of the study, compared to 1.3% +/- 2.4% for placebo treatment.
- For those who completed the 8 weeks, the comparison was 6.2% +/- 3.1% vs. 1.6% +/- 2.9%, respectively, with 12 of 18 of the bupropion subjects (67%) losing over 5% of baseline body weight compared with 2 of 13 in the placebo group (15%).
- In the study by 4, percentage losses of initial body weight for subjects completing 24 weeks were 5.0%, 7.2%, and 10.1% for placebo, bupropion SR 300, and 400 mg/d, respectively.
- Compared with placebo, net weight losses were 2.2% and 5.1% for bupropion SR 300 and 400 mg/d, respectively.
- The study by 5 also mentions that bupropion is more likely to cause weight loss than gain, but does not provide specific numbers.
- However, the study by 6 does not provide information on the expected weight loss with bupropion, as it focuses on the utilization of bupropion treatment in children, young adults, and adults in the United States.
- The study by 7 is related to the use of bupropion for smoking cessation and does not provide information on the expected weight loss with bupropion.