Lexapro (escitalopram) is an antidepressant medication used to treat depression and anxiety. As with many antidepressants, Lexapro can cause weight and appetite changes, including weight gain in some people. Various strategies can be used to help manage weight gain during treatment, or alternative medications are available if necessary.
- Lexapro (escitalopram) is an antidepressant used to treat depression and anxiety.
- Some people experience weight gain while taking Lexapro, although this can vary depending on the individual and various factors.
- Weight gain can be managed during treatment. If weight gain is excessive or other side effects are problematic, alternative medications can be considered.
Does Lexapro cause weight gain?
Lexapro (escitalopram) sometimes causes weight gain. How the medication affects individuals will vary from person to person and may depend on several factors. The amount of weight gained during treatment can differ significantly, and some people may not gain weight or may lose weight.
For example, one study shows that, after 6 months of treatment, 13.3% of participants gained more than 2kg, while 7.6% lost 2kg or more. Long-term reviews also suggest inconclusive data relating to the potential weight changes caused by escitalopram and most other selective serotonin reuptake inhibitor (SSRI) antidepressants.
How Lexapro influences weight
Lexapro works by affecting the levels and activity of the neurotransmitter serotonin. Serotonin is involved in various functions, including the regulation of mood, sleep, and appetite. As such, Lexapro could increase appetite, contributing to an increase in weight.
However, there are other aspects involved in potential weight gain with Lexapro treatment, including: [1][2][3]
- Duration of treatment: Weight might continue to increase as treatment continues, meaning that longer treatments can lead to more weight gain overall.
- Being underweight before the commencement of treatment: People who are underweight before starting treatment may be more likely to experience weight gain with Lexapro. It is common for depression to cause reduced appetite, thus leading to weight loss during depressive episodes. As such, when treatment commences, this symptom is reduced and appetite returns to normal.
- Being overweight before treatment: Some people experience increased appetite during depressive episodes, thus contributing to weight gain before treatment. As such, when they begin taking Lexapro, their appetite may be reduced to normal, contributing to little or no weight gain, or sometimes, weight loss.
- Other factors: Individual factors can impact the potential for weight gain during Lexapro treatment, such as diet, metabolism, genetics, substance use, stress, or exercise habits.
Lexapro and weight loss
Lexapro, as with other SSRIs, may cause some weight loss, particularly at the start of treatment, within the first 4 to 12 weeks. Again, this can vary significantly from person to person, and some people may not experience weight loss at all during Lexapro treatment. [2][3]
Do other antidepressants also cause weight gain?
Many antidepressants have the propensity to contribute to weight gain, although this can vary from person to person and duration of treatment. Lexapro may be more likely to cause weight gain when compared to other SSRIs, although less likely when compared to tricyclic antidepressants such as nortriptyline. [2][4]
Studies suggest that antidepressants that are most likely to cause weight gain include: [2][4]
- Nortriptyline
- Paroxetine
- Duloxetine
The least likely to cause weight gain include: [3][4]
- Bupropion
- Sertraline
- Fluoxetine
Managing weight while on Lexapro
The prescribing doctor can suggest how to manage appetite and weight when commencing or during treatment. Some tips to help manage weight while taking Lexapro include: [1]
- Exercising regularly
- Eating a healthy and balanced diet
- Ensuring proper hydration
- Maintaining a sleep routine
- Managing stress
These strategies can help manage mental and physical well-being, improve mood, and reduce potential weight gain.
Engaging in behavioral therapies can also be useful, as they can help people with mental health conditions such as depression and anxiety, as well as teach coping strategies to manage food cravings and eating behaviors. [1]
When to see your medical provider
People taking Lexapro should speak with their medical provider if: [1][5]
- They are gaining weight rapidly and excessively
- Their body mass index (BMI) increases to over 30
- They experience chest pain, breathing difficulties, or extreme changes in heart rate
- They experience persistent stomach issues such as constipation or diarrhea
- There are any signs of other health issues, such as fever or pain
Unmanageable weight gain or other health concerns will likely be monitored and treated by the doctor, and it might be necessary to change medications.
People who experience side effects or excessive weight gain should not stop taking Lexapro suddenly or before discussing a tapering plan with their doctor, as this can cause a worsening of symptoms or discontinuation syndrome.
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