I am exercising and eating well and still can't seem to shed the pounds. I am on antidepressants. What can I do?

Losing weight is often a struggle, especially when a person is also living with a mood disorder. The causes are multiple. Increased appetite and carbohydrate craving, along with reduced activity level, are common symptoms of depression. And yes, certain antidepressants and other medications may increase appetite. However, most medications do not alter metabolism, per se. Thus, weight loss can still occur when attention is given to other factors, including the composition and timing of dietary intake.

Eating more frequently and smaller amounts, increasing the relative amount of protein eaten (people generally feel more “full” when eating high protein content foods), reducing breads and starches, eating a healthful breakfast, and avoiding large meals or snacks late in the evening can provide a more balanced diet throughout the entire day.

If one believes their current efforts to lose weight should be more productive, a consultation with a nutritionist may be helpful. If that isn’t possible, keeping a written log of one’s consumption may provide clues to problem areas and reinforce better dietary habits. In particular, check out the nutritional content of commonly eaten foods and foods believed to be “healthy”.

Several readily available websites and phone apps list nutritional information for prepared and restaurant food items, and provide logs for recording consumption. We are often unaware of the hidden calories in many foods we eat. Even so-called “low fat” or “no fat” foods may be loaded with empty carbohydrates. Soft drinks, sport drinks, energy bars, restaurant salads and salad dressings may contain excessive amounts of sugar. Alcoholic beverages such as wine and beer are also loaded with carbohydrates and are a source of excessive calorie intake for some individuals.

Another critical ingredient for weight loss is exercise. Increasing both aerobic exercise and strength training, ideally four times a week for a minimum of 30 to 45 minutes, can increase muscle tone and metabolism and reduce fat stores. Regular exercise has also been shown to reduce risk for depression relapse when combined with a stable medication regimen. If one is already exercising regularly, changing up your routine and challenging your body in novel ways with repeated bursts of exertion can make your work-outs more efficient.

Chronic, low-grade sleep deprivation is another contributor to obesity. Skipping sleep leads to persistently elevated levels of the body’s stress hormone, which can cause elevated blood sugar levels and increased fat stores. Staying up late may also make one more prone to late night snacking.

Lastly, a person carefully tending to all the above yet still gaining weight should consult their physician. Certain medical conditions such as thyroid abnormalities can cause weight gain as well as complicate depression.

About the Doc

About the Doc

William Gilmer, M.D., is an Associate Clinical Professor of Psychiatry and Behavioral Sciences at Northwestern University Feinberg School of Medicine. In addition to his teaching and research activities, Dr. Gilmer maintains a private clinical practice and TMS service in Chicago. Specializing in the evaluation and treatment of mood disorders for over 20 years, Dr. Gilmer currently serves on the DBSA Board of Directors and its Scientific Advisory Board.

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