The Impact of Antidepressants on Body Weight: Mechanisms, Clinical Implications, and Management Strategies

Abstract

Depression and obesity are widespread conditions that significantly affect quality of life and public health. In recent decades, the prevalence of depression has increased, accompanied by a rise in antidepressant use. Despite the proven efficacy of antidepressants, one of their major side effects is weight gain, which can exacerbate obesity and metabolic disorders in patients. This review explores the mechanisms underlying the impact of antidepressants on body weight, including neurotransmitter regulation, inflammatory pathways, and genetic factors. The metabolic profiles of different classes of antidepressants are analyzed, with a focus on selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), noradrenergic and specific serotonergic antidepressants (NaSSA), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs). Potential weight management strategies are discussed, including pharmacotherapy modifications, behavioral interventions, pharmacological corrections, and bariatric surgery. The importance of a personalized approach in selecting antidepressants and developing integrated management strategies for patients with depression and obesity is emphasized.

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