Hello.

Thank you for choosing to seek information here and for your precise query.

We do encounter similar challenges where people who have stopped SSRIs have difficulty losing the extra weight they gained as a side effect. Following are some of the factors that might contribute to your situation.

1) Prozac is not the most preferred SSRI when you want to avoid weight gain. It has an appetite suppressant effect, though. But this effect is not significant enough and the side effect of weight gain is overpowering usually. If earlier you have used an SSRI which is known to induce weight gain lesser than Prozac, such as Zoloft, it might take longer for you to be able to reduce weight. Paroxetine (Paxil) is known to induce weight gain the most while Sertraline (Zoloft) one of the least.

2) There is always something more one can do about diet and exercise. The exercise that helped you about two years back may not be enough at the present. It has been shown that individuals taking SSRI medications usually require more amounts of exercise and a stricter calorie management. You might want to examine this aspect.

3) Since the mechanism underlying the weight gain due to SSRIs is still poorly understood, we cannot say with certainty that the sustained weight gain you have is due to any play of the receptors. And different individuals respond differently to the same group of medicines. However, there is certainly an established association between SSRI use and weight gain. Some individuals may lose weight while on SSRIs.

There appears to be no medicine related reason for why you are not able to lose weight. And 'inability to lose weight' could be re-framed as 'difficulty losing weight'. Apart from some physical (medical) reason, which I have mentioned in the following paragraph, the common reasons for difficulty losing weight are -

1.     Inadequate physical exercise
2.     A more sedentary lifestyle
3.     Inappropriate diet plan
4.     Slight or significant craving for carbohydrates

Of course, these may not apply to you. However, you might want to see if the amount of exercise is a bit inadequate.

One of the commonest medical reasons for difficulty losing weight is hypothyroidism. A low functioning thyroid is associated with depressive disorders. Thus, it is apt that you have chosen to consult an Endocrinologist. Hypothyroidism or a few more endocrine disorders might actually prevent the weight loss in spite of your efforts.

I hope this reply helps you. Please revert to me if you want to discuss more.

Wish you good health.

Abhijeet Deshmukh, MD

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Hello.

Thank you for writing back.

This sounds encouraging, indeed. The pattern of weight loss/gain that you have mentioned is not a norm and it may not be of a lot of significance in the long run. What is important is that you are able to achieve your weight goal and keep it. Hopefully, the endo consultation throws some more light on this situation.

Wish you good luck with the weight loss.

Abhijeet Deshmukh, MD

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