Lexapro & Weight Gain: Everything You Need to Know

What Is Lexapro (Escitalopram)?

Lexapro (escitalopram) is a part of the SSRI class of drugs and is frequently prescribed to treat depression and anxiety disorders.³ Like other antidepressants, Lexapro works to improve a person’s sleep, appetite, and energy levels.

Mild side effects of Lexapro typically subside over time. However, severe reactions may require immediate medical attention and can be life-threatening. Still, sometimes certain side effects can be prevented with certain measures—such as avoiding foods that give you heartburn. Your doctor will start you off on a lower dose before increasing it as needed in order to limit the risk of experiencing any negative effects.

Common Lexapro side effects include:

• Nausea, heartburn, or stomach pain
• Diarrhea or constipation
• Sexual dysfunction
• Drowsiness
• Dizziness
• Sleep disturbances
• Increased sweating
• Flu-like symptoms

Severe side effects of Lexapro that may require immediate attention include:

• Allergic reaction
• Serotonin syndrome
• Abnormal bleeding
• Seizures
• Changes in vision: Any pain in the eye or loss of vision should be addressed immediately to prevent permanent damage.
• Manic episodes
• Low salt levels
• Suicidal thoughts
• Irregular heartbeat
• Dizziness

Why Does Lexapro Cause Weight Gain?

Weight gain while taking Lexapro may occur for a few reasons. Mental health conditions such as depression often result in appetite suppression. However, once Lexapro begins to take effect and symptoms of depression are eased, a person may experience an increase in appetite, thus leading to weight gain. They are likely to re-engage in previously enjoyable activities, which may include cooking, shopping for food, or dining out. They may just begin to enjoy eating again.

A 2015 study found that 40% of participants taking either SNRIs or SSRIs experienced long-term weight gain, lasting anywhere from six months to three years. Those who began the study at a low weight or had a history of obesity were more at risk for weight gain.⁴

However, it is important to note that Lexapro changes the body’s metabolism and leads to weight gain independently of an increased appetite. It is possible to maintain a healthy weight, but taking the medication can make it challenging to lose weight. Patients should not be discouraged or think that their weight gain is only due to overeating or lack of exercise.⁵

Short-Term Vs. Long-Term Impacts of Lexapro on Weight Gain

Recent research suggests that weight gain on Lexapro is not as common as it may be for other medications. In one case, less than 10% of patients gained more weight than those in a placebo group.  Regardless, to limit the risk for weight gain, maintain regular appointments with your healthcare team and monitor any changes in your appetite or eating habits.

How to Manage Lexapro Weight Gain

If you gain weight while taking Lexapro, it is important to work with your doctor to determine the best course for management. Some patients may consider switching medications, while others will find healthy ways to reduce weight gain. Nevertheless, there are a number of ways to address appetite and weight changes on any medication. These methods may also be helpful for coping with other symptoms of anxiety or depression.⁶

Here are some ways to manage weight gain while taking Lexapro:

• Adjust your dose: Adjusting your dose may reduce the risk of weight gain. However, only do so under the supervision of your doctor.
• Switch to a different medication: While this can seem daunting, switching to a similar medication can help reduce or prevent future weight gain.
• Maintain a healthy diet: Eating nutritious foods instead of processed ones can help you limit your caloric intake and reduce weight gain.
• Engage in regular exercise: Engaging in an exercise that you enjoy can be beneficial for a number of reasons. If exercising with other people helps you stay committed, then opt for group activities.
• Work with a dietician: Having the help of a dietician can make all the difference. They will be able to provide you with realistic direction on how to manage your weight.
• Maintain a healthy sleep schedule: Not getting enough sleep can increase cravings and slower metabolism which can lead to further weight gain.

Questions to Ask Your Health Team

Being open with your healthcare team about your concerns while taking Lexapro can help you address them as they arise. Asking the right questions is an important step in treatment.

Questions to ask your care team about Lexapro include:

• How long does weight gain typically last when on Lexapro?
• Am I at risk for gaining weight if I am taking other anxiety or depression medications?
• Will a previous history of weight gain make me more susceptible?
• When should I reach out to you about weight gain?
• Are there other medications that do not result in weight gain?
• What should I do if I would like to stop taking Lexapro?

Final Thoughts

While every person responds to medication differently, taking antidepressants may result in weight gain. If you’re unhappy with how Lexapro is impacting your health, discuss other options with your doctor. They can help you identify healthy management strategies or offer alternatives.