Diet A Diet to regulate Sertraline (Zoloft)-Induced Weight gain

What need to you eat if you're ~ above SSRIs?

post August 21, 2020 | the review by Lybi Ma

The statistics around depression space staggering. If you’re living in a 50-unit apartment building, at least 10 ladies and much more than 5 men probably have depression1. And the alarming truth is that it’s increasing2.

It’s understandable then, that among the many prescribed medicine in the us is one antidepressant. Called sertraline (trade name: Zoloft), in 2018 it was the 14th in its entirety most commonly prescribed drug, more than insulin, Ambien, or Xanax3. In fact, in 2018, there were 48,999,022 prescriptions for Zoloft4.

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While antidepressants have the right to be tremendously useful for depression, one crucial side result can be weight gain, independent of the other causes of weight gain when you depressed. Return I’ve also seen some patients lose weight top top antidepressants in my own practice, through far, an ext patients put on weight, and also research shows that being on one antidepressant place you at an boosted risk of load gain5. Even world of normal weight room at danger of coming to be overweight or obese. When you’re on an antidepressant, you’re an ext likely to get weight in year 2 or 3 the treatment. And the dangers of weight obtain increase at least into the sixth year that use.

While the prices of weight get vary, and also are due to multiple determinants such as depression and also lack that exercise, the sertraline itself can make you get 10 pounds in a year6, an ext than double the weight gain if you space on fluoxetine (Prozac).

The perplexing and different repercussion of gift on sertraline is that, at the very least in pet studies7, that is associated with boost in blockage of her heart’s arteries8. However, the does this without increasing lipid concentrations, either full lipids, high-density lipoprotein, or the ratio in between the two. In fact, this threat is close come 5X greater than if animals (monkeys) were not treated.

Also, the outcomes of this study in animals is somewhat perplexing since in this study, that wasn’t even that sertraline resulted in weight acquire (depressed primates often have actually weight loss). The one an essential metabolic finding to be a to decrease in adiponectin, which correlated with the arterial blockage. This renders sense since adiponectin typically protects the love in various ways by dilating blood vessels, avoiding tissue damage by toxicity radicals, decreasing inflammation, and preventing cabinet death9,10.

Given that heart an illness is a leading cause of fatality globally11, that would benefit patients if prescribers emphasized this risk, and additionally simultaneously prescribed a an extremely different diet. For sertraline (Zoloft) specifically, there space some easy ways you can start to carry out this:

1. Prevent the west diet behavior immediately, however do this reasonably, or you will rebound. There’s no allude in feeling much less depressed if you’re increasing your chances of heart an illness at the same time. And also when you on a west diet, drugs like sertraline are much more likely to reason weight gain than once you’re not12. In fact, the greater your antidepressant dose, the higher your weight gain, however only if you space on a western diet.

The west diet is typically identified by a high content of proteins (derived from fat domesticated and also processed meats), saturated fats, refined grains, sugar, alcohol, salt, and also corn-derived fructose syrup, v an associated reduced consumption of fruits and also vegetables.

It"s not helpful to simply existing this list to patients, as this frequently sounds favor you are telling them to stop eating every little thing they like. If lock depressed, they will not it is in inclined to carry out this.

I suggest starting with eliminating foods items with high-fructose corn syrup: soda, candy, sweetened yogurt, and also many salad dressings. Also some low-fat yogurts have too lot sugar13 and just one tablespoon that fat-free French dressing has actually 3 g the sugar14. If you have actually 3 tablespoons of dressing, you’ve currently had a 4 minutes 1 of your everyday sugar allowance if she a man, and more than 1/3 that your daily allowance if you a woman15. Even granola bars16 have actually too much sugar. And also you’d be advised to protect against breakfast cereals prefer Frosted Flakes, Cocoa Puffs, and Fiber One17.

2. Increase foods that boost adiponectin: A usual Mediterranean diet is connected with higher levels the adiponectin18. Also, foods items with a short glycemic index (GI) and high fiber can increase adiponectin.

This deserve to all be mind-boggling to someone that is depressed. The three straightforward recommendations here are18: Eat foods with omega-3-fatty acids favor avocado, nuts, fatty fish and also olive oil. This could increase her adiponectin by 14-60%. Diets wealthy in fiber will boost adiponectin through 115%19. Chia or basil seeds are an amazing source of fiber (they can add this to her gut health, however skip fruited yogurt.). The fiber in chia seed exceeds dried fruit, cereal, or nuts20. And low glycemic foods incorporate steel-cut oats and butter beans. Usage zucchini noodles (zoodles) as a way to gain your pasta kick as this is low-calorie, filling, and adds fiber to your meals too.

If you wondering exactly how to remember all of this, I have a mnemonic that ns use dubbed the “ZOLOFT” diet:

Z = zest of lemon (instead that salad dressing)O = Olive oilL = Legumes (e.g. Lentils and chickpeas)O = Oats, steel-cutF = FiberT = Turkey (or another lean protein, choose seafood)

Of course, this doesn’t cover everything yet it’s a helpful guide and easy come remember if you want to manage your weight while top top sertraline.

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4. Grohol JM, Founder PD, check out E-CL updated: 15 D 2019 ~ 3 min. Top 25 Psychiatric medications for 2018. Released December 15, 2019. Accessed July 13, 2020. //

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6. Arterburn D, Sofer T, Boudreau DM, et al. Long-term Weight readjust after Initiating Second-Generation Antidepressants. J Clin Med. 2016;5(4). Doi:10.3390/jcm5040048

7. Silverstein-Metzler MG, Shively CA, Clarkson TB, et al. Sertraline inhibits boosts in human body fat and also carbohydrate dysregulation in adult female cynomolgus monkeys. Psychoneuroendocrinology. 2016;68:29-38. Doi:10.1016/j.psyneuen.2016.02.012

8. Shively CA, register TC, Appt SE, Clarkson TB. Effects of permanent sertraline treatment and also depression top top coronary artery atherosclerosis in premenopausal female primates. Psychosom Med. 2015;77(3):267-278. Doi:10.1097/PSY.0000000000000163

9. Ebrahimi-Mamaeghani M, Mohammadi S, Arefhosseini SR, Fallah P, Bazi Z. Adiponectin together a potential biomarker that vascular disease. Vasc wellness Risk Manag. 2015;11:55-70. Doi:10.2147/VHRM.S48753

10. Hui X, Lam KSL, Vanhoutte PM, Xu A. Adiponectin and also cardiovascular health: an update. Br J Pharmacol. 2012;165(3):574-590. Doi:10.1111/j.1476-5381.2011.01395.x

11. Mc Namara K, Alzubaidi H, Jackson JK. Cardiovascular condition as a leading cause of death: just how are pharmacists gaining involved? Integr Pharm Res Pract. 2019;8:1-11. Doi:10.2147/IPRP.S133088

12. Shi Z, Atlantis E, Taylor AW, et al. SSRI antidepressant usage potentiates weight gain in the context of unhealthy lifestyles: outcomes from a 4-year Australian follow-up study. BMJ Open. 2017;7(8). Doi:10.1136/bmjopen-2017-016224

13. Yogurt, fruit, low fat, 10 grams protein every 8 ounce Nutrition truth & Calories. Accessed July 13, 2020. Https://

14. Salad dressing, french dressing, fat-free Nutrition truth & Calories. Accessed July 13, 2020. Https://

15. Just how much sugar is also much? Accessed July 13, 2020. Https://…

16. Snacks, granola bars, oats, fruits and also nut Nutrition facts & Calories. Accessed July 13, 2020. Https://

17. 20 foodstuffs With High-Fructose Corn Syrup (HFCS). Healthline. Released November 10, 2016. Accessed July 13, 2020. Https://…

18. Izadi V, Azadbakht L. Particular dietary patterns and concentrations of adiponectin. J Res Med Sci off J Isfahan Univ Med Sci. 2015;20(2):178-184.

20. Kulczyński B, Kobus-Cisowska J, Taczanowski M, Kmiecik D, Gramza-Michałowska A. The chemical Composition and also Nutritional worth of Chia Seeds—Current State of Knowledge. Nutrients. 2019;11(6). Doi:10.3390/nu11061242

22. Ranjbar E, Kasaei MS, Mohammad-Shirazi M, et al. Results of Zinc Supplementation in patients with major Depression: A Randomized Clinical Trial. Iran J Psychiatry. 2013;8(2):73-79.

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About the Author


Uma Naidoo, M.D.

See more: Can A President Run For Office Again, Us Constitution

, an Instructor in psychiatry in ~ Harvard medical School is the manager of Nutritional and Lifestyle Psychiatry at Massachusetts basic Hospital.