Does Zoloft cause weight gain?

In this article:

• Zoloft weight gain
• Why Zoloft causes weight gain
• Who's more likely to gain weight
• Dosage and weight gain
• Managing Zoloft weight gain
• When to see a provider

In this article

• Zoloft weight gain
• Why Zoloft causes weight gain
• Who's more likely to gain weight
• Dosage and weight gain
• Managing Zoloft weight gain
• When to see a provider

Zoloft (sertraline) is a popular medication that belongs to the selective serotonin reuptake inhibitor (SSRI) class of antidepressants. However, many patients are concerned about Zoloft causing weight gain. Some people describe their weight gain as “barely noticeable,” while others report gaining 15 pounds.

In this article, we’ll explain why both can be true and where you will likely fall.

How much weight gain does Zoloft actually cause?

Because everyone is different in their symptoms of depression or anxiety, as well as side effects and response to medication, weight changes due to Zoloft will vary by individual. One person may gain weight while another may lose. Some people eat more when they are depressed, and when they start taking Zoloft and feeling better, they may return to a normal diet and lose weight. On the other hand, some people experience appetite loss when depressed and eat less. Then, when taking Zoloft and starting to feel better, they may start to eat more and gain weight.

While it is difficult to know how each person will respond to Zoloft in terms of weight gain, we can look at the results of some clinical studies.

• One study looked at weight gain in adults after two years of antidepressant use. Participants who took sertraline gained an average of 5.9 pounds more than those taking fluoxetine after two years.
• One research review noted that a small weight loss may occur with short-term use of SSRIs, including Zoloft. In an eight-week study, individuals who took Zoloft lost an average of 1.74 pounds. However, SSRI use is typically longer, as most people take SSRIs for at least 4 to 6 months. The review noted one particular study, which looked at people who took an SSRI for 26 to 32 weeks. It found sertraline caused weight gain of 1% (1.8 pounds for a 180-pound person); 4.2% of individuals who took Zoloft gained more than 7% of their body weight (12.6 extra pounds for a 180-pound individual)

In terms of children, Zoloft may cause decreased appetite and weight loss, which may slow growth. Children who take Zoloft will have their height and weight monitored regularly.

Why real-world reports vary so much

People’s experiences with Zoloft weight gain can be very different, and average weight changes don’t always tell the whole story. An individual’s experience can be heavily influenced by factors such as activity level, appetite, diet, age, and other medical conditions and medications. Each person may also process Zoloft differently.

Generally, most people gain little to no weight, while a minority may gain noticeably more. If you’ve been reading about Zoloft weight gain online, keep in mind that people who experience significant side effects, like substantial weight gain, may be more likely to share their experiences in forums. This can make it seem like weight gain is more common than it actually is.

Why does Zoloft cause weight gain?

Weight gain due to Zoloft (or any SSRI antidepressant) is thought to possibly be due to several factors, including:

• Affecting serotonin receptor activity, which may regulate appetite and weight
• Increasing appetite and carbohydrate cravings
• Improving symptoms of depression, and helping appetite return to normal in those who had appetite loss

Who’s more likely to gain weight on Zoloft?

There isn’t a reliable way to determine who will gain weight on Zoloft, but research suggests there may be certain risk factors that increase your risk, such as:

• Taking Zoloft long-term, beyond two years
• Gaining weight early on during treatment
• Having a lower baseline body mass index (BMI)
• Family history of obesity

If these factors apply to you, it doesn’t necessarily mean that you will gain weight on Zoloft. However, it is a good idea to mention them to your healthcare provider if weight changes are a concern.

Does the Zoloft dose matter?

Not necessarily. There isn’t a clear link between higher doses of Zoloft and increased weight gain. However, there is some evidence from a meta-analysis that taking higher doses of Zoloft may increase the risk of side effects in general.

Zoloft is usually prescribed at an initial dose of 25 mg or 50 mg per day, depending on the condition being treated. Some people remain at these doses if it works well for them, while others can have their dosage increased slowly to find the dose that works best for them. The 2023 study mentioned above found that the rate of adverse effects increased at Zoloft doses above 150 mg per day, but they did not find a relationship between Zoloft doses and weight gain, specifically.

How does Zoloft compare to other antidepressants?

If you’re worried specifically about Zoloft, here’s some good context: sertraline is actually one of the more weight-neutral options among commonly prescribed antidepressants.

A study in Annals of Internal Medicine analyzed more than 183,000 adults who started one of eight widely prescribed antidepressants, using Zoloft (sertraline) as the comparison point. Researchers tracked average weight change at six months for each drug. Here’s how they stacked up.

Comparing Zoloft to other antidepressants
Drug (Brand)	Generic name	Weight changes vs/ sertraline at 6 months	Drug class
Wellbutrin	bupropion	−0.22 kg (−0.48 lb) — the only one linked to less weight than sertraline	NDRI
Zoloft	sertraline	Reference point	SSRI
Prozac	fluoxetine	No statistically significant difference from sertraline	SSRI
Celexa	citalopram	+0.12 kg (+0.26 lb)	SSRI
Effexor	venlafaxine	+0.17 kg (+0.37 lb)	SNRI
Cymbalta	duloxetine	+0.34 kg (+0.75 lb)	SNRI
Paxil	paroxetine	+0.37 kg (+0.81 lb)	SSRI
Lexapro	escitalopram	+0.41 kg (+0.9 lb) — highest in this study	SSRI

People taking Lexapro, Paxil, or Cymbalta had a 10% to 15% higher risk of gaining 5% or more of their starting body weight than people taking Zoloft.

You may have read elsewhere that Paxil is the biggest offender for weight gain. This newer, larger study suggests Lexapro has actually edged slightly ahead of it, though the gap between the two is small enough that it probably won’t be the deciding factor for most people.

Wellbutrin stands out because it works differently from Zoloft. As an NDRI rather than an SSRI, it affects dopamine and norepinephrine instead of primarily serotonin, which may explain why it isn’t typically known to cause weight gain. That’s worth knowing, but it’s not a reason to switch on your own. Some people don’t tolerate Wellbutrin as well as Zoloft, and switching antidepressants is a conversation to have with your healthcare provider, not a DIY decision.

How to manage or minimize weight gain on Zoloft

Not everyone will gain weight when taking Zoloft or an SSRI, especially if you are aware and proactive. Here are some tips to help avoid weight gain while taking Zoloft or any antidepressant:

• First, do not stop taking Zoloft suddenly, even if you start to gain weight. Stopping an SSRI suddenly can cause withdrawal symptoms, as well as worsen depression or anxiety. If you have any concerns about your medication, consult your doctor first. You and your healthcare professional will need to consider all options regarding which medication is best and the possibility of weight gain. For example, a weight gain of 3 pounds over several years can be considered insignificant when compared to living with symptoms of depression. However, a larger weight gain caused by an antidepressant could lead to other health problems, like high blood pressure, which could require either lifestyle changes or a change to a different drug.
• If you have gained weight, ask your healthcare professional if there could be another cause. The SSRI may not necessarily be the culprit for weight gain. Another medical condition could be the cause.
• Talk to your healthcare professional or consult a registered dietitian about lifestyle changes, such as adopting a healthy diet rich in nutritious foods and an exercise plan that fits into your life. According to the Centers for Disease Control and Prevention (CDC), adults should get at least 150 minutes of moderate-intensity physical activity every week, plus two strength-training sessions. This can be done, for example, by walking for 30 minutes, 5 days per week, and adding in two strength-training workouts. You can walk outside, or even around a mall, or check YouTube for thousands of free exercise videos, including walking videos. In addition to helping avoid weight gain, this benefits overall health, too.
• Keep track of your weight while taking Zoloft. This way, you can see if there is a pattern of weight gain and make changes if necessary.
• If weight gain becomes a problem, or you do not want to take a medication that may make you gain weight, ask your healthcare provider for medical advice about trying a different medication, such as bupropion, with a lower risk of weight gain.

Ask your healthcare professional for other ideas that are personalized to your individual needs. Working together with your healthcare team, you will be able to find the treatment that works best for your depression or anxiety while also minimizing weight gain.

When to talk to your healthcare provider

If you have concerns about Zoloft weight gain, talk with your healthcare provider. They can help determine whether Zoloft is contributing, identify other factors that may be affecting your weight, recommend ways to manage or prevent further weight gain, or discuss whether an alternative would make sense for you.

If you’ve noticed changes in your weight while taking Zoloft, here is what you can do:

• Track your weight over the first few months so you can catch meaningful weight changes early.
• If significant weight gain occurs, talk to your healthcare provider rather than waiting for it to continue.
• Know that you have options, and adjusting your treatment or switching to a Zoloft alternative is possible.