The United States is facing an epidemic of weight-related health issues. The National Institutes of Health found a 9.7 percent increase in the incidence of obesity for adults between 1960 and 1994 and states that over 97 million Americans over age 20 are living at unhealthy weights. Diet, exercise and healthy sleep patterns are the foundation of weight loss, but medications, including some antidepressants, can help with appetite control.
Prozac for Weight Loss
Most antidepressants are associated with weight gain, whether by increasing appetite or by increasing social interactions, which often include eating. But one, Prozac, a selective serotonin reuptake inhibitor, causes loss of appetite initially, and combined with the increased level of energy people feel when depression lifts, this can amount to a small amount of weight loss. The prescribing information published by Lilly, Prozac's manufacturer, states that 11 to 17 percent of those taking the medication experienced loss of appetite, and 1.4 percent lost weight.
Modafinil for Mood Improvement and Weight Loss
Not all medications with the ability to elevate and regulate mood are originally classified as antidepressants. One, Modafanil, a psychostimulant, was developed to treat excessive daytime fatigue and cancer fatigue syndrome, and the drug has also proved effective at elevating mood by eliminating fatigue for those with attention deficit hyperactivity disorder, as documented in the May 2000 issue of the Journal of Clinical Psychiatry.
In addition, Modafanil is also associated with weight loss. In the October 2008 issue of Pharmacology, Biochemistry and Behavior, researchers found an 18 to 38 percent reduction of calorie intake and a reduction in the participants' feelings of hunger.
Appetite control is an off-label use of Modafinil, but further research has been sponsored by the National Institutes of Health because of the medication's high safety profile and low incidence of side effects. It's possible that mood elevation and relief of fatigue help people become more intentional about what they're eating.
Wellbutrin and Weight Loss
Wellbutrin, whose generic name is buproprion, has been used off label from the early 1990s for weight loss. Researchers from Slidell, Louisiana, found that women taking 400mg of Buproprion SR, lost 248 percent more weight than those taking a placebo. Almost 50 percent of the participants achieved a clinically significant 5 percent weight loss, meaning a 200 pound woman would have lost 10 pounds.
Other studies have found similar results, and the FDA is now considering approval of a weight-loss medication that will combine Wellbutrin with a medication commonly used to treat opiate addiction, Naltrexone. The new medication, Contrave, has completed all required clinical trials and is expected to be released in late 2010. However, the use of Contrave may be limited by the fact that it is approved specifically as a weight loss medication, and many insurance companies still refuse to treat obesity as a disease. If you need to lose weight and want to use medication to aid in that effort, look for an insurance policy that does not exclude the treatment of obesity.
References
- National Institutes of Health: Guidelines for Obesity Management: 2010
- Lilly Pharmaceuticals: Prozac Prescribing Information
- Journal of Clinical Psychiatry; Modafinil Augmentation of Antidepressant Treatment in Depression; M.A. Menza, M.D., et al.; May 2000
- Pharmacology, Biochemistry and Behavior; Modafinil Decreases Food Intake in Humans:; G.A. Perez, M.D., et al.; October 2000
- Obesity Research; Buproprion SR vs. Placebo for Weight Loss"; A.K. Jain et al.; October 2002
