Ariel Winter opened up about two fraught topics at once on Wednesday: weight loss and mental health.
The 21-year-old
“For years I had been on antidepressants that caused me to gain weight that I couldn’t lose no matter what I did,” she said. “It was always frustrating for me because I wanted to be able to get fit and feel like the work I was doing was paying off, but it never felt that way.”
Winter said that she had come to accept the additional weight because the antidepressants were solving her mental health issues, but she started feeling “eh” and decided to try out a new combination of medication.
“I started the process again and was able to find a great combination of medication that works for me,” she explained. “The change in medication instantly made me drop all of the weight I couldn’t lose before by just giving me back a metabolism. That was very unexpected.”
Winter’s experience is likely familiar for those on antidepressants. Weight gain can be a frustrating but common side effect of the drugs, explains Dr. Kevin Gilliland, a clinical psychologist and director of Innovation360, an outpatient resource center, and member of PEOPLE’s Health Squad.
“Some of the common side effects of antidepressants are weight gain, decreased sexual performance and dry mouth,” he says. “Those tend to be some of the most common ones. We don’t know for sure exactly why the weight gain occurs, but it definitely occurs and at a far greater rate than it did in the clinical trials when the drugs were first formulated. Some of it may be just the genetic response to the drugs.”
Gilliland says whether or not a person gains weight on an antidepressant completely depends on their body makeup.
“For some people it just continues to increase,” he says. “Some people gain a little bit of weight and then level off. But it varies by drugs and then it even varies individually because there’s just so much genetic difference.”
If someone is concerned about the weight gain, Gilliland first advises looking at their eating and exercise habits.
“First, make sure you’re eating healthy,” he says. “Make sure you’re eating mindfully. Make sure that you’re eating only when you’re hungry. That your physical activity is good. And you go, ‘Okay, then it’s probably associated with the medication, not with user error and not with what you’re doing and eating.’ ”
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If that’s the case, and the weight gain is from the antidepressants, some people decide to deal with the extra pounds in order to stick with medication that improves mental health, as Winter did for several years. But “when your side effects get to be as bad as your depressive symptoms,” it could be time to switch, Gilliland says.
“If you are having the side effect of weight gain and it’s really having an impact on your mood in a negative way, talk about it with your physician,” he says. Keep in mind, though, that it’s going to take trial and error to find a new combination, and there will be a period of about six weeks as the body transitions and adapts to the new drugs.
“There’s an art to medications,” he says. “Psychiatry tends to be one of the more challenging areas to get the right medication. We just don’t have the ability to run tests and pinpoint the right medication just yet. We’re close. So it really takes an art of, ‘I may combine this one and this one so that we don’t have a side effect that’s starting to be as bad as the depressing effect.’ “
In Winter’s case, the new antidepressants helped her “feel better mentally” while also eliminating that extra weight. And in sharing her experience with her nearly 4 million Instagram followers, she helped to normalize the discussion around mental health and medication.
“Antidepressants are one of the top ten medications that get prescribed,” Gilliland says, adding that around 41 million people have anxiety or depression. “When you look at the increasing rates of depression and anxiety, over the past five years it’s only gone up.”
“Antidepressant medications are a lot better than depression,” he adds. “And it’s when medications are used in combination with therapy, which she’s doing, that we see the best outcomes and benefits.”