ACTION STEP: Start by carefully tracking your food intake and exercise for several weeks using SparkPeople's free food and fitness trackers to find out exactly how much you're eating and where your calories are coming from. Also start a basic journal describing anything that feels out of the ordinary to you—whether your appetite is heartier than usual, you're exercising more or less than usual, or you're experiencing food cravings that are really hard to resist. If you find that you're having a lot of trouble managing your appetite or cravings, or that your weight is going up even though you're sure you're not eating more or exercising less than before, then it's time to talk to your doctor about the situation. Bring these records with you when you go.
Should I change medications to prevent weight gain?
The side effects of virtually all antidepressant medications can potentially include weight gain. But since individuals vary a great deal in whether or how much any particular medication will cause this or any other side effect, changing medications can be an effective way to deal with this problem. There's no way to predict in advance how you'll react to any specific medication, but studies have shown that some medications are more commonly associated with weight gain than others. Among the selective serotonin reuptake inhibitor (SSRI) drugs commonly prescribed, Paxil seems to be associated with weight gain most often, while Zoloft is at the other end of the spectrum. The SNRI (serotonin and norepinephrine reuptake inhibitor) drugs Effexor and Serzone don't seem to cause weight gain in most people, and Welbutrin may actually cause weight loss for some individuals. There is also evidence that combining two different antidepressant medications, or adding a small dosage of certain other medications (such as anti-seizure medications), can also reduce problems with weight gain. So, changing drugs can make a difference.
The downside of changing drugs, of course, is that this could also affect your depression symptoms. The brain chemistry of depression is extremely complex and varies from person to person, which is why some drugs work for you while others don't. It may take some experimentation to find something that will do the job on your depression without affecting your weight, and that can take some time.
ACTION STEP: Talk over your options thoroughly with your doctor, and don't stop taking a medication, change your dosage, or add any weight-loss supplements or OTC depression remedies without discussing it first with your doctor. Some combinations can be very dangerous, and others may cancel each other out.