Help Mirtazapine - how exactly does it affect fat metabolism? What can I eat to reduce the weight it has put on me? (it has helped my mood)

[LittleJem]

Hi all - mirtazapine is making my days more functional and more bearable, though still pretty shit.

However, in common with lots of people it has also made me put on weight. I feel like a marshmallow man - like my arms have swollen up - and my body is moving differently.

I have read everywhere that it affects the metabolism of fat (and I think also how fat is stored).

The weight gain for me has not come from hunger - some people get hungry on mirtazapine - but has just happened overnight almost. I wasn't eating well, but I just expanded like three weeks ago.

I have been to the health food store and they have supplements called 'fat burners' and 'fat binders'. Which of these will be useful (if any) in combatting this effect of mirtazapine.

Also, I don't think I can just cut out fat from my diet entirely. I am going low/no carb and starting the gym.

Any advice/scientific knowledge here much appreciated.

 

[dinosavr]

I don't have any scientific articles about it now but most probably it's not fat but water that's stuck in your body. I struggle with this issue too and I'm not sure what to do. I've been on the edge of eating disorder so my body image matters a lot but on the other hand I'm way too ashamed to let my psychiatrist know that my belly fat is more important than my life lol.

I'm currently also on venlafaxine which had caused me lack of appetite before so it kind of evens it out, but stillll. I wish there was a pill that works and doesn't make you feel like marshmallow man :(

 

[Aurora~]

Hewo~

Have been taking Mirtazapine it for about a year now. Its effects are different for everyone, personally for me, it made me eat normally where i have not eaten at all before.

I was really underweight before and lost more than 20+ pounds in less than couple months following a number of depressive episodes. Was at 90 pounds even after months into Mirtazapine. At almost 100 right now.

For me, its a few factors such as eating normally, living a sedentary lifestyle and times i might have snack unconciously, they all add up to my weight eventually.

Cutting out specific foods from your diet is not going to do anything if you're still at a caloric surplus. You'll require carbs to have some form of energy to continue day. Fats are also essential to you.

Ensure you're eating at maintenance or burn off that surplus at the gym. I would not recommend you to count as that was extremely detrimental to my emotional health.

Its not easy of course. I have been on therapy for quite awhile and very frequently to be where i am now.

Wish you the best~ c:

Edit: Moved a paragraph

 

[penguinl0v3s]

Hi all - mirtazapine is making my days more functional and more bearable, though still pretty shit.

Glad it's working well for you :)

However, in common with lots of people it has also made me put on weight. I feel like a marshmallow man - like my arms have swollen up - and my body is moving differently.

Well what happens is that serotonin doesn't only act on the brain, it also acts in the stomach, so any serotonergic-acting drug has a chance of causing weight gain. You can try fluoxetine if you really really hate that, it is known to be an appetite suppressant so it's actually weight neutral. Since the effects are hitting you so hard it might be a good idea if you have metabolic syndrome that runs through your family.

I have read everywhere that it affects the metabolism of fat (and I think also how fat is stored).

The weight gain for me has not come from hunger - some people get hungry on mirtazapine - but has just happened overnight almost. I wasn't eating well, but I just expanded like three weeks ago.

Could you explain what you mean by this? I will do my best to help if I can get what you mean.

I have been to the health food store and they have supplements called 'fat burners' and 'fat binders'. Which of these will be useful (if any) in combatting this effect of mirtazapine.

I don't think these work, there are no foods that can burn fat, you will burn fat by eating low calories and that's that. Mirtazapine is an appetite stimulant for sick cats. It works by stopping a person or cat from being able to feel full. (source)

Also, I don't think I can just cut out fat from my diet entirely. I am going low/no carb and starting the gym.

You have the right idea, antidepressants that act on serotonin make you gain weight because it changes your cravings and makes you crave carbs. While there are mixed results on this and the metabolic effects are not clear, and I am personally led to believe that they don't change your metabolism, just your cravings. (source) (source)

 

[LittleJem]

Thanks all for your comments. Here is the most detailed explanation I found online that I don't fully understand:

Mirtazapine's metabolic effects drive a shift towards carbohydrate substrate preference in energy metabolism. This shift manifests as an increased reliance on carbohydrates for energy, promoting their storage as fat in the body, which explains Mirtazapine and weight gain as a side effect.2 Mar 2024
AND
The antidepressant therapy with mirtazapine was associated with a significant increase in body weight, body fat mass, and leptin concentration. In contrast to other psychotropic medications inducing weight gain, such as some second-generation antipsychotics, mirtazapine treatment did not influence the glucose homeostasis.

And various websites saying mirtazapine changes the way your body stores fat. which annoyingly don't explain how.


It does increase appetite in some people but this is not the case with me...so the weight gain must be due to metabolic changes.

yes, lots of anti-ds can cause some weight gain. But mirtazapine (and the anti-psychotics) are notorious for at times causing massive and rapid weight gain.

I have tried fluoextine already. It did help some or even quite a lot then stopped helping any more.

I am currently functional enough to go to the gym and also am calorie counting which I'm sure is horrible for some people but is okay for me. I mean I miss eating all the fun foods but it is okahy for me to do that. I don't enjoy the gym but am going to go three or four times a week while I can.

I want to try and understand properly what it is doing and what I can and should eat but there is no real information online.

 

[curiouskitty]

I was on mirtazapine for several months. Literally the day I started taking it I felt like absolute dog-shit. The suicidal thoughts went from being present but ignorable to VERY IN YOUR FACE and CONSTANT. I was hungry all the time, and when I was not eating, I was sleeping 10-15 hours a day. My startle reflexes were completely thrown off - even if I could see somebody close the door, I would shoot up off as if I did not see it being slammed.

Quit it cold turkey. The worst fucking psychiatric med I was ever on.