Short-term use of certain types of antidepressants, primarily selective serotonin reuptake inhibitors (SSRIs), is often associated with weight loss, but long-term use, particularly of one of the drugs I’m on, Prozac (fluoxetine), has been shown to lead to weight gain. Unfortunately, it isn’t just on the front end of taking psychiatric medication that weight fluctuations occur. Reducing or eliminating SSRIs is also associated with weight gain. The most recent studies demonstrate that tapering off the medication very slowly, over a period of many months, is least likely to result in withdrawal symptoms. However, weight gain remains the toughest side effect to mitigate no matter how controlled the weaning.
In recent years, fat pride has become a lightening rod in the fitness, fashion, and wellness-related industries. Rising to prominence starting in the 1960s, the fat acceptance movement has challenged everything from how standards of beauty are publicly portrayed to discrimination against fat people in the workplace. At the same time, fat acceptance, and its close relative body positivity, has been criticized for encouraging obesity and promoting poor eating and exercise habits. The science tells us that there are correlations between body weight and certain medical conditions, including depression. As we all know, correlation is not causation. An evidence-informed perspective is that body weight and physical and mental health are linked, but one is not necessarily indicative of the other.
Until I was 36, I oscillated between being what health professionals define as overweight and obese my entire adult life. Over the last five years, I seem to have reached my “set point” just above the top of the body composition range considered healthy for my sex, height, and age. According to the charts, I’m overweight, but not obese. Physically, I’m more active and muscular than I’ve ever been. In the past, I dreaded shopping for clothing, because nothing fit the way I thought it was supposed to. As a fat person, I struggled with accepting my body’s shape and size, having been bullied and shamed for it. Although I now appear straight sized, I’m far from at peace with my body.
A little over a month into my medication taper, I am noticing my weight increasing. It isn’t dramatic but, to me, it’s apparent. My eating habits haven’t changed and, if anything, I’m exercising more. The literature confirms the issue is real while offering no proven remedies. It seems that, once again, time, patience, and repeated positive behaviors (e.g., eating nutritious food, staying active) constitute the only real solution. I’m struggling with my self-image and self-worth as a result of the changes to my physical being. My clothes don’t fit right. I feel heavy and saggy. I have no intention of trying any particular diet or adopting an unsustainable exercise regime. My plan is to continue doing what I’m doing. It’s another reminder to me that I’m not in need of fixing, because I’m not broken. I am working toward a new vision of wellness for myself.
This post’s featured image is a photograph I took of a sculpture by Nathan Sawaya called “Relationship” on exhibit at the Houston Museum of Natural Science. The piece is displayed juxtaposed with one of a young couple kissing. According to the artist, it represents the emotional connection between two people that endures despite the physical changes that take place over time.