Ask a Nutritionist: Why Can’t I Lose Weight?

The Gut Stuff Reader: 

Why can’t I lose weight? I’m eating a really gut-friendly diet with loads of variety of veg everyday, and fermented foods, and overnight 12-hour fasting. My mood has improved lots. But I’m not losing weight while other people I know are losing loads of weight eating the same regime. I’m currently taking Citalopram an anti-depressant.

Jeanette Answers:

Well done on the work so far, and congratulations on the gut-friendly actions you have been taking and mood improvement, manifesting the gut-brain connection at play. The SSRI (selective serotonin reuptake inhibitor) drug you mention which is often prescribed for depression and/or panic attacks is well known to induce weight gain as a side effect in some people, and many report difficulties shifting weight while on it. 

Many drugs, including some antidepressants, can induce “subclinical hypothyroidism” where your thyroid isn’t working as well as it should, but not bad enough to be medicated, though you could be experiencing symptoms. The thyroid is a gland in the neck which controls our metabolism. When the thyroid isn’t working properly, our metabolism can slow down making us gain weight, and make it almost impossible to lose weight. 

First stop next should be your GP and ask for a blood test to assess your thyroid function – ask for a full panel including thyroid antibodies, not just TSH. You and your GP could then consider reviewing your anti-depressant medication. The work you are doing on your diet for your gut could perhaps provide support for your mood while the drug is being reduced, but only you and your doctor can assess this. A word of warning, it is imperative to only change a dose of an SSRI under the strict supervision of your doctor. Some people suffer severe rebound symptoms when the dose is reduced and can become dangerous to themselves or others. Note some people report that metabolism can take some months to readjust even after coming off an SSRI.

No advice in this column is designed to override any by your medical doctor and should not be relied on as a substitute for specialist dietary advice. If you have any concerns about your health, visit your general practitioner, or medical consultant. 

Do you want to ask a nutritionist a question about your gut issues? You can do that HERE!