Psy-Q: How can antidepressant prescribers address weight gain concerns in adolescents?

Lea Lis, MDAnswer: “Mental health providers should address weight concerns in young people,” says Lea Lis, MD, a New York-based child and adult psychiatrist, but adds that it’s crucial the conversation stay focused on the health aspect – and not on the weight itself.

“The issue is that many antidepressants and mood-stabilizing medications [taken by youth] do affect weight, so this becomes a part of the discussion very quickly,” Dr. Lis tells Psycom Pro. “I talk about BMI being a range, and explain there is a healthy weight range, but I do not focus on exact numbers. I also talk about diet and other modifications that can be made to improve weight, as well as medications that might help with weight loss, depending on the issue.”

When asked about a recent longitudinal study linking childhood insulin levels and BMI to increased risk of psychosis and depression in young adulthood, Dr. Lis explains that, while the researchers made a connection, this was not a causation study. “This means we can’t know for sure if the BMI is going up because the child already has some symptoms of depression, and therefore is emotionally eating, or if the BMI and increased insulin level is somehow causing the depression,” she says.

What we do know, however, is that it is essential to practice healthy eating and maintain a healthy weight. “I tell my patients they should have the healthiest diet for their brains, which is made up of high carbohydrate, high fiber, and low saturated fat. It is basically the Mediterranean diet, rich in omega oils, such as fish and nuts. This has shown to be the best for both cognition and depression,” says Dr. Lis.

 

Last Updated: May 27, 2021