Therapy with antidepressants could contribute to increases in body mass, though extended-duration investigations remain scarce. The analysis incorporated 3,127 individuals (including 1,701 females) participating in the REGICOR cohort, with a mean age of 55.6 years (standard deviation 11.6) during the initial assessment period of 2003–2006, residing in northeastern Spain. Information was available from two assessments (initial and after a median interval of 6.3 years) regarding self-reported antidepressant medication, body mass, stature, along with initial data on tobacco use, leisure-time exercise, dietary patterns, educational attainment, marital status, and symptoms of depression evaluated via the Patient Health Questionnaire (PHQ-9) during the subsequent evaluation. Four patterns of antidepressant utilization were identified: no usage ever, commencement at the second assessment, cessation after initial usage, and ongoing usage across both assessments. Multivariable linear regression models were applied to evaluate links between these patterns and proportional changes in body mass. Among those without obesity initially (n = 2,404), associations with new-onset obesity at the later assessment were also examined.
Over the approximate 6-year period, participants experienced an average increase of 0.53 kg (equivalent to 1.01% of initial body mass), while 24.5% showed gains exceeding 5% of their starting weight. Most individuals (83.6%) reported no antidepressant usage, whereas 6.2% began treatment during the interval, 5.1% stopped after starting, and 5.1% indicated usage at both evaluations. After adjustments in multivariable models, relative to those with no usage, every pattern linked to higher mass increases: +1.78% (95% CI: 0.57, 2.98) for cessation after initial use, +2.08% (0.97, 3.19) for commencement at follow-up, and +1.98% (0.75, 3.20) for ongoing use. In participants free of obesity at start (n = 2,404), the odds ratio for developing obesity reached 2.06 (1.03, 3.96) with ongoing use, while results for other patterns lacked statistical significance. Within this community-based cohort of adults, persistent antidepressant utilization showed a robust link to increases in body mass. Both initiation and cessation patterns also connected to greater mass gains, though not significantly to new obesity cases. Amid rising global obesity rates and increasing antidepressant prescriptions, strategies for mass control and metabolic surveillance warrant inclusion in depression management protocols alongside medication regimens.
