Wellbutrin, known generically as bupropion, is an antidepressant medication that belongs to the norepinephrine-dopamine reuptake inhibitor (NDRI) class of drugs. While primarily prescribed for conditions like major depressive disorder, seasonal affective disorder, and smoking cessation, it has also been observed to influence weight in some individuals. This article delves into the relationship between Wellbutrin XL (an extended-release formulation of bupropion) and weight loss, examining the scientific evidence, potential mechanisms, and important considerations for those taking this medication.
Understanding Wellbutrin XL and Its Formulations
Wellbutrin XL and Wellbutrin SR are different formulations of the antidepressant bupropion. The key difference between Wellbutrin XL and Wellbutrin SR lies in the dosing schedule. XL is an extended-release medication and only needs to be taken once a day, releasing the medication more slowly than Wellbutrin SR, which is released faster. Both XL and SR formulations are approved by the Food and Drug Administration (FDA) to treat major depressive disorder.
Weight Changes as a Potential Side Effect
Weight changes are considered a side effect for both Wellbutrin XL and Wellbutrin SR. Research indicates that weight loss is more commonly associated with Wellbutrin than weight gain.
- Studies of Wellbutrin XL show that 23% of people taking a dose of 150 to 300 mg per day lost 5 pounds or more.
- Studies of Wellbutrin SR show that 14% of people taking a dose of 300 mg per day lost more than 5 pounds. At a dose of 400 mg, 19% of people lost more than 5 pounds.
It's important to note that Wellbutrin is not FDA-approved as a weight loss medication, although the drug is sometimes prescribed off-label to help.
How Wellbutrin May Influence Weight Loss
While the exact mechanisms are not fully understood, Wellbutrin's impact on weight is believed to be related to its effects on neurotransmitters in the brain, particularly dopamine and norepinephrine.
Read also: The Wellbutrin weight loss timeline
- Neurotransmitter Regulation: Wellbutrin prevents the reuptake of dopamine and norepinephrine, leading to higher levels of these neurotransmitters in the brain.
- Appetite Regulation: Dopamine plays a direct role in appetite regulation, and low dopamine levels have been linked to overeating. By altering the levels of dopamine and norepinephrine in the brain, Wellbutrin can regulate reward pathways linked to cravings.
- Increased Metabolic Rate: Wellbutrin can have a stimulant effect on the central nervous system, potentially increasing metabolic rate and allowing some people to burn calories faster.
- Boost in Energy: Because it has stimulant properties, Wellbutrin can cause an uptick in energy that might lead to increased physical activity.
- Fat Loss: Norepinephrine increases the rate of fat loss by releasing fatty acids into the bloodstream. This reduction of fat contributes to weight loss.
Studies on Bupropion and Weight Loss
Several studies have investigated the effects of bupropion on weight loss.
- One study showed that almost 70% of participants saw weight loss of more than 5% of their body weight in 8 to 24 weeks - most of which came from lost body fat.
- Another study looked at the effects of Wellbutrin weight loss when the drug was taken in combination with nutrition counseling and exercise.
A systematic review and meta-analysis collected evidence about bupropion and reported that bupropion does not cause weight gain and it mainly induces weight loss.
Combination Therapies
The combination effect of bupropion and naltrexone on weight loss is not precise. It was proposed theoretically that naltrexone could influence the neurological pathways of the brain, while bupropion would suppress the appetite. Two studies have reported that bupropion/naltrexone combination was found to be effective in achieving loss of weight in obese individuals. Bupropion/naltrexone combination produced significant weight loss when compared to either medication alone. A chemical combination of Bupropion and naltrexone is available under the brand name Contrave. Healthcare professionals might suggest a combination of phentermine and bupropion to aid in weight loss.
The Importance of a Holistic Approach
It's crucial to recognize that Wellbutrin is not a magic bullet for weight loss. Lifestyle factors, including diet and physical activity, continue to play a substantial role in managing weight. Weight management strategies often incorporate significant lifestyle adjustments, dietary changes, and increased physical exercise.
- Healthy Diet: Focus on eating a balanced diet rich in fruits, vegetables, lean proteins, whole grains, and healthy fats.
- Regular Exercise: Studies show that working out regularly is great for establishing a healthy weight long-term.
- Mindfulness: Being mindful of your portion sizes and eating regular, consistent meals will help stabilize your metabolism and make maintaining weight easier. Paying attention to what - and how much - you’re eating can be a game changer in your weight loss journey.
If you’re struggling with your weight or with making healthy lifestyle and diet changes, consider working with a dietician.
Read also: Wellbutrin XL: Understanding Its Impact on Weight
Risks and Considerations
Using bupropion to lose weight could be indicative of disordered eating, especially when other abnormal eating behaviors are present. In fact, using medications like Wellbutrin for weight control significantly increases the risk of being diagnosed with an eating disorder like anorexia nervosa (AN) or bulimia nervosa (BN).
Like most medications, bupropion can cause many side effects and health risks, such as:
- Tremors
- Vomiting
- Nausea
- Headache
- Dry mouth
- Sleep disturbances
- Nervousness
- Constipation
- Agitation
- Anxiety
- Confusion
- Delusions
- Psychosis
- Hallucinations
- Paranoia
- Rapid heart rate
- Dizziness
- Excessive sweating
- Blurred vision
Using bupropion for weight loss when an eating disorder exists can increase the risk of adverse health effects, especially seizures. It is possible to overdose on bupropion, especially in cases of misuse.
Consulting with Healthcare Professionals
If you’re taking Wellbutrin and have questions about weight loss or weight gain, openly discuss your questions or concerns with your family physician. A doctor or mental health professional can offer personal, holistic medical advice that considers everything. If you have lost more than 10 lbs. over a 4 - 6 weeks period (without change in diet or increase in exercise), consult your healthcare provider.
Read also: Weight Loss and ADHD Medication Options
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