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The woman sitting next to me in the concert hall was fanning herself vigorously with her program. It was not hot in the hall; indeed most people had on sweaters or jackets as the hall was drafty and it was very cold outside.
“Hot flushes?” I asked knowingly. “Yes,” she replied, “and they never seem to end. They are particularly bad at night. I don’t think I have slept through for months. I wake up hot and sweaty, get cold, go to sleep and then wake up hot again. But my doctor suggested I go on antidepressants. He said they might help.” At this point the lights dimmed so I said nothing. I wondered if she realized that the therapy for her hot flushes might bring with it another set of problems: weight gain.
Just about all the antidepressants available today have the potential to make people gain weight. The amounts range from 10 to upwards of 30 pounds or more. The reason for the weight gain is that these drugs seem to take away a sense of satisfaction after food is consumed. Patients report food cravings, needing to eat larger portions than before they went on the medications, and a loss of satisfaction and satiety. Added to this drug- induced overeating is the effect of menopause itself. Many women start to struggle with their weight as they go into menopause and complain that it is harder for them to lose weight than when they were younger. As my seatmate was already overweight, the addition of even 10 more pounds would be unwelcome and might even have an impact on her health. So how could going on antidepressants to relieve her hot flushes be a good idea?
. On the other hand, awakening at night due to frequent hot flushes is unpleasant and leads to daytime fatigue. Disrupted sleep is a well-known trigger for overeating and weight gain. So it was possible that my seatmate was gaining weight because she slept so badly. Is her choice between relief of hot flushes and weight gain or not sleeping and gaining weight.
Fortunately, Antidepressant-associated weight gain does not have to be inevitable. Although research studies have not yet identified why these drugs cause overeating, studies that my colleagues and I conducted have shown that there is an easy and natural way to stop it. The same brain chemical on which the antidepressants work, serotonin, is involved in appetite control. Unfortunately, the antidepressants do not make serotonin work harder at controlling eating. If they did, everyone on these drugs would never have to worry about eating too much. That is the bad news. The good news is that everyone can make serotonin work harder at preventing overeating simply by choosing the right foods to eat.
Serotonin is produced only when carbohydrates are eaten. Complex carbohydrates such as rice, potatoes, pasta, bread, cereal, crackers, tortillas, cornbread and simple sugar all activate a process in the body that leads to more serotonin in the brain. (Fructose, the sugar in fruit is the only exception.) When protein is eaten either by itself or with carbohydrate (a chicken sandwich for example) the protein part of the meal prevents serotonin from production. When new serotonin is made, it functions to put a brake on eating.
Even though the antidepressants will give my seatmate feel a persistent need to eat, regardless of how much food she has consumed, she can prevent this from happening by eating a small amount of carbohydrate before starting a meal. A cup of low-fat cereal, 4 or 5 small graham cracker squares, a low-fat granola bar or two fat-free meringue cookies will boost serotonin levels and spoil her appetite. And if she finds herself nibbling all evening, she ought to eat a dinner of only carbohydrate and vegetables. That way the increased serotonin in her brain will prevent her from snacking until she goes to sleep.
Intermission came and we both stayed seated. After a few minutes, I reached into my bag and offered her some cherry Twizzlers, my all-time favorite carbohydrate snack. “ Before you start on your antidepressants, “ I said to her, “ there is something you ought to know.”
“ Well, “ she said, after I gave her my carbohydrate –serotonin boosting suggestions,” if getting rid of hot flushes means snacking on carbohydrates, menopause may not be so bad after all.”
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A pioneer in the fitness industry, who has helped millions to get fit, Gilad Janklowicz, continues to inspire and lead, with his consistent message, “keep it simple”. 
Heather Bauer is a Registered Dietitian specializing in the interrelation between eating habits, metabolism, and lifestyle. Since 2001, the has offered private diet and nutrition counseling through her New York city-based nutrition practice, Nu-Train. 
Calorie Bargain: Keep the Beat: Heart Healthy Recipes from the National Heart, Lung, and Blood Institute
Calorie Bargain: Quaker Simple Harvest All Natural Dark Chocolate Chunk Chewy Granola Bars (
