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Looking for some advice, hopefully experiences, with SSRI (Anti-Depressants)

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Hello everyone! I am fairly new to post but have been following the tumblr for awhile now. I want to thank the lets recover team and everyone who has offered support. It has been more helpful than you could imagine. My dietician has recommended I start on Zoloft (an SSRI antidepressant). A little background: I have had anorexia restricting type for about 4 years now. I have bee seeing a therapist/dietician for about a year. I was never severely underweight, but definitely underweight. In the past year I have improved, but never been able to make the leap to 2500+ calories (I am over 25). I have gained some weight but still have a lot of symptoms of starvation and my dietician says I still need to gain probably at least 10 pounds. I am guessing I am very close to a low healthy BMI right now, I do blind weigh in. My dietician feels that because it has been over a year of treatment with minimal progress I would benefit from an SSRI to help with the anxiety and OCD I experience. I really do not like the idea of taking medication, I know it may be a little bit of loss of control feelings here. I just was wondering if anyone had any experience with Zoloft or any SSRI's during treatment. I have to be honest my biggest fear is that it will cause weight gain, not natural weight gain, but medical weight gain, which scares me to death. I do not know if SSRI's have any affect on your metabolism or not? I want to gain weight because I am eating more not due to a medication. Any experiences or advice is welcome and greatly appreciated. I am really struggling here! Thanks!

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I am suppose to start the antidepressant tonight and am really torn. Any help would be greatly appreciated. I have this strong feeling that if I just make the jump to 2500+ calories I probably would not need the anxiety medicine, but I have struggled for a year now to get to the 2500 calorie minimum. I have been battling anorexia for 4 years next month but only attempting recovery for the past year. Any suggestions??? I am really nervous about meds! Thanks to everyone for any help. I have made so much progress by prayer and reading all the posts on here! Thanks again Smile

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It does seem, after a quick google search, that Zoloft can give extra weight gain. But I don't think you should worry too much about this, because many experience that their depression get alot better when they gain back to their set point weight. Even if the medication causes you to overshoot, then it will probably be better for your depression and then you can stop taking it. When you stop, your weight will go where it should. 
But I really do think this is a matter you should discuss with your therapist and see if she has any other ideas to help your depression that doesn't trigger so much extra worries about gaining. Gaining weight is hard enough as it is. 

If I were you, I would focus on upping my intake to make the starvation symptoms (depression is one of them) go away.

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Thanks for your advice. I found the same thing when I goggled Zoloft. My pharmacist said actually weight loss is a symptom due to nausea and loss of appetite. I decided to hold off a little longer and really challenge myself to increase the calories. That is a huge struggle for me, but if I am honest I do indeed notice a better disposition when I have eaten more. My dietician is fine with me just increasing my food intake because she really recommended the meds for anxiety more than depression, she was just hoping if we lowered the anxiety maybe I could reach the calorie goal. She doesn't realize that she kind of triggers me because she keeps focusing on 2500 to gain and then keeps telling me 2000 will be enough to maintain and if I am honest I know I never was overweight prior to my ed and I am certain I never ate below 2500 with the exception on rare really busy days or days I was not feeling well, but her focus on 2000 calories with light exercise just tends to confirm what I am doing right now is ok. I walk about 30 minutes lightly 5 days a week and am eating usually 1500 - 1800 a day. I have gained but not consistently. I am at a low healthy bmi according to her, I don't know my actual weight. I really just want to thank you for your answers and support. You do not realize how helpful it is to just be reassured that others are out there fighting the same battle and winning!!!! Have a great day! Thanks again!

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I believe your dietician has little experience with how much we actually need to maintain. Have you showed her the research saying that 2500 is more correct?  The thing is that even though I believe many dietitians have a lot of knowledge about food, they are still colored by the fear of fat that our society has fallen victim too. All they talk about is not eating too much, even though it's four times more deadly to be eating too little! I eat over 2000 to maintain my weight,  and by looking back in time I realize that I have always done that. Trust yourself and your own body and please tell your dietitian how much you get triggered by those comments. If you're not taken seriously, change dietitian.

Stopping the exercise for a while is also worth considering as that will make your symptoms of starvation go away quicker. If it's any comfort to you: I stopped for 7 months, and after I started again I was actually in a better shape than when I stopped Smile

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I have talked to her about 2000 to maintain bothering me and she agrees that we need to see. She encourages me to eat 2500 a day to gain and then says we will look at what I need to maintain. She has been working with eating disorders for 30 years and so I sometimes feel like I shouldn't question her, and she is awesome and has helped a lot, but I can't help but feel like the information on here and youreatopia just makes so much sense. I have seen everyone's story and the wonderful article which is so inspirational about "you are not a rare unicorn!" I know I maintained previously on over 2000 most days also. I did quit all exercise for a little over 2 months and I have to admit I did seem to see more progress in symptoms, but I added back the 30 minute light walks more for mental purposes and to walk my dog who really missed being walked. I really do appreciate your support and I know we will make it to full recovery! Thanks again you do not know how much you have helped in just reassuring me what I already know most times. Thanks again!

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The 2500 kcal is a guideline, and it will not be perfect for everyone as we are all different. But youreatopia also says that even though we should gain on that amount, it's important to let go of all numbers when we are weight restored and start eating by hunger cues. 2500 is a minimum to gain on as it makes sure that you get enough energy to fix the damage, but you will probably not need that much when you're weight restored. 2500 is not at all bad for you after recovery either, but your hunger may not lead you to that amount. But to be clear: trying to maintain on exactly 2000 is disordered as recovery is about getting to trust your body and the signals it's giving you, whether that leads you to 2000, 2100,2200, 2300 or 3000. You get my point. Your dietitian don't need to "figure out" what you should maintain on, because that up to your body, and only your body, to decide. And it will, as long as you let it.

And I do think you are lucky to have an understanding dietitian, but you are always allowed to ask questions. Even though she has been doing it for 30 years, she may still have more to learn Smile Trust your self, because to me it seems like you already do know what's right for you Smile

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