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Health Guide / Bupropion

Wellbutrin weight loss: how effective is bupropion for weight loss?

steve silvestro

Reviewed by Steve Silvestro, MD, written by Michael Martin

Last updated: Mar 21, 2021
4 min read

table of contents

  1. Does Wellbutrin cause weight loss?
  2. What is Wellbutrin?
  3. Are weight loss drugs right for me?
  4. Side effects of bupropion
  5. Weight loss treatments

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

If your healthcare provider has prescribed bupropion (brand name Wellbutrin) to you for depression or help with quitting smoking, you might be curious about one of its common side effects: weight loss. 

Can Wellbutrin be used on its own as a weight loss medication? 

We’ll break down what the science says, how Wellbutrin works, and what you and your healthcare provider should consider before you start taking Wellbutrin as part of a weight loss regimen.

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Does Wellbutrin cause weight loss?

It can. Bupropion (the generic form of Wellbutrin) was initially prescribed as an antidepressant. It is the only antidepressant associated with weight loss (Alonso-Pedrero, 2019). Healthcare providers noticed that mostly pleasant side effect, and today bupropion is sometimes prescribed as part of a medication for weight loss (naltrexone/bupropion, brand name Contrave), as well as a stop-smoking aid (brand name Zyban). 

As far as the evidence that bupropion by itself causes weight loss: 

  • A 2016 study that analyzed the long-term weight loss effect of various antidepressant medications found that non-smokers who took bupropion lost 7.1 pounds over two years. (This effect was not seen in smokers). Users of the other antidepressants in the study gained weight (Arterburn, 2016).
  • Bupropion seems to be effective for weight-loss maintenance as well. A 2012 study found that obese adults who took bupropion SR (standard release) in 300mg or 400mg doses lost 7.2% and 10% of their body weight, respectively, over 24 weeks and maintained that weight loss at 48 weeks (Anderson, 2012). 
  • And a 2019 review of 27 studies on antidepressants and weight gain found that antidepressant use increases body weight by an average of 5%—except bupropion, which is associated with weight loss (Alonso-Pedrero, 2019). 

What is Wellbutrin?

Bupropion is a drug known as an NDRI (norepinephrine-dopamine reuptake inhibitor). It prevents the brain from absorbing free-floating norepinephrine (a.k.a. adrenaline) and dopamine (otherwise known as the feel-good hormone). This increases the level of both chemicals in the brain (Huecker, 2020). Experts aren’t exactly sure how bupropion works to stimulate weight loss. It may act on receptors and neurotransmitters in the brain that affect metabolism and appetite.

Bupropion is sold in generic form and under several brand names, including: 

Bupropion is FDA-approved to treat major depressive disorder (MDD) and seasonal affective disorder (SAD). It is also used to help people quit smoking (smoking cessation).

Are weight loss drugs right for me?

If you’re interested in taking bupropion for weight loss, talk with your healthcare provider about whether a weight loss medication is the right option for you. 

Healthcare providers consider certain factors before prescribing a weight loss medication. These include the potential benefits of the medication, any possible side effects, your current medical status and medications, your family’s medical history, and cost (NIH, 2016). 

Healthcare providers generally prescribe weight loss medications for people with a BMI (body mass index) of 30 or higher, which signifies obesity. If your BMI is 27 to 29, healthcare providers may prescribe a weight-loss drug if you’re experiencing health problems related to overweight, such as hypertension (high blood pressure) or type 2 diabetes (NIH, 2016). 

Your healthcare provider also might determine your overweight or obesity can be best treated with simple lifestyle changes—such as a healthy eating plan, regular exercise, and better sleep—before prescribing medication. 

Side effects of bupropion

Bupropion can cause certain side effects. Common side effects associated with bupropion include mental changes (like hostility or agitation), dry mouth, headaches, nausea and vomiting and dizziness, and others (DailyMed, 2018). 

Serious side effects can include seizures, hallucinations, confusion, hypertension (high blood pressure), and allergic reactions (MedlinePlus, 2018). Seek medical advice immediately if you experience these side effects while taking bupropion.

Bupropion can also cause drug interactions with certain other medications, including (DailyMed, 2018): 

  • Monoamine oxidase inhibitors (MAOIs)
  • Blood thinners
  • Digoxin
  • HIV antivirals
  • Anti-seizure medications
  • Drugs that increase dopamine levels
  • Drugs that lower the seizure threshold 

This is not a complete list of side effects or drug interactions. If you have questions whether a drug or supplement you’re taking might interact with bupropion, ask your healthcare provider or pharmacist.

Weight loss treatments

If you’re considering a medication to treat obesity, bupropion is one of several options. Other medications include phentermine/topiramate (brand name Qsymia), liraglutide (brand name Saxenda), and bupropion/naltrexone (brand name Contrave).

Keep in mind, though, that no weight-loss pill will work magic. Your healthcare provider will recommend a healthy diet and regular exercise in addition to any medication. 

References

  1. Alonso‐Pedrero, L., Bes‐Rastrollo, M., & Marti, A. (2019). Effects of antidepressant and antipsychotic use on weight gain: A systematic review. Obesity Reviews : An Official Journal of the International Association for the Study of Obesity, 20(12), 1680–1690. doi: 10.1111/obr.12934. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31524318/
  2. Anderson, J. W., Greenway, F. L., Fujioka, K., Gadde, K. M., McKenney, J., & O’Neil, P. M. (2002). Bupropion SR enhances weight loss: a 48-week double-blind, placebo- controlled trial. Obesity Research, 10(7), 633–641. doi: 10.1038/oby.2002.86. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12105285/
  3. Arterburn, D., Sofer, T., Boudreau, D. M., Bogart, A., Westbrook, E. O., Theis, M. K., Simon, G., & Haneuse, S. (2016). Long-Term Weight Change after Initiating Second-Generation Antidepressants. Journal of Clinical Medicine, 5(4), 48. doi: 10.3390/jcm5040048. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27089374/
  4. DailyMed – Bupropion hydrochloride tablets (2018). Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=77346c0b-c605-47ed-ba2a-86fc757c7d74
  5. GlaxoSmithKline. WellbutrinXL. (n.d.). Retrieved from https://www.wellbutrinxl.com/safety
  6. Huecker, M. R., Smiley, A., & Saadabadi, A. (2020). Bupropion. In StatPearls. StatPearls Publishing. Retrieved March 18, 2021 from https://pubmed.ncbi.nlm.nih.gov/29262173/
  7. MedlinePlus – Bupropion (2018). Retrieved from https://medlineplus.gov/druginfo/meds/a695033.html
  8. National Institutes of Health. Prescription medications to treat overweight and obesity. (2016). Retrieved from https://www.niddk.nih.gov/health-information/weight-management/prescription-medications-treat-overweight-obesity
steve silvestro
Steve Silvestro, MD

Dr. Steve Silvestro is a board-certified pediatrician and Senior Manager, Medical Content & Education at Ro.

Related articles

Important Safety Information for Bupropion Sustained-Release (SR)

Warning: Suicidal Thoughts and Behaviors

Suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. In short-term studies, antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults under age 24. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24; there was a reduction in risk in patients 65 and older.

Patients of all ages being treated with antidepressants should be observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially early during antidepressant treatment and when the dose is adjusted up or down. Families and caregivers of patients should look for the emergence of symptoms on a day-to-day basis, since changes may be abrupt.

Call your healthcare provider right away or 911 in an an emergency if you observe any of the following behaviors, especially if they are new, worse, unusual, or worry you: emergence of suicidality, worsening of depression, emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, inability to sit still or restlessness, racing thoughts that you can’t fully control, or becoming easily distracted.

What are the FDA-approved uses of bupropion SR?

Bupropion SR is an aminoketone antidepressant used to treat Major Depressive Disorder (MDD). It is also categorized as a norepinephrine-dopamine reuptake inhibitor (NDRI).

Who should not use bupropion SR?

Do not use bupropion SR if:

  • You have had seizures in the past or have been diagnosed with a seizure disorder.
  • You have a current or prior diagnosis of bulimia or anorexia nervosa. 
  • You have abruptly discontinued alcohol, benzodiazepines, barbiturates, or antiepileptic drugs.
  • You are taking a class of medications called monoamine oxidase inhibitors (MAOIs). Examples of MAOIs include isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Emsam), and tranylcypromine (Parnate), linezolid, or intravenous methylene blue. When MAOIs are used at the same time as bupropion, there is an increased risk of very high blood pressure levels which can lead to a medical emergency. 
  • You have a known allergic reaction to bupropion hydrochloride.

How should I take bupropion SR?

You can take bupropion SR with or without food. The tablet should be swallowed whole and not crushed, split, or chewed.

You should take bupropion SR exactly as prescribed, and continue to take bupropion SR as prescribed even after your symptoms improve. You should not change your dosing regimen or stop taking bupropion SR without discussing with your provider first. A gradual reduction in dosage rather than abruptly stopping is recommended whenever possible.

If your symptoms are not improving or you have any questions about changing or stopping medication, reach out to your Ro-affiliated provider for guidance.

What should I tell my Ro-affiliated provider before using bupropion SR?

  • Bupropion SR contains the active ingredient bupropion. It is the same active ingredient that is found in medications called Wellbutrin, Wellbutrin SR, Wellbutrin XL, Aplenzin, Zyban, or Forfivo XL. Tell your provider if you are taking one of these medications.
  • Bupropion SR has many drug interactions. It’s important to tell your Ro-affiliated provider all of the medications you are currently taking, including prescription, over-the-counter medications, vitamins, and herbal and dietary supplements. Some medications to watch out for include:
    • Monoamine oxidase inhibitors (MAOIs), including the antibiotic linezolid (Zyvox) and intravenous methylene blue (rare)
    • Antipsychotics, such as risperidone (Risperdal) and haloperidol (Haldol)
    • Other antidepressants, including SSRIs and SNRIs
    • Theophylline (Elixophyllin)
    • Corticosteroids, such as prednisone
    • Drugs used to treat Parkinson’s Disease called levodopa and amantadine
    • Digoxin (Digox)
    • Tamoxifen
  • It’s important to share your entire medical history with your provider. In particular, tell your provider if you have a past history of:
    • Suicidal thoughts or attempted suicide
    • Bipolar Disorder
    • Family history of Bipolar Disorder or family history of suicide
    • Seizures
    • Liver problems
    • Kidney problems
    • If you are a smoker and/or you’re trying to quit smoking
    • Alcohol or opiate abuse
    • Diabetes
    • Eating disorders
  • Tell your provider if you are pregnant, planning to become pregnant, or breastfeeding. You should discuss with your provider if bupropion SR should be used during pregnancy and while breastfeeding.

Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

What are the most serious side effects that I or a caregiver should monitor for when taking bupropion SR?

If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

These serious side effects are rare, but can occur with bupropion SR. You or a caregiver should carefully monitor for these side effects, especially in the beginning of treatment and with dose changes.

  • Smoking Cessation: Some people have had serious side effects while taking bupropion to help them quit smoking (known as the brand name drug Zyban). These side effects include new or worse mental health problems, such as changes in behavior or thinking, aggression, hostility, agitation, depression, or suicidal thoughts or actions. If you are thinking of quitting smoking, talk to your provider before you start taking bupropion.
  • Risk of seizure: Bupropion SR can cause seizure and the chance of seizure is related to too high of a dose of bupropion SR. Tell your provider about any past history of seizure, all medical history, and any other medications you are taking.
  • Increase in blood pressure: Bupropion SR can increase blood pressure. Your blood pressure should be well controlled prior to starting treatment. The chance of high blood pressure may be higher if you also use nicotine replacement therapy (such as a nicotine patch) to help you stop smoking. Your provider will monitor your blood pressure regularly. Consider monitoring your blood pressure at home.
  • Activation of Mania/Hypomania: Especially at the beginning of treatment, monitor for changes in behavior such as an unusually elevated mood, feeling unusually irritable, a big increase in energy, being more talkative than usual, racing thoughts, or engaging in risky behaviors. These changes in behavior could be signs of undiagnosed Bipolar Disorder.
  • Psychosis and other neuropsychiatric reactions: Depressed patients treated with bupropion SR have had a variety of neuropsychiatric signs and symptoms, including delusions, hallucinations, psychosis, concentration disturbance, paranoia, and confusion. Some of these patients had a diagnosis of bipolar disorder. Monitor for these signs and symptoms and tell your provider right away if these reactions occur.
  • Eye Effects: In rare instances, antidepressants may cause a certain type of eye problem called acute angle-closure glaucoma. Monitor for eye pain, changes in your vision, or swelling or redness in or around the eye.
  • Allergic Reactions, some severe: Discontinue bupropion SR if you develop an allergic or anaphylactic reaction including skin rash, itching, hives, chest pain, swelling, and shortness of breath.
  • Cognitive and Motor Impairment: Bupropion SR may impair judgment, thinking, and motor skills. Avoid driving a car or operating hazardous machinery until you know that your performance is not affected.
  • Alcohol Use: Limit or avoid using alcohol while taking bupropion SR. If you usually drink a lot of alcohol, talk with your provider first before suddenly stopping. If you suddenly stop drinking alcohol, you may increase your chance of having seizures.

What are the most common side effects of bupropion SR?

  • Agitation
  • Insomnia, trouble sleeping
  • Headache
  • Dizziness
  • Nausea, vomiting
  • Constipation
  • Tremor
  • Sweating
  • A rapid or irregular heartbeat
  • Dry mouth
  • Loss of appetite, weight loss
  • Sore throat

You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

This information is not comprehensive. Please see the full Prescribing Information for complete safety information. 

Important Safety Information for Bupropion Extended-Release (XL)

Warning: Suicidal Thoughts and Behaviors

Suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. In short-term studies, antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults under age 24. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24; there was a reduction in risk in patients 65 and older.

Patients of all ages being treated with antidepressants should be observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially early during antidepressant treatment and when the dose is adjusted up or down. Families and caregivers of patients should look for the emergence of symptoms on a day-to-day basis, since changes may be abrupt.

Call your healthcare provider right away or 911 in an an emergency if you observe any of the following behaviors, especially if they are new, worse, unusual, or worry you: emergence of suicidality, worsening of depression, emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, inability to sit still or restlessness, racing thoughts that you can’t fully control, or becoming easily distracted.

What are the FDA-approved uses of bupropion XL?

Bupropion XL is an aminoketone antidepressant used to treat Major Depressive Disorder (MDD) and seasonal affective disorder (SAD). It is also categorized as a norepinephrine-dopamine reuptake inhibitor (NDRI).

Who should not use bupropion XL?

Do not use bupropion XL if:

  • You have had seizures in the past or have been diagnosed with a seizure disorder.
  • You have a current or prior diagnosis of bulimia or anorexia nervosa. 
  • You have abruptly discontinued alcohol, benzodiazepines, barbiturates, or antiepileptic drugs.
  • You are taking a class of medications called monoamine oxidase inhibitors (MAOIs). Examples of MAOIs include isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Emsam), and tranylcypromine (Parnate), linezolid, or intravenous methylene blue. When MAOIs are used at the same time as bupropion, there is an increased risk of very high blood pressure levels which can lead to a medical emergency. 
  • You have a known allergic reaction to bupropion hydrochloride.

How should I take bupropion XL?

You can take bupropion XL with or without food. The tablet should be swallowed whole and not crushed, split, or chewed.

You should take bupropion XL exactly as prescribed, and continue to take bupropion XL as prescribed even after your symptoms improve. You should not change your dosing regimen or stop taking bupropion XL without discussing with your provider first. A gradual reduction in dosage rather than abruptly stopping is recommended whenever possible.

If your symptoms are not improving or you have any questions about changing or stopping medication, reach out to your Ro-affiliated provider for guidance.

What should I tell my Ro-affiliated provider before using bupropion XL?

  • Bupropion SR contains the active ingredient bupropion. It is the same active ingredient that is found in medications called Wellbutrin, Wellbutrin SR, Wellbutrin XL, Aplenzin, Zyban, or Forfivo XL. Tell your provider if you are taking one of these medications.
  • Bupropion XL has many drug interactions. It’s important to tell your Ro-affiliated provider all of the medications you are currently taking, including prescription, over-the-counter medications, vitamins, and herbal and dietary supplements. Some medications to watch out for include:
    • Monoamine oxidase inhibitors (MAOIs), including the antibiotic linezolid (Zyvox) and intravenous methylene blue (rare)
    • Antipsychotics, such as risperidone (Risperdal) and haloperidol (Haldol)
    • Other antidepressants, including SSRIs and SNRIs
    • Theophylline (Elixophyllin)
    • Corticosteroids, such as prednisone
    • Drugs used to treat Parkinson’s Disease called levodopa and amantadine
    • Digoxin (Digox)
    • Tamoxifen
  • It’s important to share your entire medical history with your provider. In particular, tell your provider if you have a past history of:
    • Suicidal thoughts or attempted suicide
    • Bipolar Disorder
    • Family history of Bipolar Disorder or family history of suicide
    • Seizures
    • Liver problems
    • Kidney problems
    • If you are a smoker and/or you’re trying to quit smoking
    • Alcohol or opiate abuse
    • Diabetes
    • Eating disorders
  • Tell your provider if you are pregnant, planning to become pregnant, or breastfeeding. You should discuss with your provider if bupropion XL should be used during pregnancy and while breastfeeding.

Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

What are the most serious side effects that I or a caregiver should monitor for when taking bupropion XL?

If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

These serious side effects are rare, but can occur with bupropion XL. You or a caregiver should carefully monitor for these side effects, especially in the beginning of treatment and with dose changes.

  • Smoking Cessation: Some people have had serious side effects while taking bupropion to help them quit smoking (known as the brand name drug Zyban). These side effects include new or worse mental health problems, such as changes in behavior or thinking, aggression, hostility, agitation, depression, or suicidal thoughts or actions. If you are thinking of quitting smoking, talk to your provider before you start taking bupropion.
  • Risk of seizure: Bupropion XL can cause seizure and the chance of seizure is related to too high of a dose of bupropion XL. Tell your provider about any past history of seizure, all medical history, and any other medications you are taking.
  • Increase in blood pressure: Bupropion XL can increase blood pressure. Your blood pressure should be well controlled prior to starting treatment. The chance of high blood pressure may be higher if you also use nicotine replacement therapy (such as a nicotine patch) to help you stop smoking. Your provider will monitor your blood pressure regularly. Consider monitoring your blood pressure at home.
  • Activation of Mania/Hypomania: Especially at the beginning of treatment, monitor for changes in behavior such as an unusually elevated mood, feeling unusually irritable, a big increase in energy, being more talkative than usual, racing thoughts, or engaging in risky behaviors. These changes in behavior could be signs of undiagnosed Bipolar Disorder.
  • Psychosis and other neuropsychiatric reactions: Depressed patients treated with bupropion XL have had a variety of neuropsychiatric signs and symptoms, including delusions, hallucinations, psychosis, concentration disturbance, paranoia, and confusion. Some of these patients had a diagnosis of bipolar disorder. Monitor for these signs and symptoms and tell your provider right away if these reactions occur.
  • Eye Effects: In rare instances, antidepressants may cause a certain type of eye problem called acute angle-closure glaucoma. Monitor for eye pain, changes in your vision, or swelling or redness in or around the eye.
  • Allergic Reactions, some severe: Discontinue bupropion XL if you develop an allergic or anaphylactic reaction including skin rash, itching, hives, chest pain, swelling, and shortness of breath.
  • Cognitive and Motor Impairment: Bupropion XL may impair judgment, thinking, and motor skills. Avoid driving a car or operating hazardous machinery until you know that your performance is not affected.
  • Alcohol Use: Limit or avoid using alcohol while taking bupropion XL. If you usually drink a lot of alcohol, talk with your provider first before suddenly stopping. If you suddenly stop drinking alcohol, you may increase your chance of having seizures.

What are the most common side effects of bupropion XL?

  • Agitation
  • Insomnia, trouble sleeping
  • Headache
  • Dizziness
  • Nausea, vomiting
  • Constipation
  • Tremor
  • Sweating
  • A rapid or irregular heartbeat
  • Dry mouth
  • Loss of appetite, weight loss
  • Sore throat

You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

This information is not comprehensive. Please see the full Prescribing Information for complete safety information.