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Clinical Research

The effects of fluoxetine on body weight, waist circumference, and body mass index in individuals who are overweight or have obesity: a meta-analysis of randomized controlled trials

International Journal of Obesity volume 49, pages 2446–2452 (2025)Cite this article

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Abstract

The effect of fluoxetine administration on body weight (BW), waist circumference (WC), and body mass index (BMI) remains inconclusive, as many studies have reported contradicting results. We conducted a meta-analysis of randomized controlled trials (RCTs) to assess the impact of fluoxetine prescription on these anthropometric indices. A comprehensive systematic review was conducted in PubMed/MEDLINE, SCOPUS, Web of Science, and EMBASE for manuscripts indexed before Jun 28st, 2025. The results were computed using the DerSimonian and Laird random effects model and reported as weighted mean differences (WMD) with 95% confidence intervals (CI). The current meta-analysis included 22 RCT arms (2348 individuals: placebo = 1166; fluoxetine = 1182) on BW, 2 RCT arms (77 individuals: placebo = 39; fluoxetine = 38) on WC, and 4 RCT arms (215 individuals: placebo = 105; fluoxetine = 110) on BMI. The present meta-analysis included 22 RCT arms (2348 individuals: placebo = 1166; fluoxetine = 1182) on BW. Fluoxetine treatment significantly reduced BW (WMD: −2.095 kg, p < 0.001), with significant heterogeneity noted among the RCTs (I² = 84.7%, P < 0.001). Fluoxetine supplementation decreased BW more substantially when the dose was ≥60 mg/day (WMD: −2.759 kg, p < 0.001) compared to <60 mg/day (WMD: −1.017 kg, p = 0.001), in trials lasting ≤12 weeks (WMD: −3.000 kg, p < 0.001) versus >12 weeks (WMD: −1.114 kg, p = 0.047), and when administered to individuals living with obesity (WMD: −2.246 kg, p < 0.001) compared to those living with overweight (WMD: −1.972 kg, p < 0.001). Fluoxetine did not impact WC or BMI values. Fluoxetine administration is associated with a reduction in BW, particularly when prescribed at doses ≥60 mg/day, during short-term interventions (≤3 months), and in individuals living with obesity.

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Fig. 1: Flowchart depicting the study selection and inclusion processes for the present meta-analysis.
Fig. 2: Forest plot of RCTs investigating the effects of fluoxetine on body weight.
Fig. 3: Forest plot of RCTs investigating the effects of fluoxetine on BMI.
Fig. 4: Forest plot of RCTs investigating the effects of Fluoxetine on WC.

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Data availability

All data generated or analyzed during this study are included in this published article, and you can find these data in references.

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  • 29 October 2025

    In this article a wrong version of supplementary file 3 was uploaded

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Authors and Affiliations

  1. Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong, China

    Fan Cui & Jianjun Dong

  2. Department of Endocrinology, Linyi Traditional Chinese Medicine Hospital, Linyi, Shandong, China

    Fan Cui

  3. Department of Nursing, Linyi Cancer Hospital, Linyi, Shandong, China

    Fanchao Dong

  4. Department of Breast Surgery, Linyi Cancer Hospital, Linyi, Shandong, China

    Zhiqiang Yang

  5. Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran

    Mohammad Safargar

  6. Department of Cellular and Molecular Pathology, Stefan S. Nicolau Institute of Virology, Romanian Academy, Bucharest, Romania

    Mihnea-Alexandru Găman

  7. Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

    Mihnea-Alexandru Găman

  8. Department of Hematology, Center for Clinical and Basic Research (CCBR Clinic), Bucharest, Romania

    Mihnea-Alexandru Găman

  9. Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Hamed Kord-Varkaneh

Authors
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Contributions

The authors’ contributions were as follows: FC, MS, JD and HK-V carried out the research, data analysis, and statistical assessment. FC, FD, ZY, JD and M-AG were involved in writing and structuring the manuscript. JD and HK-V took part in designing the research. FC, FD, ZY and JD were responsible for revising the manuscript. All authors reviewed and approved the final version of the manuscript.

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Correspondence to Jianjun Dong.

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Cui, F., Dong, F., Yang, Z. et al. The effects of fluoxetine on body weight, waist circumference, and body mass index in individuals who are overweight or have obesity: a meta-analysis of randomized controlled trials. Int J Obes 49, 2446–2452 (2025). https://doi.org/10.1038/s41366-025-01891-6

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