Can a beta blocker cause weight gain
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Can Beta Blockers Cause Weight Gain?
Introduction to Beta Blockers and Weight Gain
Beta blockers are commonly prescribed medications for managing hypertension and chronic heart failure. However, there is growing evidence suggesting that these medications may contribute to weight gain in some patients. This article synthesizes findings from multiple studies to explore the relationship between beta blocker use and weight gain.
Evidence from Clinical Trials
Several clinical trials have documented weight gain as a side effect of beta blocker therapy. In a systematic analysis of eight prospective randomized controlled trials, patients on beta blockers experienced a median weight gain of 1.2 kg over six months compared to control groups1. Similarly, another study reported a weight gain of 1.2 kg in patients treated with beta blockers, attributing this to a decrease in metabolic rate by approximately 10%2.
Beta Blockers and Chronic Heart Failure
In patients with chronic heart failure (CHF), beta blockers have been associated with weight gain. A study involving 276 CHF patients found an average weight increase of 0.9 kg over one year, with more significant gains in those with milder symptoms (NYHA class I and II)3. Another study confirmed that beta blocker therapy in CHF patients led to significant weight gain and better outcomes compared to those who did not receive beta blockers6 10.
Age-Related Weight Gain
Research also indicates that beta blockers may exacerbate age-related weight gain. In a study of middle-aged and elderly patients, those on beta blockers gained more weight compared to those on ACE inhibitors, particularly in the 50-69 age group4. This suggests that beta blockers may have a more pronounced effect on weight gain in older populations.
Beta Blockers in Diabetic and Obese Patients
The Glycemic Effect in Diabetes Mellitus: Carvedilol-Metoprolol Comparison in Hypertensives (GEMINI) trial highlighted differences in weight gain between different beta blockers. Patients on metoprolol experienced a significant weight gain of 1.19 kg, whereas those on carvedilol did not5. This finding is particularly relevant for patients with type 2 diabetes and hypertension, who are already at risk for weight-related complications.
Beta Blockers and Obesity in Elderly Populations
A post-hoc analysis of elderly Chinese patients revealed that those on beta blockers had a higher prevalence of obesity compared to those not on these medications. Specifically, atenolol was associated with a higher rate of obesity compared to metoprolol and other beta blockers7 8. This suggests that the type of beta blocker may influence the extent of weight gain.
Mechanisms Behind Weight Gain
The mechanisms by which beta blockers cause weight gain are not fully understood, but several hypotheses exist. Beta blockers may reduce resting energy expenditure and thermogenesis, leading to an energy surplus and subsequent weight gain9. Additionally, beta blockers can induce insulin resistance, which may further contribute to weight gain and complicate diabetes management9.
Conclusion
The evidence suggests that beta blockers can indeed cause weight gain in some patients, particularly those with chronic heart failure, older adults, and individuals with diabetes or obesity. The extent of weight gain may vary depending on the specific beta blocker used. Clinicians should consider these potential side effects when prescribing beta blockers, especially for patients who are already at risk for weight-related health issues.
Sources and full results
Most relevant research papers on this topic
Hypothesis: Beta-adrenergic receptor blockers and weight gain: A systematic analysis.
Beta-blockers may cause initial weight gain in obese hypertensive patients, making obesity management more challenging.
Meta-Analysis
Highly CitedUse of beta‐blockers in obesity hypertension: potential role of weight gain
Beta-blockers may cause weight gain in overweight hypertensive patients, making obesity management more challenging, questioning their use as first-line therapy.
Highly CitedBeta-blockers and weight change in patients with chronic heart failure.
Beta-blocker use and intensification of heart failure treatment is associated with weight gain in chronic heart failure patients, particularly in those without peripheral edema and with functional class I and II symptoms.
Observational StudyAntihypertensive medication with beta-blockers and ACE-inhibitors-effects on weight gain associated with ageing.
Beta-blocker therapy promotes weight gain more than ACE-inhibitor therapy in middle aged and elderly patients, while older patients show only a small increase in body weight.
Observational StudyBody weight changes with beta-blocker use: results from GEMINI.
Metoprolol tartrate is associated with increased weight gain compared to carvedilol, particularly in patients with hypertension and diabetes not taking insulin therapy.
Observational StudyEffect of beta-adrenergic blockade on weight changes in patients with chronic heart failure.
Beta-blocker therapy in patients with chronic heart failure due to left ventricular systolic dysfunction reduces the risk of cachexia and significant weight gain, leading to better outcomes.
Observational Study
Rigorous JournalAssociation between beta-blocker use and obesity in Hong Kong Chinese elders: a post-hoc analysis.
Beta-blocker use in elderly Chinese individuals is associated with a higher prevalence of overweight and obesity, questioning their use as the main antihypertensive in this population.
Observational StudyBeta-blockers, hypertension, and weight gain: the farmer, the chicken, and the egg.
Beta-blockers use is associated with a higher prevalence of obesity in elderly Cantonese-speaking Chinese individuals, but the cause and effect remain unclear.
Observational Study[Obesity and diabetes as side-effects of beta-blockers].
Beta-blockers can promote weight gain and insulin resistance, potentially aggravating existing diabetes and eliciting diabetes in predisposed patients.
37 Effect of beta-andrenergic blockade on weight changes in chronic heart failure patients due to left ventricular systolic dysfunction
Beta-blocker therapy in chronic heart failure patients with left ventricular systolic dysfunction reduces cachexia and improves weight gain and outcomes compared to patients not receiving or tolerating beta-blocker therapy.
Observational Study