Weight gain associated with metoprolol
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Metoprolol and Weight Gain in Patients with Hypertension and Diabetes
Research shows that metoprolol is associated with weight gain, especially in patients with type 2 diabetes and hypertension. In a large study comparing metoprolol tartrate to carvedilol, patients taking metoprolol gained an average of 1.19 kg over five months, while those on carvedilol did not experience significant weight changes. The weight gain was more pronounced in patients who were obese or morbidly obese, and there was no significant link between weight change and changes in blood sugar or blood pressure levels .
Metoprolol and Weight Changes in Chronic Heart Failure and Cachexia
In patients with chronic heart failure (CHF) who have cachexia (a condition involving severe weight loss and muscle wasting), metoprolol therapy has been shown to partially reverse weight loss. Studies found that after six months of metoprolol or other beta-blocker therapy, cachectic patients experienced significant weight gain and improvements in certain hormone levels, such as leptin and insulin. These effects were more pronounced in cachectic patients compared to noncachectic ones, suggesting that metoprolol may help restore body weight in this specific group 23.
Genetic Factors, Obesity, and Metoprolol Response
The response to metoprolol, including its effect on body weight, may be influenced by genetic factors. In patients with both CHF and obesity, those with a specific genetic variant (CYP2D6 gene 1846G/A polymorphism) were more likely to experience weight gain during metoprolol treatment. Patients with the GG genotype had better clinical outcomes and less weight gain compared to those with the GA genotype, who also experienced more side effects .
Metoprolol in Combination Therapies for Weight Loss
When metoprolol is used as part of a combination therapy (such as Tesomet, which includes tesofensine and metoprolol) in patients with hypothalamic obesity, the combination has been shown to result in significant weight loss compared to placebo. In this context, metoprolol did not cause weight gain and was well tolerated, suggesting that its effect on weight may depend on the patient population and the presence of other medications .
Conclusion
Metoprolol is generally associated with modest weight gain in patients with hypertension, diabetes, and obesity, with the effect being more pronounced in those who are already overweight. However, in patients with chronic heart failure and cachexia, metoprolol may help reverse weight loss. Genetic differences can influence individual responses to metoprolol, including the likelihood of weight gain. When used in combination therapies for specific conditions like hypothalamic obesity, metoprolol does not appear to promote weight gain.
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