Weight control while taking beta blockers

Exercise

by piglet22 - 2024-05-28 06:28:04

Gemita

You know my journey to higher doses of Bisoprolol and how it really knocks you for six.

I'm on 7.5 mg daily taken as two doses of 3.75 mg morning and evening.

The leg pain on hill climbing in particular is really noticeable.

Hills I cycled up are now a struggle to walk.

Yes, I am heavier than I was and the last MOT at the surgery, the chubby HCA asked me if I would like to go on a weight control course.

I declined.

I'm aware of the balance between calorie intake, energy expenditure and weight gain.

Sometimes, there isn't a lot going on in life and a decent meal can be something to look forward to.

The last thing I need is to start counting calories.

I find it irritating to be judged by numbers like BMI Hb1AC, alcohol units lipids etc. Living is risky.

The GP texted me to tell me I was one point from type 2 diabetes. Previously it was non-diabetic hyperglycaemia.

I went on a diabetes course and this woman taking it swept her arms down her body like a catwalk model and looked at us poor listeners but didn't have to say "you could look like me"

Apart from the arrogance I bit my lip and didn't say that I didn't like skinny women 

Diet, Exercise, Beta Blockers

by Gemita - 2024-05-28 07:39:34

Piglet, yes I do know how difficult your journey has been and I really do not know how you have managed to take such a high dose of Bisoprolol.  2.5 mg or 3.75 mg is more than enough for me and often leaves me wanting to sleep all day and then wide awake at night!  Yes it certainly calms the body, but knocks us for six.

Although my weight is fairly stable, I seem to be putting it on around the tummy and so is Michael who is also on Bisoprolol, so I am pretty sure it is the medication.  No I don’t count calories either, never have and even though Michael has diabetes, we are allowed to eat what we like sometimes.  It is one of the pleasures in life after all.

I may try again to ask about an alternative to Bisoprolol as a rate control med, either a different beta blocker or a calcium channel blocker, to see whether things can improve for both of us.  I know you have tried another beta blocker.  Have you noticed any difference between Bisoprolol and your previous beta blocker in side effects?

We have both done a diabetes course (for Michael).  Better experience than yours I think.  Really learnt a lot and came away feeling less concerned about our diet which has always been healthy.  I recall being asked what would hit the blood stream and spike our glucose levels more quickly:

A slice of white bread

or

A piece of chocolate cake

Well most of us thought the cake, but apparently the white bread would spike glucose levels more quickly since the fat in the chocolate cake would take longer to be digested, so would be slower to hit the blood stream and increase glucose levels.  No doubt though the calories in the chocolate cake would be higher!

have heard that other medication also can cause weight gain

by new to pace.... - 2024-05-28 09:26:34

for me right now have fallen off my healthy eating program.  Hope by the end of this week.  Can have better control.  Suspect a little depression is why have fallen. Since not on any medication, so cannot blame that. 

Able to get in my half hour walking in the pool, When to warm go into the big box stores and wander the whole store pushing an empty cart.  Even though not walking fast am moving.  Rather then sitting in front of computer playing games or on this site.

new to pace

Tummy fat and more

by Andiek11 - 2024-05-28 10:43:18

Gemita - 

I've been on metoprolol succinate now for about 7 or 8 months and it has knocked me for a loop.  Weight gain, especially on the belly, is one hallmark as is depressed mood.  Evenly a mildly depressed mood can definitely rob one of motivation to get up and move in general.  I'm also pretty sure that this beta blocker has thrown my blood lipids into the trash.  I'm not happy with the med, but struggle in that this specific drug is the gold standard for my situation. (Yep there are other beta blockers, but supposedly not as effective for my situation.)

It has become a quality of life issue for me.  I've gained weight, can cry easily for little cause, and motivation sucks.  It is nigh on impossible to get ahold of my cardiologist (this is still a work in progress) to discuss. His last email response passed along my his RN said that I should just start a statin drug to deal with the lipid issuw.  Hard stop.  I will need a huge preponderance of evidence that staying on metoprolol is so important that it is best for me to take a second drug to treat the side effects of the first.

Had a long, conversation with my PCP who comfirmed side effects and my thinking were on target, and that I was not imagining things or taking a crazy approach.  She suggest a beta blocker holiday to see how weight, mood and blood lipids change, and then to revisit the topic and explore other options. My PCP said some people just can't take Beta Blockers - she's seen this before.   I'm trying to now have this conversation with my Cardiologist since he prescribed the med, but so far dead air.  I have thus made the executive decision to begin to titrate down my dosage with the goal of stopping, and then discussing at my 3 month PM appt at the end of July. 

Bottom line is that I don't want to undermine the benefits that  the pacemaker and appropriate drugs can have in helping my heart to heal, but after all this work I'm not intrestest in loosing quality (or quantity) of life because of medication side effects.

DISCLAIMER: Least others read the above and think "oh maybe I should try this," DON'T!!  I only got to this place after months of research and talking to (or attempting to talk to), members of my medical team.  I'm also on an extremely low dose - 12.5mg once daily.  Everyone is diferent and thus the impact of stopping your meds could be very different. I am NOT A DOCTOR.  ;) 

Betablockers not associated with weight gain.

by Selwyn - 2024-05-28 12:30:21

Carvedilol  and Nebivolol ( 3rd generation beta blockers) should not cause weight gain.

Sadly, most folk are taking second generation beta blockers ( metoprolol, bisoprolol, sotalol.)

Weight gain may be a symptoms of heart failure.  

Dosage is according to the individual  ( a 50kg lady, is not the same as a 120kg man). I suggest you discuss this with your cardiologist.

Tiredness usually wears off with time. The more lipid soluble, older, betablockers enter the brain and are therefore best for anxiety symptoms. Tiredness goes hand in hand with lipid solubility.

Nothing ventured, nothing gained - hope this does not  refer to weight !

AndieK, Selwyn and New to Pace

by Gemita - 2024-05-28 14:32:31

Andie, I am so sorry you are struggling with Metoprolol.  You may be right about the beta blocker affecting cholesterol levels. They can do this apparently.  I always had low cholesterol levels prior to meds for AF.  I too am tempted to stay off my beta blocker since I have had to stop it for 48 hours in preparation for my stress echo tomorrow and for the most part, my heart has been fine off it.  Like you, I would not recommend others stop any heart medication without speaking to their doctors.  Stopping a beta blocker can be dangerous.  I am only on a low dose too and have been slowly weaning myself off it over months with some success.

I may adopt a pill in the pocket approach after I have spoken to my cardiologist about a medication change.  They did suggest this some years ago, but of course a pill in the pocket won’t prevent an arrhythmia from starting, whereas a regular anti arrhythmic or rate control medication, like a beta blocker, might.  Also a pill in the pocket may take a few hours to effectively treat any rhythm disturbances and I could get into trouble before my heart rate is under control, so lots to think about.

Selwyn, thank you so much for your advice.  I did see the two beta blockers you mentioned when researching and I have got them on my list to discuss with my Cardiologist on the 12th June.  I hope Carvedilol and Nebivolol will also improve sleep quality, since we are both getting bizarre dreams.  Some beta blockers are known apparently to reduce production of melatonin.   Weight gain a symptom of heart failure?  That is what I would most fear.  I should know more in the next few weeks.

New to Pace, some of this weight gain is probably due to lifestyle too.  I am mainly housebound these days with my caring duties, so I need to get out more, when it stops raining.  I hope you had a wonderful pool party on Sunday and got some welcome exercise?  I will let you know how I get on tomorrow with my exercise challenge.  

More info needed

by Prof P - 2024-05-28 14:39:04

I take 25 mg of metroprolol daily since getting my PM three years ago.  I have been running (and still do) for over 40 years (I'm 74, so my expectations are lower now).  I've not seen any appreciable difference in my weight, but I would say that running (or jogging now) has become more difficult.  I just lack the endurance I had and can't seem to get back to a comfortable pace - I'm running and walking.  I would be happy with slower and steadier.

I will be following this thread, since I am interested in these third generation beta blockers.  Perhaps they will make a difference.  

Weight gain

by AgentX86 - 2024-05-28 22:40:04

Weight is controlled by two things.  Fluid retention and calories. Some drugs affect the fluids in the body, furosemide (Lasix) and salt being obvious ones. A pint of water is a pound, so significant weight gain becomes apparent quickly.

Weight gain/loss comes down to input and output.  Weight = (calories input) - (calories burned).

Drugs can can only affect weight by changing one of these two variables.  A drug that makes one lethargic (a beta blocker, as mentioned), will reduce calories burned because you really don't want to exercise, burning fewer calories). Amphetamines (uppers), increase activity, thus increasing activity. These were used in the '60s as diet drugs.

At the other end are drugs will supress (Ozempic) or increase the apetite (steroids). Ozempic is the '20s diet drug that will probably be even more damaging than amphetamines (opinion).

The bottom line is that weight = (calories input) - (calories burned).

Interesting information

by piglet22 - 2024-05-29 05:32:32

It's good to hear others experiencs with beta blockers.

What worries me is that you can have changes in medication made by two parties, normal surgery and hospital consultant and basically you are left to get on with it.

I suppose it's the time/staffing/demand problem.

You can have a significant change in medication, 50 mg Atenolol to 10 mg Bisoprolol in my case, with next to no follow up.

If beta blockers have effects as others describe, it's surprising that you don't get a checkup.

I certainly would put exercise intolerance at the top of the list of undesirable side effects. It can effect your self esteem and wellbeing.

Yes, you can read the PIL with it's long list of side effects and suggestions to see your GP, but it's not that easy.

If the GP suspects medication problems, are they going to change the consultants' prescription?

As you go through life and pick up problems so the medication list grows 

I take seven medications daily, some going back two or three decades and in that time have had one GP review and one surgery pharmacist review. Not once has ever there ever been a change  made other than substituting an alternative except for when a drug becomes difficult to obtain. There was one change, ineffectual, substituting Losartan for Ramipril to try and stop the Ramipril cough.

However, when I compare my care compared with my parents' care, I count myself self a lot better off, but with room for improvement.

Sleep, H/rates, Diet & Motivation

by Penguin - 2024-05-29 18:07:09

Motivation to move around / Reduced Metabolic Rate

I've not taken a beta blocker but I hear what you (Gemita) and others are saying about these drugs and how they might reduce metabolic rate and desire to move around.  

I've gained weight for similar reasons although the cause was not a BB. Sleep is a big deal when it comes to motivation, as are your caring responsibilities and putting others first I suspect!  I've found it tricky to exercise with h/rates which seem to cut out too, but have had to adopt a 'long term, moderate view' to both diet and exercise and do little and often and keep diet varied, low calorie and with lots of 'delicious' saturated tastes e.g. garlic, ginger, spices, chilli to distract from smaller quanities. 

These measures 'seem' to be reducing visceral fat - but it's not been easy.

Weight

by AgentX86 - 2024-05-29 19:44:06

I repeat.  The ONLY way to lose (fat) weight it to either exercise more or eat less.  It doesn't work any other way.

Look at it this way.  Your body regulates heat within a very tight range.  Calories are used to maintain this heat, and for things like pumping blood and digestion (which all add to the heat load). If the metabolic rate went down (burning fewer calories), so would the temperature of the body. This doesn't happen in any significant way.

If you want to put a simple equation to it,

weight(lbs) = (in(food) - out(exercise) - 2000(housekeeping) * days / 3000

About 2000 calories a day (less for a small woman) are used for the body's houskeeping, breathing, digenstion, heart, and temperature regulation.

A pound of fat contains about 3000 calories.

To lose weight, cut down in, or increase out. Those are really the only variables.

The "days" part isn't insignificant.  An mere 100cal excess, every day, is 10lbs per year. It doesn't take much of a change in activity (a mile walk) or just a small change in apetite, to make this small difference every day. Big differenes are small differences piled on top of each other. This why losing weight is so hard.  It takes a lot of time to make a real difference. Because it takes so much time, it realy does take a lifestyle change.

If someone has a magic diet, you can bet that they're selling something. ...and probably not something good for you, much less your wallet.

Beta blockers are certainly not the most effective anti-hypertensive meds out there

by Gemita - 2024-05-30 06:54:28

Prof P, R2D2, AgentX86, Piglet, Penguin, thank you all for your contributions.  All excellent responses for those looking for management of weight gain.  It really is all about finding interesting, tempting, filling foods that will satisfy us for longer and not make us feel that we are depriving ourselves from the pleasures of eating.

Weight loss can be difficult to achieve with certain complex medical conditions whatever we do, although I agree by eating fewer calories than we expend through physical activity, we should lose weight - eventually.   It is always more effective if we reduce calories slowly, consistently over a long period, rather than going on crash diets which just don’t work or which cause rapid weight gain when we go back to eating a healthy, normal calorie intake diet.

Whatever we say about beta blockers, I do feel on the whole they are safer than anti arrhythmic meds in calming say rhythm disturbances and controlling heart rate.  At least, this is what I have always been told by health professionals.  I know that some beta blockers like the one I am on (Bisoprolol) is fairly safe since at lower doses it is very cardio selective (mainly targets the heart) and does not adversely affect other parts of the body, so fewer side effects are experienced overall.  I appreciate though that beta blockers aren’t for everyone.  According to many doctors we have consulted, beta blockers are not first line treatment for high blood pressure because other meds, like calcium channel blockers are usually more effective.

R2D2

by Gemita - 2024-06-03 07:04:39

Janene, I am glad you have let out your frustration.  I am so small framed and barely eating and yet piling on the weight especially around the middle ever since I started heart meds.  I put it down to the meds and also to the fact that I have no desire/strength to move about most days.

It is easy to stay active when we are feeling relatively well, without carrying extra weight, but add a heart med like a beta blocker, a heart condition, like heart failure and throw in the odd heart rhythm disturbance and it is easy to see why some of us don’t fare so well.  Beta blockers lower metabolic rates (slow the body’s ability to change food into energy).  Of course with heart failure the increase in weight can often be due to oedema and we cannot always do very much about that, however hard we try.

In your case, I accept that your weight gain is likely associated with Carvedilol.  What to do about it is another matter?  While Carvedilol may help with your symptoms in general, I cannot see that carrying extra weight can ever be helpful with your stage of heart failure.  I would be asking more questions and perhaps looking for alternative meds unless you feel comfortable carrying the additional weight and feel better overall on Carvedilol?  It is a fine balancing act, isn't it, but we will get there if we keep up the pressure.  I am certainly not giving up, are you?

Physics agrees with AgentX86

by sgmfish - 2024-06-03 19:14:53

(Yes, I am a physicist....)

Energy can neither be created or destroyed. When it comes to weight, as AgentX86 indicates, it can ONLY be about calories-in minus calories-burned (calories are a measure of energy). Exercise, altho good, doesn't do much for most folks since you only burn an additional 100 calories when you walk a mile. The other variable is the number of calories required just to stay alive (called your Resting Metabolic Rate or RMR). Unless you stay in bed all day, you need your RMR plus another 500 calories or so for a normal lifestyle assuming no real exercise.  As AgentX86 indicates, this requirement averages around 2000 calories/day. However, it can be 2400 for a man, and at the same time, just 1700 for a woman. A heavily physical job (let's say crab fishing) can add to this requirement such that one burns 3500 calories/day. Backpacking with a 60 pound pack hiking 8 hours/day including 2000 vertical feet of climbing can require 4500 calories/day. I don't know this for a fact, but perhaps medical conditions, or medicines, or other factors, could mess with this minimum requirement too. Perhaps RMR for some might be as low as 1000 calories/day. So indeed it is all about calories-in and calories-out, but one's daily calorie requirement can vary quite a bit for various people living various lifestyles. These facts might explain some of the differences in folks experiences with weight.

Lighten up

by sgmfish - 2024-06-07 15:26:31

No one is denying your experience; folks are just providing information. Believe what you like. Folks have all kinds of beliefs including that the universe is only 6000 years old in spite of the overwhelming scientific evidence to the contrary. Good luck finding answers to your issues.