After a few long episodes of Afib in a row my cardiologist put me on daily Bisoprolol in April. Unfortunately within a month I had gained 10lb and felt extremely fatigued and lethargic so I saw him again recently and asked to go back to using it as a PIP.
I fairly quickly regained my energy levels but despite upping my exercise regime and being very careful what I eat (including intermittent fasting) the weight refuses to budge. Am I being too impatient?
Has anyone else has this issue?
Yes! Found it very disheartening . Some years ago after my first ablation I was on a fitness regime and losing weight steadily until I was put on Bisoprolol and weight loss ground to a halt ! This is known to be a problem as the whole system is slowed down.
Give it time and hopefully your metabolism will return to normal before very long.
I really hope so! Thanks for the encouragement 😁
A little bit, possibly. I was hovering just above clinical underweight for years so some weight gain might be better in my situation. But it’s something that people need to be alert to, especially those struggling to keep their weight down.
Yep! Every beta blocker I have tried has had this effect. I have to eat very little to maintain weight while on them. I assume it is the damper it puts on energy, each time we do something throughout the day we do so with less energy or zeal while on beta blockers. It adds up.
I think you’re right. I find I am less inclined to be active and move around so that would translate into needing less energy from food.
It’s infuriating isn’t it and not much of a choice, frequent Afib or significant weight gain and lethargy 😫
Yes and unfortunately I really never managed to lose all the weight gain. Biso and probably Flecainide seems to have permanently slowed my metabolism. I now put on weight if I so much as look at food and have to work extraordinarily hard to not put on weight, even though I haven’t had heart meds since 2014.
the rationale for gaining weight with Beta Blockets seems clear. However, I don’t think there is the same for Flecainide. my experience with Flecainide is that I have slowly lost weight over last 12 mths but I suspect that has nothing to do with the Flecainide. (I’m not on B blockers)
It’s good to hear you say Flecainide didn’t lead to weight gain etc as that is the drug my cardiologist wants to put me on next if coming of the beta blockers leads to frequent episodes of Afib and flutters.
I am quite small and normally slim so a 10lb weight gain is quite significant for me!
I also lost weight and generally felt more energetic on Flecainide. Mind you, also gave up alcohol at the same time.
Just wondering how you are doing on Flecainide without beta blockers. My EP is so keen that they be taken together that I'm reluctant to push. He says Flecainide can provoke certain arrhythmias and the beta blockers protect against it. But I'd love to drop the Bisoprolol!
Both my Cardiologist and EP were aware and cautious about taking Flecainide without a beta blocker but It was a compromise based on QOL. Note, I originally had A Flutter but once sorted after 2nd ablation (12mths ago)I did develop PAF and am managing that with just 50mg 2 x daily Flec with additional PIP Flec if required. No BBlocker.
I'm glad to read everyone's comments as I've put on so much weight since starting bisoprolol and as I recently said to an Arythmia nurse, "lost my oomp" I know some is ageing and a fear that came with the diagnosis but I'm challenging that, just difficult when feeling so lethargic. She talked about a change to Verapamil, anyone have good/bad experiences of this?
It is so frustrating and if I had realised the side effects of Bisoprolol then I don’t think I would have started taking it in the first place! Like you I very much lost my oomph and actually felt quite depressed but that has improved significantly since coming of the Bisoprolol. Just really need to get this weight off now but it’s not going well so far 😫
I dont think the bisoprolol directly causes the weight gain its the effect its had on me the lack of motivation, lethargy, everything being done at a slow pace lack of interest in going for the long walks I used to do (along with an element if fear of it causing an episode) All that means I'm sitting and eating the wrong foods, I struggle with my weight anyway and my go to for low mood, boredom, inactivity, energy slump are those sugary foods. Hopefully if my Dr goes along with the suggestion of verapamil it might improve things. Hope yours does
From what I understand, rapid weight gain is always fluid retention for some reason or other. A beta-blocker can't cause this directly, I didn't think, but might through its various interactions with your heart and blood pressure. I expect your GP will have a worthwhile idea on this.
Slow weight gain might be fat, but this can only be caused by more calories being consumed than are burnt since the metabolism itself is fixed throughout much of life, slowing a little as we pass 70, I believe. Beta-blockers have been shown to have a tiny effect on metabolism, I think, but not much. The only illness to cause metabolic changes would be thyroid related.
Steve
That’s not what my cardiologist said, he said it is almost certainly the beta blockers and they have this effect on quite a few people.
if you search and read several double-blind studies on Google Scholar regarding this, you'll find that there is some small evidence that beta-blockers might affect the metabolism but only very slightly. It didn't seem to me to be enough to cause much if any weight gain.
Rapid weight is usually fluid, and that can increase and decrease in all sorts of ways as it is under more general control of various hormones and organs, especially the kidneys.
Steve
Well something has happened and it seems quite coincidental that it happened literally within weeks of going on the beta blockers. I am a small slim active individual and it has been quite a shock to go from 8st 8lb to 9st 4lb so quickly with no change to my eating or drinking habits. Yes I was lethargic and tired but as we all know exercise has only a very limited effect on weight. If it doesn’t start to come off soon I will see about having blood tests for an under active thyroid but I would have thought that would have been picked up in all the blood tests my cardiologist already did.
It’s all very annoying!!
I can see what you mean. One of the studies, if I recall, did seem to show that metoprolol (another beta-blocker popular in the USA) could cause a small increase in weight. I doubt, though, that your doctor would be worried by that (relatively small) amount of increase. I would suspect the heart rate being slowed and BP reduced will have altered things a bit and caused you to generally burn fewer calories each day which, over time, could increase weight. Even increased anxiety levels burn significant numbers of calories and AF (for me anyway) increases anxiety significantly.
If your thyroid function has altered (and beta-blockers have wide ranging effects as there are beta receptors in many parts of the body) then I would think you would have noticed other effects than weight, given the significance of the hormone.
Steve
The only thing I'd add here to Steve's comments is - that's a surprisingly fast weight gain. I'd recommend getting a full raft of blood tests, including thyroid.
hi Steve. I suspect the weight gain whilst on (as opposed to caused by) Beta Blockers is a secondary consequence of the lower max heart rate and lethargy which results in less exercise, reduced muscle mass and so less calories burned and if calorie intake remains the same, a calorie surplus. This fits in with your view above.
Yes, you're right, it's much harder to move around while on beta blockers due to the extreme tiredness it causes. It is necessary to reduce your food intake to maintain your weight. Having said that, I lost 5 stones while on bisoprolol but I didn't eat very much at all to do it. It's not easy!
Hi - and yes. Thank you. That makes sense. The cardiologist (who I wouldn't try to gainsay) would have given a simplified version I would think, one suited to the time and context. The only way that the metabolism can change is via a thyroid effect, to my knowledge.
Many people reasonably look to drugs as the cause of weight gain, when it is, in reality, a change in calorie input / output that is the only possible cause - outside of fluid retention, of course.
Steve
my consultant cardiologist is always telling me to make sure my GP checks my thyroid.
I remember reading that thyroid levels are not internationally recognised and different countries treat at differing levels. It is said to be a potential contributory cause of AF, I believe.
Steve
Having been a ‘clinical’ Reflexologist of 25 years, that is, I’m specifically checking people’s health through areas on the feet, I find that most women do have a thyroid imbalance and of course, we’re ruled by hormones more than men. At menopause the whole hormonal system go’s haywire 😵💫
well I’m on both Bisoprolol & Flecainide, gamed weight steadily even though I’d cut my portions down. Bisoprolol makes my HR go low when I’m sleeping or sitting, so I take it every other day (1.25mg) GP said it’ll be doing nothing at that rate 🤷🏼♀️ Developed T2D last year and went low carb, but weight was dropping off in hospital anyway. Ruddy meds, the side effects worse than the conditions 🙄
The GP was being a bit humorous as 1.25mg most certainly is a potent dose for me (and others I have read from). It takes about an hour to begin to work, but often peaks the next day, with an effect lasting well over a day. It can easily drop my HR to 40-50 or so.
If you don't need the bisoprolol to control AF symptoms, then I would maybe ask your GP about stopping it. The cardiologist I saw put me on losartan (100mg) even though my BP was normal as he said it has been shown to preserve the heart over long periods of time. Beta-blockers have a similar effect, I think, but if it is too strong for you, maybe a different approach might be possible?
Steve
He did say it’s doing nothing and should stop it, but he isn’t my Consultant and he’s rather over confident 🙄 I could stop it but probably need to inform either/both of em 🙄
I have a great rapport with my Cardiologist consultant, just penned a questionnaire and got good reply, he also adds in the GP 😜
Do he’ll know what I want him to do 🤣
I’ve been on a low dose of Bisoprolol for just over a year and I’ve actually lost a bit of weight.
I started on 2.5 mg, but have been on daily 1.25 now since July. It could be, like others have said, it slows you down. Initially I did feel a lot slower, but the lower dose has helped that. I have infrequent episodes, but am reluctant to take it just as a PIP in case they become more frequent.
Really sorry to hear your problems. Like you I am snall - 5ft 1 inch . Luckily didn't have weight gain with Bisoprolol, but my blood sugar levels went up to pre-diabetic levels - a recorded side effect. As a result I was offered the NHS prevention course and dutifully went. I've cut down on carbs and snacking. Eat more nuts and seeds and lost a stone (while continuing Bisoprolol), kept it off for 3 years and my blood sugar levels are normal. I use an app called Carbs and Cals which really helps, although I have had to adapt it to my style of cooking and put my own recipes in there!
Has anyone had Petechiae/Blood Spots whilst on Bisoprolol?
Bisoprolol or something else?
Tiredness & Weight Gain
Anyone else tapering off bisoprolol or any other anti-arrhythmic/beta blocker? 
