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Effects of Concomitant Medications on Weight
Concomitant Pharmacotherapy
Limitations in the reported effects on body weight
➤ The reported weight effects of concomitant non-anti-obesity
medications should be interpreted with caution because the
data describing these weight effects:
• Are mostly derived f rom observations of studies not specif ically
designed to evaluate the effects of these medications on body
weight.
• Are mostly derived f rom comparisons of the reported effects
f rom different studies, rather than derived f rom a direct head-to-
head comparison within the same controlled clinical trial.
• Studies often report variable weight effects, depending on the
condition being treated (e.g., psychiatric medications being used
for multiple psychiatric conditions), dataset, analysis [head-to-
head versus meta-analysis and specif ic agents having especially
inconsistent reported effects (e.g., haloperidol, sertraline)].
• The reported effect is mostly expressed as mean values, with the
potential for wide variances in individual weight responses to a
particular drug.
Pharmacotherapy That Might Alter Body Weight
Cardiovascular Medications
May increase body weight:
• Some beta-blockers
▶ Propranolol may increase body weight
▶ Atenolol may increase body weight
▶ Metoprolol may increase body weight
▶ Carvedilol may not increase body weight
• Older and/or less lipophilic dihydropyridine ("dipine") calcium
channel blockers may increase body weight due to edema,
possibly because they are more vasodilatory compared to non-
dihydropyridines and lipophilic dihydropyridines. The increased
edema may exacerbate obesity-related edema (and sleep apnea-
related peripheral edema) and also confound estimates of body fat.
▶ Nifedipine may increase body weight
▶ Amlodipine may increase body weight
Diabetes Mellitus Medications
May increase body weight:
• Most insulins
• Sulfonylureas
• Thiazolidinediones ("-zones")
• Meglitinides (e.g., nateglinide,
repaglinide)
