Do Statins Cause Weight Gain?

Statins are powerful drugs to lower cholesterol and have probably saved millions of lives (or rather, delayed millions of deaths) in people who have proven atherosclerosis (i.e. in secondary prevention). However, as all medications, they do have their adverse effects and their use in people with no clinical signs of atherosclerotic disease remains controversial.

Now, an article by Takehiro Sugiyama and colleagues, published in JAMA Internal Medicine, points to another possible “adverse” effect of statins – weight gain.

The researchers examined the relationship between changes in calorie and fat intake between stating uses and non-users in a nationally representative sample of 28,000 US adults, 20 years or older, from the National Health and Nutrition Examination Survey (NHANES), 1999 through 2010.

While back in 1999-2000 caloric intake was significantly lower for statin users compared with nonusers (by about 180 kcal/d) this difference between the groups became smaller as time went by.

In contrast, no significant change was observed among nonusers during the same study period.

As with calories, statin users back in 1999-2000 ate about 10 g less fat perday than non-userers, but “noramlised” their fat intake as time went by.

In line with this, BMI increased more among statin users (+1.3) but not in non-users (+0.4) during this time period.

The authors interpret these finding to indicate that over time efforts aimed at dietary control among statin users may be becoming less intensive as statin users (and their health-care providers) may be relying more and more on the pills to do the job.

As there is no biological plausible link between statin use and an increase in appetite, this does seem a very reasonable hypothesis.

Perhaps not unlike the common observation that people starting exercise programs may begin eating unhealthier diets (or simply more calories) because they feel “protected” by their physical efforts.

I guess we could all do a better job in reminding ourselves that pharmacotherapy should always supplement healthier lifestyles rather than replace them.

@DrSharma
Las Vegas, NV