Statins are medications that treat high cholesterol and reduce the risk of heart attack or stroke. The generic drug atorvastatin, sold under the brand name Lipitor®, is a common statin. Statins have some reported side effects, but the benefits outweigh the risks for most people.
You may wonder about Lipitor/atorvastatin side effects and whether they include weight gain. Here’s what you should know about how statins work, their potential side effects, and whether they can cause weight gain.
How Do Statins Work?
High levels of low-density lipoprotein cholesterol (LDL) cholesterol — also known as “bad” cholesterol — are a significant risk factor for heart disease, heart attack, and stroke. Excess LDL cholesterol builds up in your blood vessels and interferes with blood flow to your heart or brain. Statins help reduce your risk of heart disease by lowering your cholesterol and keeping it from blocking your arteries.
Common statin medications include:
- Atorvastatin (Lipitor)
- Fluvastatin (Lescol®)
- Lovastatin (Mevacor®)
- Pravastatin (Pravachol®)
- Rosuvastatin (Crestor®)
- Simvastatin (Zocor®)
These medications all work similarly. Aside from the cholesterol in your diet, your liver also makes cholesterol with the help of an enzyme called HMG-CoA. Statins prevent your liver from making too much cholesterol by blocking that enzyme.
In addition to lowering LDL cholesterol, they may also lower high triglyceride levels, which also helps reduce heart disease risk.
Possible Side Effects
Most people tolerate statins well, but side effects depend on the specific medication and dose you take. You may notice these mild side effects when you start the medication, but they usually improve within a few days to weeks:
- Confusion or brain fog.
- Constipation.
- Diarrhea.
- Dizziness.
- Fatigue.
- Forgetfulness or memory loss.
- Headache.
- Heartburn or gas.
- Indigestion.
- Loss of appetite.
- Nausea.
Another reported side effect of statins is muscle pain or achiness. This affects a small percentage of people and often improves as your body adjusts to the medication.
Some statins also affect your insulin, causing insulin resistance and higher-than-normal blood sugar. This may raise your risk of diabetes, especially if you have other risk factors like a family history.
In very rare cases, statins can cause rhabdomyolysis. This serious, potentially life-threatening condition causes muscle tissue to break down or dissolve. The contents of the muscle cells then enter the bloodstream and can damage the kidneys.
Rhabdomyolysis may cause these symptoms:
- Dark-colored urine or reduced urination.
- Fever.
- Muscle stiffness, achiness, or weakness.
- Nausea.
Contact your health care provider immediately if you notice any of these symptoms — or have any bothersome symptoms. They may recommend stopping or switching medications.
Do Statins Cause Weight Gain?
Weight gain isn’t a known side effect of these medications. And there isn’t one statin that is less likely than others to promote weight gain. Still, some people report gaining a few extra pounds after starting on a statin.
One lab study found that statin drugs can lower levels of leptin, a hormone that helps control appetite. But no human studies have confirmed that. Overall, research studies haven’t shown that these medications contribute to weight gain.
Instead, doctors suspect that after some people start on a statin, they’re less careful about their diet. For example, if your doctor determines you have high cholesterol, you might try to lower it with heart-healthy lifestyle changes like:
- Cutting out saturated fats from foods like cheese, red meat, or ice cream.
- Eating fewer packaged snack foods like chips, crackers, or cookies.
- Eating more high-fiber foods like fruits, vegetables, and whole grains.
- Exercising more frequently.
These changes can all benefit your heart health, but sometimes, they don’t lower your cholesterol enough. That’s when your doctor may recommend a statin for further help.
But if the statin works well, you may feel like you can ease up on your diet or exercise less. Doing so would cause you to consume more calories and burn less, leading to weight gain.
Statins and Belly Fat
Many people start taking statins to lower cholesterol in middle age. Gaining weight in your abdomen around that same time is also common. However, there’s no evidence that statins promote belly fat or increase waist size, so it’s doubtful the medication is to blame.
Instead, age is the likely culprit. By their 40s, many women have declining estrogen levels as they approach menopause. And men experience lower testosterone levels around middle age.
When sex hormone levels decline, your body is more likely to lose muscle and gain fat — often in your abdomen. Your metabolism also slows as you age, making it easier to gain weight and more challenging to lose.
How to Avoid Weight Gain While Taking a Statin
Taking a statin shouldn’t cause you to gain weight easier or make it harder to lose weight. However, other factors, like age, a slowing metabolism, and less attention to your diet and exercise, can lead to weight gain. Remembering statins may affect your blood sugar is also important.
Adding these healthy habits can help you maintain a healthy weight, blood sugar, and cholesterol:
- Add an extra serving of a fruit or vegetable to each meal and snack.
- Aim for 25 to 35 grams of fiber daily. Fiber comes from fruits, vegetables, beans, nuts, seeds, and whole grains like oatmeal, whole wheat bread, or quinoa.
- Cut back on red and processed meats like burgers, sausages, hot dogs, and bacon. Choose fish, poultry, or a meatless meal instead.
- Replace sweetened beverages with plain or sparkling water or unsweetened herbal tea.
- Save desserts and sweets for special occasions. Try to satisfy your sweet tooth with fresh fruit.
- Skip the packaged snacks and fast food. Nourish your body with whole, fresh foods and home-cooked meals instead.
- Strive for at least 45 minutes of exercise each day. Alternate between three days of strength training and three to four days of aerobic exercise, such as brisk walking or swimming.
Statins should not cause weight gain, but everyone’s body is different. If you’re gaining weight, work with a nutritionist. A few diet or exercise changes can help you get back on track.