Does Zetia Cause Weight Gain Or Weight Loss?

Hello and thank you for your question!

We've had a few folks reach out to us recently regarding Zetia, and we're happy to answer your question here.

Does It Cause Weight Changes?

Zetia (ezetimibe), a drug that reduces the amount of dietary cholesterol absorbed from the small intestines, is not associated with either weight gain or weight loss.

Clinical studies for ezetimibe did not note any difference in weight in those that took the drug versus those that did not.

Additionally, a change in weight is not a listed side effect in the prescribing information for the drug. Below is the 'adverse reaction' chart included in the prescribing information:

Having said this, other cholesterol drugs are associated with changes in weight, and this is likely the reason some people think that Zetia is the culprit.

What About Other Cholesterol Drugs?

It's uncommon that ezetimibe is prescribed by itself, without other cholesterol drugs being used first.

In fact, it is most commonly taken with 'statin' medications, like Lipitor (atorvastatin) and Crestor (rosuvastatin).

Unlike ezetimibe, statin medications are associated with weight gain. However, the mechanism behind this, and whether or not it's the statin drugs that cause weight specifically, is unknown.

Statins And Weight Gain

The general consensus leans towards dietary and lifestyle choices in statin users being the primary reason for weight gain, not the drug itself.

One of the largest studies on the matter, published in JAMA in 2014, sampled over 20,000 adults, and after analyzing all the data, concluded the following:

Caloric and fat intake have increased among statin users over time, which was not true for nonusers. The increase in BMI [body mass index] was faster for statin users than for nonusers.

As mentioned, most experts consider weight gain with a statin to be mostly behavioral...meaning that statin users pay less attention to diet and exercise than non-users.

Perhaps there is a belief they are more 'protected' from the negative effects of a bad diet than non-statin users.

Interestingly enough, however, recent studies show that there could be reasons behind weight gain caused by the statin drugs themselves.

A 2018 study found that statins may decrease a protein called leptin, which plays a vital role in regulating hunger and fat storage.

The study theorizes that a statin-caused decrease in leptin could cause individuals to not feel full after eating, promoting an increase in hunger over time.

Final Words

Circling back around to the original question, regarding Zetia and weight gain/loss, as mentioned, it is not associated with any changes.

Based on all the information currently available, it appears that any change in weight that occurs at the same time someone starts to take Zetia is likely due to other factors or drugs, not Zetia itself.