Does Zetia Cause Weight Gain Or Weight Loss?
In our latest question and answer, the pharmacist discusses whether or not the cholesterol medication Zetia causes weight changes.
My doctor just started me on Zetia and I am worried about it causing me to gain weight. I've read online that some people gain weight while others lose some. Which is it?
Aug 19, 2021- Zetia (ezetimibe) is not associated with weight gain or weight loss based on clinical studies and prescribing information.
- Weight changes that occur when starting Zetia are likely due to other factors or other medications like statins, which are commonly taken with Zetia.
- Statins may be associated with weight gain, possibly due to dietary choices or changes in how the body regulates hunger.
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.
References & sources
Glossary — Terms in This Answer
- Ezetimibe
- The active ingredient in Zetia, a medication that reduces cholesterol by blocking its absorption in the small intestines.
- Dietary cholesterol
- Cholesterol that comes from food sources and is absorbed through the digestive system.
- Statin
- A class of cholesterol-lowering medications that work by reducing cholesterol production in the body.
- Adverse reaction
- An unwanted or harmful effect that occurs as a result of taking a medication.
- BMI
- Body Mass Index, a measurement of body fat based on height and weight.
- Leptin
- A protein in the body that helps regulate hunger and feelings of fullness.
- Prescribing information
- Official documentation provided by a drug manufacturer that lists a medication's uses, side effects, and safety information.
- Clinical studies
- Research tests conducted on human subjects to evaluate the safety and effectiveness of a medication.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
More answers from Brian →