Adverse Effects of β-Blocker Therapy on Weight Loss in Response to a Controlled Dietary Regimen

Background: The effects of beta-blockers on metabolic parameters including weight loss are poorly understood. Methods: From a database of 3582 patients who completed The Ottawa Hospital Weight Management Program between 1992 and 2011, a total of 173 patients were receiving beta-blockers and were eligible for the study. We determined differences in rate of weight loss in the first 6 weeks of this 900 kcal/d Optifast (Nestle Health Science, Vevey, Switzerland) meal replacement program for patients treated with beta-blockers compared with (1) matched controls and (2) all participants in the program not being treated with beta-blockers. Secondary outcomes included changes in waist circumference. Results: Mean percent weight loss in the beta-blocker group was reduced compared with the rest of the group (9.7% vs 10.0%; P = 0.0001) as well as with matched controls (9.7% vs 10.3%; P = 0.004). Results were the same after adjusting for prevalent cardiovascular disease (9.7% vs 10.0%; P = 0.006). Similarly, a smaller decrease in waist circumference at 6 weeks was observed in the beta-blockeretreated group compared with the rest of the group (-24.2 vs -26.3 cm; P = 0.002) and with matched controls (-24.2 vs -25.2 cm; P = 0.04) and was not altered by adjustment for cardiovascular disease (-24.2 vs 26.3 cm; P = 0.004). Conclusions: In the absence of a clear medical indication, alternatives to beta-blockers should be considered for the treatment of hypertension in obese individuals.