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A scale and a box of statins | Does atorvastatin cause weight gain?
Drug Info

Does atorvastatin cause weight gain?

It’s not uncommon to pack on the pounds while taking this medication. Here’s why.
Leandra Beabout
By | Sep. 23, 2024 Medically reviewed by Karen Berger, Pharm.D.

Key takeaways

  • Atorvastatin is a statin used to treat high cholesterol or high triglyceride levels. Weight gain is not a direct side effect.

  • Rather, weight gain on atorvastatin may be linked to a relaxed approach to diet and exercise or increased appetite rather than the medication itself.

  • Maintaining a healthy, low-cholesterol diet and exercising regularly can help prevent weight gain while taking atorvastatin.

  • Talk to your healthcare provider if you experience sudden or unexplained weight gain while taking atorvastatin.

In this article:

Atorvastatin, first branded as Lipitor, is a generic prescription drug that is FDA approved to treat hyperlipidemia, commonly known as high cholesterol. It is also used to lower the risk of heart attack and heart disease. Atorvastatin belongs to a class of medications called HMG-CoA reductase inhibitors, or statins, which are commonly prescribed together with a healthy diet and exercise to lower cholesterol and triglyceride levels.

Atorvastatin is not one of the many medications known to cause weight gain. Still, some people do gain weight on statin medications such as atorvastatin. Exactly how and why may vary, but research has linked statin use with increased calorie intake.

Can atorvastatin cause weight gain?

“Research suggests that statins do not directly cause significant weight gain or fat redistribution, such as belly fat,” says Sue Ojageer, Pharm.D., founder of Pharmacy Mentors and a SingleCare Best of the Best Pharmacy Awards winner. “That said, any medication can have side effects, and some patients may notice changes in their weight or body composition while on statins.”

In other words, weight gain is not a side effect of atorvastatin, but taking this statin drug may cause other effects that impact your weight. Factors that may contribute to weight gain while taking a statin include:

  • A false sense of security
  • Appetite changes
  • Insulin resistance

A false sense of security

People who take atorvastatin may develop a false sense of security as they start to experience lower cholesterol levels. Statin users might assume the treatment’s effectiveness is a permission slip to indulge in more sugary or processed foods without worrying about their impact on their health.

Research backs this theory. A 10-year study of 31,170 Americans found that people using statins significantly increased their fat and calorie intake over time. Eating more may contribute to weight gain.

Appetite changes

Research has also linked statin use with decreased leptin, a hormone that helps control appetite. A dip in leptin could cause patients to feel unusually hungry after starting atorvastatin. Anyone taking statins for the first time should report unusual cravings or a lack of post-meal satisfaction to their healthcare provider.

Increased insulin resistance

A 2021 study found that atorvastatin use can lead to insulin resistance, a well-known precursor to Type 2 diabetes. Other lifestyle-related risk factors for Type 2 diabetes include being overweight and exercising fewer than three times per week.

When you’re insulin resistant, your body can’t efficiently convert the glucose in your bloodstream (blood sugar) into energy. Though participants in the study did not gain weight, insulin resistance can eventually result in weight gain.

RELATED: How to lose weight with insulin resistance

Does atorvastatin make it hard to lose weight?

More research is needed on whether atorvastatin directly impedes or accelerates weight loss efforts. On one hand, atorvastatin could increase your appetite or cause insulin resistance—two things that might make weight loss more difficult. On the other hand, atorvastatin is intended to be used in conjunction with a low-cholesterol diet and exercise. When paired with healthy lifestyle changes, this statin might even help people with obesity or who are overweight lose weight.

It’s important to remember that many factors can contribute to body weight changes. If you experience weight gain or trouble losing weight on atorvastatin, seek medical advice from a healthcare professional.

Tips for managing your weight on atorvastatin

“What you eat can play a vital role in managing cholesterol levels, and if you are on a statin, you should still incorporate foods that are fiber-filled and loaded with healthy fats for cardiovascular health,” says Vicki Shanta Retelny, RDN, registered dietitian nutritionist and author of Total Body Diet For Dummies. In other words, the types of foods you eat can help you avoid weight gain while on statins.

Fill up on fiber

Fiber can make you feel full faster than other nutrients—and satisfaction lasts longer, too, says Shanta Retelny. She suggests eating fiber-rich foods such as fruits, vegetables, whole grains, nuts, and seeds.

Take it a step further by focusing mostly on soluble fiber. “Soluble fiber is a type of fiber that can help lower cholesterol. Food sources of soluble fiber include oats, avocado, apples, and beans,” explains Jacqueline Gomes, RD, a registered dietitian and nutritionist.

Eat more protein

“Foods higher in fiber and protein not only take longer to digest, but you can stay full on fewer calories—the cornerstone to healthy weight management,” says Gomes.

Healthy, high-protein foods include lean animal products, along with nuts and seeds. “Some examples of quality protein sources include poultry, fish, tofu, eggs, Greek yogurt, and cottage cheese,” she adds.

Prioritize unsaturated fats

Fat is essential to a healthy diet—but the fat type matters, especially if you have a risk of cardiovascular disease. People on low-cholesterol diets should reduce or eliminate saturated and trans fats while prioritizing unsaturated fats, including omega-3 fatty acids.

Shanta Retelny says unsaturated fats are found in foods such as avocados, nuts, seeds, and fatty fish such as salmon, halibut, and tuna. Her suggestion for satisfying eats while on atorvastatin? “Spread avocado on a piece of whole grain toast, add nuts as a snack, or sprinkle seeds like chia, flax, or hemp seeds over a salad. Enjoy fatty fish at least two times a week!”

Exercise

Exercising regularly is one of the best ways to avoid weight gain on atorvastatin or any other statin. Aerobic activity has also been shown to improve cholesterol levels.

“Fitness is key, with at least 150 minutes a week or 30 minutes at least 5 days a week. Building muscle mass is vital to boost metabolism, plus changing the composition of the body can decrease metabolic syndrome, which includes high cholesterol,” says Shanta Retelny. Consult a healthcare provider before beginning any new exercise program.

Alternatives to atorvastatin

“Statins are generally the first line of treatment due to their proven efficacy in lowering LDL cholesterol and reducing cardiovascular events,” says Dr. Ojageer. “However, as with any medications, side effects can occur, and some patients tolerate certain statins better than others.”

Besides atorvastatin, some HMG-CoA reductase inhibitors (statins) include:

Like atorvastatin, none of these cholesterol medications are known to cause weight gain directly. However, they can still have side effects. Muscle aches and weakness are common side effects of statins. (Note: Intense muscle pain is a sign of rhabdomyolysis, a rare but serious side effect of statins where muscle tissues break down, which can cause kidney damage.)

“Lower doses or alternative statins like pravastatin or fluvastatin might be recommended [for some patients], as they are associated with fewer muscle-related side effects,” says Dr. Ojageer.

And then there are some examples of atorvastatin alternatives that are not statins:

“These medications have different mechanisms of action and are generally well-tolerated, though they may be used in combination with statins for those who require more intensive cholesterol-lowering therapy,” explains Dr. Ojageer. Like atorvastatin, these medications are not known to cause weight gain.

Ultimately, there is no one safest drug that is right for everyone with unhealthy cholesterol levels. The medication that’s best for you depends on your individual health history. Talk to your prescribing healthcare provider if you are concerned about side effects, including weight gain.