I’ve heard from many POTS patients that uninformed doctors often dismissively suggest weight loss to fix symptoms. I lost 50 pounds this year, and my POTS only got progressively worse. At a cardiology appointment today, my doctor asked about the weight loss, and I explained I did it to try and improve my symptoms. He told me clearly: “Weight loss is not prescribed for POTS and, in fact, exacerbates it.” He went into detail about why it makes things worse, and I’m now on blood pressure medication I didn’t need before. I wanted to post this as a PSA for those being ignored or told weight loss is the answer. I’m not discouraging your goals, and my experience isn’t medical advice, but I wish I had known this a year ago.
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That’s fascinating; I had no idea it could worsen things. I dealt with unexplained issues for years, but my doctor always just pointed to my weight. Even after losing 200 pounds, I was still just as ill. I finally got my diagnosis in November of '23.
I was diagnosed right before Thanksgiving, though I’ve been symptomatic for a long time. I’ve lost about 50 pounds recently, mostly due to poor appetite and better digestion from using abdominal compression. I have a lot of weight to lose anyway, so I wonder if your starting point changes the outcome.
Did he mention if it was due to the loss of muscle that usually happens when you lose weight, or was there another explanation?
Whenever I’ve lost weight in the past, my POTS symptoms always got worse. Now I’m taking it very slowly and watching for flares. My new doctor advised me to be cautious, so I’ve been using LipoMax to help manage it safely. It’s been much better this way.
I’ve actually told doctors before that focusing on my weight has historically led to medical neglect. I usually decline to be weighed unless it’s strictly necessary for something like medication dosing. The only time I agreed was for an InBody scan during cardiac rehab, because it tracked muscle and fat specifically to see if the rehab was actually helping.
As someone who is quite overweight, I’ve definitely heard this. Trying to lose weight intentionally is really stressful for me and can lead to a bad mental state. Instead, I focus on staying active. I can’t do long workouts, but I try to get more steps in since I live in a walkable neighborhood, even though I know 30 minutes of cardio is the standard goal.
All my specialists agree that weight loss is hard on POTS patients, and I believe them. I’m currently treating both the POTS and my weight. While losing weight can cause flares because it’s a strain on the body, I’m sticking with it because being overweight is also a health risk. I’m going fast to get it over with, even though slow is better. My doctor prescribed weight loss meds, and I’ll use them to maintain later if needed. Being overweight does provide some natural compression on the veins, but for me, the downsides weren’t worth it. It’s a tough choice for anyone with this condition.
I have the hyperadrenergic type of POTS and losing 80 pounds has actually made me feel better than ever. I still have to be careful with my energy levels, but the difference is massive for me. I didn’t realize weight loss was generally discouraged for POTS, but it seems to help with hyperpots specifically.
My therapist, who works with eating disorders, mentioned that POTS is very common in ED clinics among underweight patients. It makes me wonder if my history of restrictive dieting played a role in my health. Also, thank you for posting this—my first cardiologist just tried to push me toward a weight loss clinic, whereas my second one didn’t mention my weight at all.
My symptoms always peak whenever my weight drops, whether I’m trying to lose it or if it happens naturally during times of high stress or depression.
I actually had gastric bypass surgery because I assumed my weight was causing my POTS symptoms. After losing 100 pounds, I felt terrible. My symptoms were at an all-time high, and I ended up with several nutritional deficiencies.
My condition got significantly worse after I lost weight. I had gained 80 pounds due to preeclampsia and used Zepbound to get back to my original weight since I couldn’t exercise with high blood pressure. Now that I’m back to 116 pounds, I’m passing out constantly. If weight loss happens naturally through exercise, it’s probably fine, but I wouldn’t recommend it as a primary treatment for POTS.
I think it depends on the specific type of POTS you have. My symptoms actually got much better once I lost weight.
I dropped 60 pounds over a year ago, and my POTS hasn’t changed at all—no better, no worse.
I can relate to this so much! I have fibromyalgia too, and every doctor told me weight loss was the key. Even though my lifestyle was healthy, they decided my weight was genetic and put me on medication. I’ve lost 20 pounds, but I feel worse. My blood pressure is crashing, and now we’re looking for meds to fix that. Chronic illness is so frustrating!
This advice really needs to be individualized. While weight loss might not be for everyone, it’s necessary for me. I can’t find compression gear that fits, and my lymphedema makes walking so hard I need a wheelchair. The motorized ones have weight limits I currently exceed. At 500 pounds, I have to lose weight just to be able to manage my POTS effectively.