If you or a loved one have been prescribed statins, it’s for good reason. Statin medications help reduce high cholesterol, which, in turn, lowers your risk for serious heart conditions.

But some people may find that they gain a few pounds around the time they start taking statin medication.

And that can leave them wondering, Do statins cause weight gain? Or is something else going on?

We talked with preventive cardiologist Vikas Sunder, MD, to get to the heart of the issue.

The connection between statins and weight gain

Some medications come with warnings on the bottle that state weight gain as a potential side effect. That includes ones like antidepressant medications, corticosteroids and insulin.

But statins don’t come with that disclaimer. That’s because statins haven’t been proven conclusively to cause weight gain.

“There’s some data to suggest that statin users tend to have increased weight gain and increased caloric intake,” Dr. Sunder shares. “But science hasn’t shown that it’s the medication itself that is causing weight gain.”

In other words, weight gain and statin use are associated. But that doesn’t necessarily mean that taking statins causes weight gain. It’s a question of correlation versus causation.

An example from our everyday lives:

If a study shows that people who own pets tend to have less incidence of indoor allergies, does that mean that pets lower your risk for allergies? Maybe.

Or is it that people who don’t have allergies are more likely to get a pet? Probably more likely.

The same is true for statin use and weight gain. Do statins cause you to put on weight? Or could it be that people who take statins have something else going on that leads to a higher risk for weight gain? Maybe a bit of both?

“It’s hard to know for sure with the information available, but it could be that behavior is at least part of the issue, that it’s not just the statins themselves,” Dr. Sunder says.

He covers some possible reasons for the connection between statins and weight gain.

Statins’ potential effect on hunger hormones

At least one study has suggested that taking statins may reduce a hormone that helps control your appetite. That is, in petri dishes.

Leptin is the hormone that tells your body that you’re full. And researchers in that study showed that, at the cellular level, introducing statins reduced leptin production.

Less leptin means more hunger feelings. And the hungrier you feel, the more likely you may be to eat foods that lead to weight gain.

More studies are needed to show whether these results can be translated to people. But it may help to explain why people taking statins can be more prone to weight gain.

The effect of less-healthy habits

Statins are used to treat high cholesterol. And we know that high cholesterol is often associated with a less-than-nutritious diet and low levels of exercise.

Plenty of people who are active and eat a nutritious diet can still have high cholesterol. So, it’s not always the case that high cholesterol is a result of a high-fat diet or a sedentary lifestyle. But those things do tend to go hand-in-hand.

We also know that less healthy eating habits and low levels of exercise are related to weight gain.

So, it may not be that statins are causing weight gain. It may be that the lifestyle people lead before and while taking statins can cause weight gain. That means that people taking statins may have experienced similar weight gain even if they weren’t taking the medication.

False sense of security

There are typically two routes healthcare providers take to treat high cholesterol:

• Lifestyle adjustments, like changes to your diet and increased exercise.
• Medication, namely statins.

Typically, statins are prescribed when lifestyle changes don’t do the trick or when people choose to take medication rather than change up their eating and exercise habits.

So, the reason that people gain weight on a statin may be less about the medication itself and more about the habits of people who choose to take the medication.

“It’s possible that taking statin medications creates a scenario where people feel protected by the medication and lose track of healthy habits,” Dr. Sunder suggests.

In other words, if you take statins to reduce your cholesterol, you may be less inclined to scrutinize your habits. Because, you may think, you don’t need to; the medication is taking care of it for you.

So, you get a little loosey-goosey with keeping up with your exercise routine and your commitment to eating well.

The result? Weight gain.

In reality, statins should be used in addition to lifestyle changes, Dr. Sunder advises. Think of the medications as just one arrow in your quiver for fighting high cholesterol.

What to do about statin weight gain

Achieving and maintaining a healthy weight is important for cholesterol management and for your health overall.

Follow a heart-healthy diet — like the Mediterranean diet — that contains a variety of plant-based foods, lean protein and limited processed foods. Aim for 150 minutes of moderate-intensity aerobic exercise per week and 15 minutes of strength training twice a week.

And even if you’ve gained a few pounds while taking statins, know that stopping the medication isn’t the way to go.

“The benefits of statins are far too important. And are much greater than any increased risk of weight gain,” Dr. Sunder emphasizes.

Instead, continue to take your medication. Talk with your healthcare provider about weight gain and other changes since you started taking statins. They can help you manage any side effects while keeping your cholesterol at a healthy level.