Did you know weight gain is common in people with heart failure? This is due to the heart not being able to pump effectively, leading to reduced circulation. Extra fluid may accumulate in your body if there is a decrease in the amount of blood going through your kidneys. As a result, you may gain weight. We spoke to our expert Dr C Raghu, Clinical Director and Senior Interventional Cardiologist, Yashoda Hospitals, Hyderabad, who explained the connection between heart failure and weight gain.
“Heart Failure is the inability of the heart to circulate blood adequately. Even though the term 'heart failure' seems like a catastrophic event, it is usually a gradual decline in heart function. It is not a disease per se, but a collection of symptoms caused by different diseases, such as heart attack, high blood pressure, ageing, obesity, heart valve problems, diabetes etc”, said Dr Raghu.
Challenges of Heart Failure Circulation
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Heart failure results in two main obstacles for the circulation, such as:
- Inadequate oxygen supply to various organs: It manifests as fatigue, mental confusion and pale skin
- Fluid builds up in various organs: This leads to weight gain, shortness of breath, cough and wheezing, loss of appetite, and swelling of legs, feet and abdomen
Mechanism of Weight Gain in Heart Failure
“Impaired heart function leads to reduced blood pressure and blood supply to the kidneys cascades a hormonal response. Abnormal hormone production leads to salt and water retention which results in weight gain”, added Dr Raghu.
“Weight gain is a gradual process and swelling is not evident in the early stages. At least five litres of water needs to be accumulated before the swelling of feet sets in and by the time the patient seeks medical attention nearly 20 litres is retained. Surprisingly, despite such a large volume of fluid accumulation, the patient might not experience symptoms”, said Dr Raghu.
Weight gain in heart failure indicates worse outcomes, such as the need for hospitalisation, sudden death, and abnormal heart rhythm. In a 2023 study, both weight gain (about 4.5 kg) and weight loss (about 8 kg), known as cardiac cachexia, were associated with worse outcomes.
Also Read: All About Heart Failure: Expert Debunks Myths About This Condition
Monitoring and Management of Weight Gain
Weight gain requires diligent daily weight monitoring. A weight gain of one kg over three days or two kg over one week is considered significant.
Dr Raghu highlighted, “Weight gain and monitoring of weight have not been shown to retard the chances of hospitalisation or death. However, it is customary for physicians to ask patients to monitor weight daily and suggest medicines that increase urine output as well as reduce salt intake in case of significant weight gain.”
Restriction of fluids is suggested for heart failure patients to avoid excess fluid logging. Usually, a fluid intake of 1.5-2.0 litres per day is advocated for heart failure patients and overzealous fluid restriction leads to worsening of kidney function.
How To Manage Weight Gain
Dr Raghu listed some steps to combat weight gain in heart failure as follows:
- Daily weight tracking
- Exercise programs and training, such as cardiac rehabilitation
- Adherence to medicines
- Heart-healthy diets and nutrition
- Management of cardiac risk factors such as diabetes, hypertension etc
Bottomline
Dr Raghu concluded, "Heart failure is a constellation of symptoms and weight gain is a predominant feature of worsening disease. Weight gain precedes symptoms and if addressed early results in improved patient symptoms. Patient education on weight management is an important measure to prevent worsening heart failure. Medicines and lifestyle modifications play an important role in managing heart failure-related weight gain."
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your expert if you are dealing with any health issues for necessary treatment.]