Propranolol (propanolol hydrochloride) is a beta-blocker medication commonly prescribed for high blood pressure, anxiety, migraines, and heart conditions. Many people taking this medication wonder whether it might affect their weight, especially since concerns about weight gain can influence medication adherence and overall treatment satisfaction.
Key Takeaways
Some people taking propranolol experience small weight gains, while many do not. Clinical studies report modest average increases of around 2.6 lb over six months or longer in some samples, and larger differences in specific long-term trials, but results vary by the study population, dose, and treatment duration.
The mechanism likely involves reduced metabolism and decreased physical activity capacity rather than increased appetite, as propranolol can lower resting metabolic rate by a few percent (~40-100 kcal/day per day as reported in small trials).
If you're concerned about weight changes on propranolol, talk to your healthcare provider about monitoring strategies, lifestyle adjustments, or alternative medications rather than stopping treatment on your own.
What is Propranolol?
Propranolol belongs to a class of medications called beta-blockers, which work by blocking the effects of adrenaline on your heart and blood vessels. The medication slows your heart rate, reduces blood pressure, and decreases the heart's oxygen demand.
Healthcare providers prescribe propranolol for several conditions:
High blood pressure (hypertension)
Irregular heart rhythms (arrhythmias)
Chest pain (angina)
Migraine prevention
Essential tremor
Anxiety and performance anxiety (off-label use)
Hyperthyroidism symptoms
Post-traumatic stress disorder (PTSD)
The medication comes in immediate-release and extended-release formulations, with dosages ranging from 60mgto 320mg daily, depending on the condition being treated. Both variants of Propranolol work differently, and one cannot be substituted for the other without proper medical advice.
Note: Medication details of Propranolol, including dosage and usage, are provided for general understanding and are not a prescription recommendation. Always consult a licensed healthcare provider before starting, changing, or discontinuing any medication.
The Connection Between Propranolol and Weight Changes
The relationship between propranolol and body weight is complex, with research showing mixed results and individual experiences varying considerably.
What Research Shows
Clinical studies show that propranolol can lead to modest weight gain in some patients. In a randomized trial of patients who took propranolol after a myocardial infarction (heart attack), those treated with the medication gained on average around 2.3 kg (a little over 5 pounds) as opposed to the placebo group that gained 1.2 kg (approximately 2.6 pounds) on average over a one year period. This difference persisted on follow-up.
However, these results are specific to that population and may not apply to all people taking propranolol. Generally, the amount of weight gain varies considerably between individuals and may also depend on the dose and duration of medication and the type of beta-blocker used.
Not Everyone Gains Weight
It's important to understand that weight changes on propranolol are not universal. In a study of 367migraine patients where 13 patients were treated with propranolol, only one of those taking propranolol (about 8%) experienced weight gain after six months, meaning the majority of patients maintained their weight during treatment.
Individual factors that influence whether you'll gain weight include:
Baseline metabolism and body composition
Activity level before and during treatment
Dosage and duration of treatment
Other medications being taken
Underlying health conditions
Dietary habits and lifestyle
How Propranolol May Affect Weight
Understanding the mechanisms behind potential weight changes can help you and your healthcare provider develop strategies to manage this side effect.
Reduced Metabolic Rate
Beta-blockers like propranolol work by blocking the body's response to adrenaline and related stress hormones. This action can affect how your body burns calories at rest and during routine activities.
Research suggests that propranolol may influence metabolism through several mechanisms. Studies indicate that blocking beta receptors reduces the body's thermogenic response to food and decreases resting energy expenditure (REE), both of which can lead to small weight changes over time.
Research on glucose metabolism found that propranolol reduced energy expenditure during glucose processing, suggesting the medication affects how efficiently the body uses energy from food.
The metabolic effects appear to be more pronounced in certain situations. Beta-blockers can inhibit facultative thermogenesis (the extra calories burned in response to food, cold, and stress), which diminishes daily energy expenditure and may promote weight gain.
Decreased Physical Activity and Fatigue
One of the most common side effects of propranolol is fatigue, which can indirectly contribute to weight changes by reducing exercise tolerance and overall activity levels.
How fatigue affects weight:
Lower energy levels make exercise feel more difficult
Reduced motivation for physical activity
Less movement throughout the day (non-exercise activity)
Earlier bedtime or more sedentary behavior
When tired individuals move less, fewer calories are utilized, which can result in gradual weight gain over time. This effect can be particularly noticeable for people who were previously very active, as the medication may limit their exercise capacity.
Changes in Appetite and Eating Patterns
While not the primary mechanism, some people report changes in appetite when taking propranolol, though research findings on this are mixed.
For example, one case study reported a patient who gained 3 kg (about 6.6 lbs) in two weeks due to "uncontrollable overeating", which ceased when the drug was stopped. However, this doesn't appear to be the most common pathway for weight changes.
Metabolic and Hormonal Effects
Propranolol can affect how your body processes glucose and responds to insulin. Clinical studies using standardized methods to measure insulin sensitivity have found that treatment with propranolol can significantly decrease insulin sensitivity in hypertensive patients.
Research also suggests that blocking beta receptors using propranolol may affect post-meal lipolysis (breakdown of fats), leading to lower availability of free fatty acids, which may influence energy partitioning and fat storage.
These metabolic changes don't typically cause diabetes in otherwise healthy individuals, but they represent subtle shifts in how the body processes energy that could contribute to weight changes over time.
Individual Factors That Influence Weight Changes
Not everyone who takes propranolol may experience weight gain. Several personal factors influence whether and how much your weight might change on this medication.
Baseline Activity Level
People who are physically active before starting propranolol may notice weight changes more than sedentary individuals, particularly if the medication affects their exercise capacity or energy levels.
Dosage and Duration
Higher doses of propranolol and longer treatment duration appear to be associated with a greater likelihood of weight changes. The studies showing weight gain typically involved long-term use (months to years) rather than short-term treatment.
Age and Overall Health
Older adults and people with certain medical conditions may be more susceptible to metabolic changes from propranolol.
Other Medications
Taking propranolol alongside other medications that affect weight or metabolism can compound effects.
Comparing Propranolol to Other Beta-Blockers
Different beta-blockers have varying effects on body weight, which is an important consideration when choosing treatment.
Older Beta-Blockers
Weight gain is more likely with older beta-blockers such as propranolol, atenolol, and metoprolol, with the average weight gain being approximately 2.6 pounds. These medications are classified as non-selective or older-generation beta-blockers without vasodilating properties.
Research comparing metoprolol to carvedilol (a newer generation beta-blocker) in patients with diabetes and hypertension found that metoprolol-treated patients gained an average of 1.19 kg over five months, while carvedilol-treated patients showed no significant weight change.
Newer Beta-Blockers
Comparative studies suggest newer beta-blockers with vasodilating properties, such as carvedilol, nebivolol, and labetalol, are less likely to be associated with weight gain than older agents such as metoprolol or propranolol, but individual responses vary and drug choice should be individualized..
In patients with a higher body mass index, the difference was even more pronounced, with obese patients on metoprolol gaining significantly more weight compared to those on carvedilol.
The difference in weight effects between older and newer beta-blockers relates to their different mechanisms of action and metabolic effects.
Managing Weight While Taking Propranolol
If you're taking propranolol and are concerned about weight changes, several strategies can help you maintain a healthy weight.
Dietary Approaches
Focusing on nutrient-dense, whole foods can help counteract the metabolic effects of propranolol:
Emphasize vegetables, fruits, lean proteins, and whole grains
Control portion sizes to match your potentially reduced energy expenditure
Limit processed foods, added sugars, and excessive calories
Stay hydrated throughout the day
Consider smaller, more frequent meals to support steady energy
Physical Activity Strategies
Exercise remains important, though you may need to adjust your approach:
Work with your healthcare provider to determine safe exercise parameters
Focus on consistency rather than intensity if fatigue is an issue
Include both aerobic activity and strength training
Monitor your heart rate, as beta-blockers lower maximum heart rate
Build activity into daily routines (stairs, walking, active hobbies)
Monitoring and Communication
Regular tracking helps you and your healthcare provider make informed decisions:
Weigh yourself regularly (weekly is often sufficient)
Keep a food and activity journal
Note any changes in energy levels or exercise tolerance
Track your symptoms and medication effects
Report sudden weight increases promptly (for example, several pounds over a few days), as rapid gain can reflect fluid retention or other problems requiring urgent evaluation
When to Talk to Your Healthcare Provider
You should discuss weight concerns with your doctor if:
You gain more than 5 pounds within the first few months of treatment
Weight gain continues beyond the first 3-6 months
You experience significant fatigue that limits daily activities
You're having difficulty maintaining a healthy weight despite lifestyle efforts
You notice sudden, rapid weight gain (possible fluid retention)
You're concerned about metabolic changes or diabetes risk
Alternative Medication Options
If weight gain becomes problematic, your healthcare provider might consider:
Switching to a newer beta-blocker like carvedilol or nebivolol
Changing to a different class of medication for your condition
Adjusting your current dose
Adding medications that don't affect weight
Combining treatments for optimal management
Note: Never stop taking propranolol or change your dose without medical supervision, as this can be dangerous for certain conditions, especially heart conditions.
The Bottom Line
Propranolol can contribute to modest weight gain in some patients, with research showing modest increases of around 2.6 lb over six months or longer in some samples. The weight changes are likely the result of a reduced metabolic rate and decreased physical activity capacity rather than a dramatically increased appetite.
However, it's important to remember that not everyone experiences weight gain on propranolol, and when it does occur, it typically stabilizes after the first few months rather than continuing indefinitely. Individual factors, including age, baseline activity level, dosage, and overall health, significantly influence whether weight changes occur.
If you're taking or considering propranolol, the medication's benefits for your specific condition should be weighed against potential side effects. Many people successfully manage their weight while taking propranolol through mindful eating, regular physical activity adapted to their energy levels, and close communication with their healthcare providers.
For those who do experience problematic weight gain, alternatives exist. Newer beta-blockers like carvedilol may offer similar benefits with fewer weight-related side effects. Your healthcare provider can help you find the best treatment approach that balances effective management of your condition with your overall health goals, including maintaining a healthy weight.
Medical Disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified healthcare provider with any questions you may have regarding medications or mental health treatment. Never disregard professional medical advice or delay seeking it because of something you have read in this article. If you are experiencing a mental health crisis, call 988 (Suicide and Crisis Lifeline) or seek immediate emergency care.
Sources
Mayo Clinic Staff. (2023). Beta blockers: Do they cause weight gain? Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/beta-blockers/faq-20058385
Rossner, S., Taylor, C. L., Byington, R.P. et al. (1990). Long term propranolol treatment and changes in body weight after myocardial infarction. British Medical Journal, 300(6729):902–903. https://pmc.ncbi.nlm.nih.gov/articles/PMC1662668
Senn, J. R., Loliger, R. C., Fischer, J. G., et al. (2023). Acute effect of propranolol on resting energy expenditure in hyperthyroid patients. Frontiers in Endocrinology, 13:1026998. https://pmc.ncbi.nlm.nih.gov/articles/PMC9892445/
Acheson, K. J., Ravussin, E., Wahren, J. et al. (1984). Thermic effect of glucose in man. Obligatory and facultative thermogenesis. The Journal of Clinical Investigation, 74(5):1572–1580. https://pmc.ncbi.nlm.nih.gov/articles/PMC425334/
Elsevier. (n.d.). Propranolol – Neuroscience topic overview. ScienceDirect. Retrieved November 11, 2025, from https://www.sciencedirect.com/topics/neuroscience/propranolol
Lamont, L. S. (1995). Beta-blockers and their effects on protein metabolism and resting energy expenditure. The Journal of Cardiopulmonary Rehabilitation, 15(3):183-5. https://pubmed.ncbi.nlm.nih.gov/8542522/
U.S. National Library of Medicine. (2024). Propranolol hydrochloride tablet, film coated [DailyMed monograph]. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a4edba76-29b8-41fb-bf0b-d4633abba003
Shahrokhi, M., & Gupta, V. (2023). Propranolol. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK557801/
Maggioni, F., Ruffatti, S., Dainese, F. et al. (2005). Weight variations in the prophylactic therapy of primary headaches: 6-month follow-up. The Journal of Headache and Pain, 6(4):322-4. https://pubmed.ncbi.nlm.nih.gov/16362700/
Welle, S., Schwartz, R. G., & Statt, M. (1991). Reduced metabolic rate during beta-adrenergic blockade in humans. Metabolism, 40(6):619-22. https://pubmed.ncbi.nlm.nih.gov/1650879/
Shahrbabaki, M. E., Nasirian, M., & Shahrbabaki, P. E. (2015). Extreme weight gain due to short-term use of low-dose propranolol. Journal of Mazandaran University of Medical Sciences. https://consensus.app/papers/extreme-weight-gain-due-to-shortterm-use-of-lowdose-shahrbabaki-nasirian/30a407e7a6e855a7aac1d1b850de0503/
Lithell, H. O. (1991). Effect of antihypertensive drugs on insulin, glucose, and lipid metabolism. Diabetes Care, 14(3):203-9. https://pubmed.ncbi.nlm.nih.gov/1828417/
Christin, L., Ravussin, E., Bogardus, C. et al. (1989). The effect of propranolol on free fatty acid mobilization and resting metabolic rate. Metabolism, 38(5), 239-444. https://doi.org/10.1016/0026-0495(89)90195-9
Messerli, F. H., Bell, D. S., Fonseca, V. et al. (2007). Body Weight Changes with β-Blocker Use: Results from GEMINI. The American Journal of Medicine, 120(7), 610-615. https://www.amjmed.com/article/S0002-9343(06)01261-7/abstract
