Pulmonary hypertension causes a decrease of blood flow to the heart and increased pressure in the lungs, which can limit ordinary activity. Shortness of breath, chest pain, and fatigue can make exercise difficult for people with pulmonary hypertension. With that difficulty comes with an increased risk of weight gain, especially if your diet stays the same while your activity level decreases. “Now with PH, I can't walk more than 100 feet without being out of breath and gasping for air, and I can't exercise,” one myPHteam member said.
A different member summed up why keeping weight off is so important: “The more you weigh, the harder your heart has to work and the more oxygen your body needs.”
A healthy weight is usually defined as having a body mass index (BMI) of 18.5 to 24.9 for adults ages 20 or older. A person is considered overweight if their BMI is 25 to 29.9 and obese if their BMI is 30 or over. BMI calculators are available online that can tell you which stage you are at.
If you have mild pulmonary hypertension, weight loss and exercise can effectively manage your condition as well as some oral medications. Most types of PH cannot be reversed by either method, but healthy diet and exercise can make managing the symptoms easier. One myPHteam member said, “I need to get serious about weight loss!”
Weight gain isn’t always caused by diet when you have PH. It can also be caused by fluid retention. “During summertime, the swelling due to water retention is almost unbearable. Being on a 1 liter fluid restriction due to heart failure makes it even worse,” one myPHteam member complained.
To keep fluid retention to a minimum, your doctor may put you on a 2 liter fluid restriction. You may also have a sodium-restricted diet, as sodium can cause fluid retention when the heart is functioning less effectively. Since fluid retention can mean a worsening of your condition, people with pulmonary hypertension are often advised to weigh themselves every day. “I really gain water weight and have problems breathing,” one member said about excess sodium.
Some members have reported weight gain as a side effect of their medications. It’s known that steroids can cause increased appetite. “I gained 50 pounds on Prednisone,” one member said. Another said, “I gained 50 pounds taking Lyrica.”
Even if weight gain is a result of increased caloric intake, losing weight can be possible. One myPHteam member had a whole routine for weight loss: “Staying away from steroids, drinking a half-gallon of water or more daily, walking at least 3 miles five days a week, physical therapy, and exercise without pain is how I lost weight.”
Weight loss involves several lifestyle changes. Start with just one change at a time if they all feel too overwhelming. Here are some of the most effective strategies for losing weight with PH.
Even a reduction of 500 calories a day can cause weight loss of a pound or more a week. One member said, “I just cut down on portions and my motto is ‘Don’t like, don’t eat.’” Another member found portion reductions were easier if plates were smaller. “I have gone to a measuring cup for my liquids, which is mostly water, but I use lemons a lot. I also changed my plate size to a cake plate.”
You might not be able to safely do every form of activity and should ask your doctor about the right exercise for you. Monitor your heart rate and, if you feel dizzy or lightheaded, stop right away. Try to limit walking activity to flat paths; inclines can cause dangerous blood pressure fluctuations.
If your symptoms are severe, ask your doctor about a cardiac rehabilitation program. It is designed to help those with heart disease and lung disease exercise safely. One myPHteam member described such a program, “They do help you learn how to breathe correctly, and you do slow and easy workouts to build your strength.”
“I have lost 47 pounds since 2018 just from PT exercises and walking with my [walker] at or up to 3 miles a day,” one member reported. Another said, “On the days I’m OK, I try to log as much time as possible on the treadmill.” A third member recommended, “Low impact aerobics, stretching exercises, leg lifts, using a pulley on arms.”
Choose whole, healthy foods as much as possible. It is much harder to eat excessive calories of fruits, vegetables, whole grains, and low-fat meat and dairy products than junk foods with high saturated fat or sugar content and little other nutrition. “I find that by making good choices from healthy foods, I can maintain my weight,” one member said. Pulmonary arterial hypertension (PAH) is especially affected by diabetes, insulin resistance, and other health problems associated with obesity.
Be aware of the main habits that can cause weight gain: grazing (eating small bits of food throughout the day), binging (eating large amounts of food in one sitting), snacking, and not counting the consumption of excess liquid calories. Any of these can cause extra calories and weight gain. “Stop eating. Only when you are hungry,” one member advised another on weight loss.
Many diet medications have no effect at all, and others contain stimulants like caffeine — which should be avoided by people with pulmonary hypertension. One formerly sold diet medication, fen-phen, is associated with pulmonary hypertension as a side effect. People who used fen-phen have a 23-fold increased risk of PH.
Try to keep away from diets that decrease or eliminate one type of food, such as carbohydrates or fat. One member warned others about the keto diet, “Our bodies need ALL the nutrients to function well, especially when it is battling a chronic disease.”
Such diets are difficult to maintain over a long period of time, and people who live with pulmonary hypertension need to take in a healthy balance of nutrients, electrolytes, and fluids.
Another member said this about drastic diets: “I have been lectured by many of my doctors about how unhealthy they are to my body with diabetes, renal, cardiac, pulmonary hypertension and other conditions going on with my body.” This is especially important for people taking Coumadin (Warfarin), potassium, or diuretic medications. If you’re not sure if your intended weight loss plan is safe for PH, ask your doctor before you start.
Members of myPHteam share their experiences with pulmonary hypertension, including their plans for diet and exercise. Here are some recent conversations on myPHteam about weight loss:
Are you trying to lose weight? Have you found any methods that work for you? Comment below or start a conversation on myPHteam.