If you're on a weight loss journey, you're probably thinking about all the positive effects that may come from meeting your health goals – a healthier physique, better sleep, or more energy, for example.
But with weight loss can also come some weird, wonky side effects, says Carolynn Francavilla Brown, MD, a Colorado family doctor, obesity specialist, and diplomate of the Board of Obesity Medicine. Eustachian tube dysfunction (ETD) is one lesser-known side effect of losing weight.
Eusta-what?
Francavilla Brown, who hosts a podcast about weight and health, sat down with WebMD to explain more about eustachian tube dysfunction and other strange side effects that can result from weight loss. (Spoiler alert: One of them may require new seat padding.) She also shares what you can do if these conditions pop up when the weight comes off.
WebMD: What exactly is eustachian tube dysfunction?
Francavilla Brown: Eustachian tubes are the tubes behind your ears that connect to your sinus. They have three main functions: draining fluid, controlling air pressure, and protecting your middle ear. So when you have dysfunction of that, you'll hear a lot of popping in your ears. They might feel plugged, or you may have an echo sensation. It can be a very annoying feeling, like that feeling you might get when you're on an airplane and change altitude, except it's recurrent. Some people get ETD from allergies. Smoking is also a common cause.
WebMD: How does eustachian tube dysfunction result from losing weight?
Francavilla Brown: Fat is one of the things that's supporting structures in our body. If you lose a lot of fat in the area around [your] eustachian tube, the tube can become what we call pendulous, which is a fancy word for saggy. [This can lead] to a popping or plugged feeling because the tube might not be clearing out mucus the way it should be.
WebMD: How common is eustachian tube dysfunction for people who lose weight?
Francavilla Brown: It can actually be a really common side effect for people who have excess weight loss or who have a really large amount of weight loss. A study in International Archives of Otolaryngology, for instance, found that 47% of people who got bariatric surgery had symptoms of eustachian tube dysfunction at a six-month follow-up.
Although the study focused on bariatric surgery, ETD can result from any large amount of weight lost, such as surgery, GLP-1s, or lifestyle changes. I suspect we will see more ETD in the future because of the volume of weight loss we see from GLP-1 [medications].
WebMD: How long can this problem last and is it harmful for your hearing?
Francavilla Brown: It can last for quite a long time because that tube doesn't necessarily always get back to a nice shape the way it was supposed to be. It definitely can be pretty persistent for some people. It doesn't always get better. It's not really harmful in any way. It's just very annoying.
WebMD: Are there remedies to help cure it?
Francavilla Brown: Because the ETD is caused by loss of the supporting tissue from weight loss, it can be hard to treat. It does often get better with time.
Avoiding caffeine, staying hydrated, and trying to "clear your ears" are strategies. This could be yawning, swallowing, chewing gum, or what's called the Valsalva maneuver, where you breathe forcefully with your mouth closed, while pinching your nostrils.
Otherwise, if your symptoms persist, you may want to visit an ENT [ear, nose, and throat doctor]. They can sometimes offer special nasal sprays or drops or surgical treatments to help.
WebMD: What are some other weird side effects of weight loss?
Francavilla Brown: Another one is Slimmer's paralysis. Fat is serving a role in our body, and so it provides cushion around lots of our different body parts, including our nerves. If you lose too much fat on the side of your leg around the peroneal nerve, that nerve can get pinched. It can lead to pain or burning in the nerve, and can even lead to lack of function, meaning that you would have a foot drop.
You [could potentially] be dragging your foot behind you. That's something you would want to have recognized right away, so that it could be treated. You may even need surgery because it can become irreversible, meaning that you would not walk normally again. But this is a rare side effect seen in people who've had a very large weight loss.
Dizziness is a more frequent one that we see. Again, that can happen with any type of large weight loss, whether someone has gotten surgery, used a GLP-1 medication, or done an aggressive diet where they've lost a lot of weight. A lot of times people's blood pressure will get lower, and that can be a beneficial thing for people with high blood pressure, but sometimes it gets too low and their body isn't used to it yet. That will create dizziness, especially when going from sitting to standing or lying to standing. [In rare cases], they could pass out. Dizziness does tend to get better with time. That usually only sticks around for about six months or so for most people.
WebMD: What can people do about dizziness if they have it?
Francavilla Brown: Definitely make sure you are staying hydrated. They may need to incorporate electrolytes, so maybe having an electrolyte drink daily if they're having a lot of dizziness. Avoid standing for really prolonged periods of time, and some people may even benefit from wearing compression socks or sleeves to help return blood flow to their heart. [But if you are getting dizzy, talk to your doctor right away because there can be many other causes.]
WebMD: On your podcast, you also spoke about discomfort sitting in chairs after losing weight and body temperature changes. What are those about?
Francavilla Brown: Fat provides cushion for our body. So sitting in different positions or sitting on your chair may be less comfortable than it used to be when you have less adipose tissue there. I've heard from patients who can't believe how uncomfortable certain chairs are since they've lost weight!
Also, patients talk about feeling more cold. There's two mechanisms for that. The first is that one of the roles of our adipose or fat tissue is it provides insulation and keeps us warm. So when you have less of that fat tissue, you have less insulation keeping you warm. The second part is that when you have lost a large amount of weight, your metabolic rate goes down. Your body is actually conserving energy in different ways. One of those is, it actually will make your temperature lower. [In addition], you might not grow as much hair, or your nails might not be as strong. And you might feel colder because your body is not putting as much energy into keeping your body warm because it's trying to decrease that metabolic rate so that you don't lose more weight.
WebMD: Does the cold feeling eventually go away?
Francavilla Brown: I would say that tends to get less bothersome over time. But most people, if they keep the weight off, they will continue to find that they're colder than they used to be. They may need to dress differently or bring a sweater when they go out to help warm up.
