title: Adverse Effects of β-Blocker Therapy on Weight Loss in Response to a Controlled Dietary Regimen.
abstract: The effects of β-blockers on metabolic parameters including weight loss are poorly understood.
  
  
  
  From a database of 3582 patients who completed The Ottawa Hospital Weight Management Program between 1992 and 2011, a total of 173 patients were receiving β-blockers and were eligible for the study. We determined differences in rate of weight loss in the first 6 weeks of this 900 kcal/d Optifast (Nestlé Health Science, Vevey, Switzerland) meal replacement program for patients treated with β-blockers compared with (1) matched controls and (2) all participants in the program not being treated with β-blockers. Secondary outcomes included changes in waist circumference.
  
  
  
  Mean percent weight loss in the β-blocker group was reduced compared with the rest of the group (9.7% vs 10.0%; P = 0.0001) as well as with matched controls (9.7% vs 10.3%; P = 0.004). Results were the same after adjusting for prevalent cardiovascular disease (9.7% vs 10.0%; P = 0.006). Similarly, a smaller decrease in waist circumference at 6 weeks was observed in the β-blocker-treated group compared with the rest of the group (-24.2 vs -26.3 cm; P = 0.002) and with matched controls (-24.2 vs -25.2 cm; P = 0.04) and was not altered by adjustment for cardiovascular disease (-24.2 vs 26.3 cm; P = 0.004).
  
  
  
  In the absence of a clear medical indication, alternatives to β-blockers should be considered for the treatment of hypertension in obese individuals.
authors.affiliation: Department of Medicine, The Ottawa Hospital Weight Management Clinic, Ottawa, Ontario, Canada.
authors.forename: Mirna
authors.initials: M
authors.lastname: Azar
authors.affiliation: Ruddy Canadian Cardiovascular Genetics Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Majid
authors.initials: M
authors.lastname: Nikpay
authors.affiliation: Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Mary-Ellen
authors.initials: ME
authors.lastname: Harper
authors.affiliation: Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Ruth
authors.initials: R
authors.lastname: McPherson
authors.affiliation: Department of Medicine, The Ottawa Hospital Weight Management Clinic, Ottawa, Ontario, Canada. Electronic address: bdent@toh.on.ca.
authors.forename: Robert
authors.initials: R
authors.lastname: Dent
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects*; D000328:Adult; D016022:Case-Control Studies; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy*; D055105:Waist Circumference / Q000187:drug effects; D015431:Weight Loss / Q000187:drug effects*; D061217:Weight Reduction Programs
chemical_list: D000319:Adrenergic beta-Antagonists