Should I Take Spironolactone for Weight Loss?

Diuretics flush the water, but not the weight

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Obesity and being overweight affects close to 40% of United States adults, according to the National Center for Health Statistics. This epidemic has caused many people to turn to fad diets, fat-burning supplements, and prescription drugs for quick weight loss.

One drug prescribed for weight loss is spironolactone. However, no scientific study has evaluated this medication specifically for weight loss. Though often prescribed, it remains unclear if spironolactone is effective for losing weight.

Woman holding spironolactone and benefits are listed
Illustration by Emily Roberts, Verywell.

What Is Spironolactone?

Spironolactone (Aldactone) is a prescribed diuretic, which means that it causes fluid elimination from the body, according to the US National Library of Medicine. Spironolactone was approved by the U.S. Food and Drug Administration (FDA) to treat a variety of health issues.

The primary function of spironolactone is treating fluid retention in the body, which often leads to weight loss. However the weight loss that occurs consists of only water weight. Diuretics effectively flush out water from the body, not fat.

Spironolactone is described as a potassium-sparing diuretic, or water pill. As your body flushes water, spironolactone is supposed to prevent your body from absorbing too much sodium and nevertheless keep your potassium levels from getting too low.

Spironolactone also blocks the body's androgen receptor and some of the production of androgens. Androgens are a group of hormones responsible for male traits and reproductive activity. Androgens are made in the testes, ovaries, and adrenal glands. Testosterone is the main androgen in men and converts into the estrogen hormone in women. 

Uses

There are some prescribed uses for spironolactone. For instance, a woman with PCOS (causing high testosterone levels) who experiences hair loss or excess body hair may be prescribed spironolactone to relieve these symptoms. But people also use the medication off label for weight loss and fat loss.

Prescribed Uses

Spironolactone is prescribed to treat several health conditions, including the following:

  • Fluid buildup from liver disease
  • High blood pressure
  • Low potassium (it raises levels, giving its name “potassium-sparing”)
  • Symptoms related to excess androgen production in females

Women who produce too much testosterone are often prescribed spironolactone to decrease the symptoms caused by an overproduction of this hormone. The following conditions are related to excess androgen production in females:

  • Acne
  • Excessive body or facial hair growth
  • Female-pattern hair loss
  • Polycystic ovary syndrome (PCOS)

Weight Loss 

Spironolactone will cause the elimination of water from the body, causing weight loss, but it does not cause fat loss directly. Losing body water is not the same as losing body fat through healthy nutrition and exercise. You may become less bloated using a diuretic, but the weight will return once body fluid levels return to normal.

In some cases, taking spironolactone might result in the loss of body fat. For instance, a woman who already has high testosterone levels that contribute to insulin resistance (making it difficult to lose body fat) may find that lowering these levels with spironolactone helps with fat loss.

On the other hand, testosterone often raises metabolism and makes building muscle easier. This makes lowering the levels with medication a double-edged sword. Although spironolactone may relieve symptoms caused by fluid retention and could be helpful for specific health conditions, there is no evidence that it promotes healthy long-term weight loss.

No scientific studies have examined spironolactone specific to weight loss, so its effectiveness for this purpose remains unknown.

Side Effects

Taking any prescribed medication, including spironolactone, comes with side effects. Spironolactone can cause changes in blood levels of potassium. If changes are severe enough, this can result in death. Spironolactone can also interact with other drugs and may be harmful if taken during pregnancy. It can cause breast tenderness, and a stopping of periods for women, among many other symptoms.

Some of the most common side effects of taking spironolactone include:

  • Breast tenderness in women
  • Dizziness
  • Drowsiness
  • Dry mouth
  • Enlarged breast tissue in men (gynecomastia)
  • Headache
  • Irregular menstrual periods
  • Post-menopausal vaginal bleeding
  • Stomach upset, vomiting, and diarrhea

Other more severe side effects include:

  • Arrhythmia
  • Confusion
  • Decreased urination 
  • Difficulty breathing or swallowing
  • Flu-like symptoms
  • Muscle pain or weakness
  • Numbness or tingling
  • Serious skin reactions
  • Unusual bleeding or bruising

Though it may help in specific cases, spironolactone is not a weight loss drug. Spironolactone needs to be used with caution and under the supervision of a qualified health care provider.

A Word From Verywell

Spironolactone is approved by the FDA to treat a variety of health conditions. But physicians warn that no one should ever take a water pill to lose weight. However, spironolactone can be used effectively for specific health conditions.

But spironolactone should not be taken unless prescribed by a health care professional. If you are taking spironolactone, your blood levels should be monitored regularly. Consult your health care professional prior to taking any medications.

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Article Sources
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  1. Centers for Disease Control and Prevention. Overweight and Obesity. Adult Obesity Facts. Obesity is a common, serious, and costly disease. Page last reviewed February 27, 2020.

  2. US National Library of Medicine. MedlinePlus. Spironolactone. Updated 16 March 2020.

  3. Faconti L, Mills CE, Govoni V, et al. Cardiac effects of 6 months' dietary nitrate and spironolactone in patients with hypertension and with/at risk of Type 2 diabetes, in the factorial design, double-blind, randomized controlled VaSera trialBr J Clin Pharmacol. 2019;85(1):169–180. doi:10.1111/bcp.13783

  4. Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clin Epidemiol. 2013;6:1-13. doi:10.2147/CLEP.S37559

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