The kind of weight gain that heart problems can cause is not the same that’s caused by eating too much.

In fact, weight gain from chronic heart failure has absolutely nothing to do with body fat.

“Heart failure can lead to weight gain due to fluid retention most likely seen in the lower extremities, though much fluid can accumulate in the abdomen as ascites or in the chest as pleural effusions,” says cardiologist and internal medicine specialist Norman E. Lepor, MD, who’s with Cedars Sinai in Beverly Hills, CA.

In the lower extremities, the weight gain presents as swelling around the ankles and lower legs.


This fluid retention can extend higher up in the legs and affect the groin area.

A person with chronic heart failure (formerly more commonly referred to as “congestive” heart failure) can gain five pounds of fluid weight in a single night.

This is why people with chronic heart failure are instructed to weigh themselves first thing every morning — and never skip a morning.

Why this Heart Problem Causes Sudden Weight Gain

Though fluid retention can be caused by a variety of illnesses, chronic heart failure is a very common cause.

Fluid in the lungs is called a pleural effusion, and this will show up on a CT scan or X-ray.

Dr. Lepor says that this fluid retention in heart failure patients is treated with diuretics and salt (sodium) restriction.

The diuretics, such as Lasix, treat the symptom, not the underlying disease process.

Another name for the fluid retention or “swelling” is edema.

The fluid can cause, for instance, an increase of eight pounds over a period of just several days — despite the patient not changing their eating habits. 

Men and women with chronic heart failure are urged to also document their weight every morning to see if there’s any unexplained weight gain from week to week, not just day to day.

Not all people with chronic heart failure develop the edema in their lower extremities.

For some, the sudden weight gain could be in their abdomen (ascites; pronounced uh-sight-eez) or the pleural effusion (excess fluid around the lungs).

Having performed over 4,000 coronary angiograms and angioplasties, Dr. Lepor has focused on prevention and treatment of coronary heart disease. 
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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