DRINK A FEW too many beers or eat an extra slice of pizza or two and you might wake up feeling bloated and generally puffy. So you might think popping a water pill will help you de-bloat.
Water pills, also known as diuretics, will likely make you pee, but they won’t really help with bloating or weight loss, doctors say—even though there are several over-the-counter options that promise to do so.
“Diuretics are a family of medicines that work at the kidney level to move sodium, fluid, and other electrolytes out of the body,” explains Jonathan Adam Fialkow, M.D., deputy director of clinical cardiology at Baptist Health Miami Cardiac & Vascular Institute.
The drugs are mainstays in the treatment of hypertension, heart failure, and some endocrine conditions, he adds. Diuretics are actually one of the most prescribed types of medications, mainly because the conditions they treat are so common.
In some instances, water pills could temporarily reduce bloating or water weight, but they’re not typically prescribed (or recommended) for this purpose, says Amar Shere, M.D., a cardiologist at Morristown Medical Center, which is part of Atlantic Health System.
“Essentially, you’re losing body water, which may appear to be weight loss; however, as soon as the water returns to the body, the weight is typically regained,” he explains.
Taking water pills could also possibly cause dehydration, electrolyte imbalance, or dizziness, says Mary Greene, M.D., a cardiologist with Manhattan Cardiology in New York City and contributor to LabFinder. So, it’s better to talk to your doctor first.
How do water pills work?
High blood pressure typically casues excess fluid retention, also known as edema, says family medicine physician Mark Loafman, M.D. This puts strain on blood vessels and the heart. And when the heart’s output is decreased, it can trigger the kidney to retain fluid.
Diuretics increase sodium and water excretion from the kidneys, reducing overall blood volume, Dr. Shere says. This decreases pressure on blood vessel walls and lowers blood pressure.
Some also work by blocking hormones in the kidneys, Dr. Fialkow says. Others help relax blood vessels to allow blood to flow more easily.
With heart failure, the heart’s ability to pump blood to the rest of the body is impaired, causing fluid buildup. Diuretics work via different mechanisms to remove the excess fluid, reduce swelling, and minimize symptoms, Dr. Shere says.
“Diuretics reduce the heart’s workload by decreasing the volume of blood returning to the heart, making it easier for the heart to do its job,” he explains. Ultimately, this reduces your risk of heart attack, stroke, and heart failure.
Why are water pills typically prescribed?
Diuretics are the standard first-line treatment for hypertension, kidney disease, and several types of heart disease, Dr. Loafman says. “These conditions are generally associated with some degree of fluid overload or edema, and diuretics are often one of the most effective ways of helping eliminate some of the excess fluid.”
The drugs might also be prescribed for electrolyte imbalances, deep vein thrombosis, or venus stasis, where the blood flow to the legs is slowed, Dr. Greene says.
Liver cirrhosis, lymphedema (tissue swelling that often occurs in the arms and legs), and hormonal disorders, such as hyperaldosteronism, where the body produces too much of the hormone that regulates sodium and potassium, Dr. Shere says.
There are a few different types of diuretics, including thiazide diuretics, loop diuretics, potassium-sparing diuretics, and others, he adds. Doctors will determine which type is best for you based on your health issues.
What are the side effects?
Most diuretics are safe and well-tolerated when they’re prescribed and managed by a physician, Dr. Fialkow says.
But depending on the specific diuretic, some people might experience side effects such as light-headedness, dehydration, dry mouth, or low potassium levels, he explains.
Increased urination, electrolyte imbalance, headaches, low blood pressure, and headaches are other potential side effects, Dr. Shere says.
If you’re taking diuretics and experience any side effects, talk to your doctor.
Can water pills help with de-bloating and weight loss?
Water pills can sometimes temporarily reduce bloating and weight when caused by fluid retention, Dr. Shere says.
The medications will make you pee more frequently, which does remove excess water, so any weight loss is related to water loss, not fat loss, Dr. Shere explains.
Diuretics typically aren’t prescribed for weight loss or bloating—they also shouldn’t be considered a long-term weight loss solution, he explains. “Their use for weight loss can also often lead to a high risk of misuse and adverse health effects, especially in individuals with eating disorders.”
Bloating is usually a digestive issue related to constipation or irritable bowel syndrome, which diuretics won’t help, Dr. Greene adds.
Should you take an OTC diuretic?
Doctors typically don’t recommend taking over-the-counter diuretics. Dr. Fialkow says the products usually have a weak diuretic effect. Some contain caffeine and could cause heart palpitations, while only having a minimal or transient effect on bloating or water weight.
“If one uses a diuretic to decrease bloating, understand what it may do to your body, how it may interact with other foods and medications, but generally what is labeled as ‘diuretic’ over the counter is very mild compared to the medications we use for medical conditions,” Dr. Fialkow explains.
OTC diuretics could also increase your risk for dehydration or electrolyte imbalance, Dr. Shere says.
Adding certain foods to your diet, like fruits, vegetables, and beans, can increase your fiber intake and help minimize bloating, Dr. Loafman says.
If you’re frequently bloated, seem to retain water, or want to lose weight, Dr. Loafman recommends talking to your doctor. They can test you for health conditions, such as gastrointestinal problems or high blood pressure, and prescribe medications and recommend diet and lifestyle changes that can help.
