Weight Loss and Unrelated Ear Symptoms
Nancy, a 45-year-old CFO of an energy company, came to see me for difficulty losing weight. Over six months, she had gained 15 pounds amidst significant work and family stress. We discussed stress management strategies, increased her physical activity, and connected her with a dietitian. I also started her on a low dose of Zepbound.
Five months later — and 15 pounds lighter — Nancy reached out after visiting her ENT for right-sided ear pressure and a sensation of clogging. Surprisingly, instead of diagnosing earwax buildup, he suggested her symptoms were related to rapid weight loss.
So how can weight loss cause such seemingly unrelated ear symptoms?
The eustachian tube is a small passage that connects the middle ear to the back of the nose. Its job is to equalize pressure and drain fluid. When it isn’t working properly, people may feel ear fullness, popping, muffled hearing, or even hear their own voice or breathing unusually loudly.
Rapid weight loss can sometimes trigger a condition called patulous eustachian tube dysfunction. Normally, a small cushion of fat surrounds the eustachian tube and helps it stay closed. With significant weight loss, that fat pad can shrink, causing the tube to stay open and transmit internal sounds directly to the ear.
For many people, these symptoms gradually improve as their weight stabilizes and the body adjusts. In the meantime, there are supportive strategies an ENT can recommend to ease the discomfort:
At-home and conservative strategies:
Stay well hydrated — dryness can make symptoms worse.
Try lying down or lowering your head — this increases blood flow around the tube and may temporarily relieve symptoms.
Avoid decongestant nasal sprays or pills — they can thin tissues and make the problem worse.
Medical and ENT-guided options:
Special nasal drops (like saline or estrogen) may help the tube stay closed.
In-office treatments designed to gently inflame the eustachian tube lining can help thicken tissues around the tube opening.
In more persistent cases, an ENT may use fillers (fat, cartilage, or other materials) to restore the “cushion” and reduce the tube’s openness.
Surgery is a last resort, reserved for severe and stubborn cases.
Nancy opted for conservative management. She focused on hydration and lowered her Zepbound dose to prevent further weight loss. Since her case was mild, her symptoms improved significantly within several weeks — and after two months, she reported complete resolution of her ear pressure and clogging.
Alexandra Paul contributed to this article.