Does Weight Effect My Veins?

The short answer is yes.

A number of patients recently have presented to our clinic with concerns that the weight they have gained while being at home during the Covid-19 pandemic has resulted in the development of vein issues in their legs, specifically varicose veins.

Venous insufficiency and resultant varicose veins can be caused by prior episodes of blood clots in the leg veins.  More commonly, varicose veins are caused by the failure of small and delicate one way valves within leg veins that direct blood back to the heart.   These valves are numerous and located up and down the length of the leg veins.   When we stand or sit these valves prevent blood from pooling in our legs.  However, when a number of these valves fail or buckle (like an umbrella in a wind storm that turns inside out) blood falls downward towards our ankles and feet and a higher pressure of blood develops within the leg veins.  This higher pressure is transmitted peripherally to what are normally small vein branches that sit under the skin.  Over time, this higher pressure causes these small vein branches beneath the skin to expand, dilate and eventually become prominent. These “varicose veins” can ache, throb and occasionally produce itching and swelling.

The failure of the valves in the leg veins is NOT caused by weight gain or obesity per se.  These valves usually fail due to an inherited or genetic predisposition which as we age “programs” the valves to fail.

Weight gain of as little as 10 lbs. or 5% DOES magnify the effect of the valve failure.  As a person gains weight in the presence of these failing valves, the added weight exerts constant pressure on the veins deep within the pelvis and upper thigh.  This pressure is then transmitted down into the remaining veins of the leg.  The result is that weight gain often results in the blossoming of bulging varicose veins.

Weight loss can reduce the prominence of varicose veins and indeed is the suggestion we often make before recommending an office based intervention on the leg veins.  We also make it clear to our patients that while weight gain itself does not cause the valves to fail nor varicose veins to develop, weight gain does greatly exacerbate the reversal of blood flow and the pooling of blood in the legs.  The result of weight gain can be an increase in the prominence and symptoms associated with varicose veins.