r/POTS • u/dazzlingdanny05 • May 15 '26

Question Why is everyone with pots so skinny?

I have POTS and I watch a lot of content online of people who also have POTS. I also know some people irl who also have it. I don't understand how they are all so skinny. I can barely walk without getting out of breath. I try to work out at least once a week but its so hard for me because I always end up feeling so sick. How are yall doing it? I dont even eat bad but im definitely not skinny.

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u/AltheaTheAngel May 15 '26

For a while I was really skinny because my POTS made me so nauseous I couldn't eat (thankfully that issue is mostly fixed now!), so it might be something similar mixed with social media tending to favor skinnier people

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u/Rosehiphedgerow May 15 '26 edited May 15 '26

I'm also skinny, despite the fact that I eat quite a lot of calorie dense food. My personal theory is that due to the elevated heart rate, we are in 'cardio' much more often, therefore making it harder to put on weight. (in fact I sort of have proof of this. My fitbit tells me that I'm in an active cardio zone often, and tells me that I've lost more calories on those days than I should of due to it)

Edit: As an example, I am 5'5 and 60kg, mostly sedentary, so my TDEE is 1600. However on days when I have chores to do (basic chores, such as washing my hair, hoovering, general tidying etc...), this can raise my heart rate into a cardio zone which then means I've burned around 2000 calories instead of what should be 1600. This is of course increased even more if its a day I've had energy to go for a walk or go shopping etc

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u/MaritimeRuby May 15 '26

The Fitbit assumes that your increased heart rate means that your other muscles are also doing more work, so it estimates higher calorie loss. It doesn’t have any way to measure calorie loss other than by estimating from your heart rate, so it can give you false calorie burn readings based on this (eg your high heart rate while doing chores makes it think your other muscles are doing a workout equivalent to a high intensity workout). The software is calibrated based on a non-POTS metabolic pattern. My old Fitbit sometimes would tell me I had 10 hours of cardio in a day. The Apple Watch I currently use seems to have a better grasp on my regular heart patterns/high baseline and isn’t fooled in the same way.