This is one we hadn't heard before: a doctor explains what's behind this nuisance that affects around two million people.
More than half of all Americans—around 55%—say they want to lose weight, according to a 2024 Gallup Poll, with 27% reportedly pursuing that goal actively. For many of these, even modest weight loss brings welcomed benefits: improved mobility, a more comfortable wardrobe, better sleep, and reduced risk of chronic illnesses like heart disease, diabetes, and certain cancers.
However, weight loss can also sometimes cause unexpected effects throughout the body. Tonia Farmer, MD, an otolaryngologist (ear, nose, and throat doctor) and head and neck surgeon, points to one example: eustachian tube dysfunction, a common ear condition leading to over 2 million U.S. doctor visits annually, according to a 2017 study.
If you’ve ever flown or hiked to high altitudes, you probably know this sensation—pressure, pain, fullness, muffled hearing, and the urgent need to “pop” your ears. Because this is a common experience sometimes unrelated to weight loss, few people link the two, Dr. Farmer tells The Healthy by Reader’s Digest. “The eustachian tube connects the ear to the back of the nose and throat and works continuously to equalize pressure,” Dr. Farmer explains. “The thought process is that, because of that weight loss, the muscles around the tube pull it down and thin it out—so you get that eustachian tube to open and it stays open.”
The Cleveland Clinic says there are three main subtypes of eustachian tube dysfunction:
- Patulous eustachian tube dysfunction, in which the tube remains open
- Obstructive eustachian tube dysfunction, in which the tube is blocked
- Baro-challenge-induced eustachian tube dysfunction: temporary dysfunction due to altitude changes (on airplanes, while scuba diving, etc.)
Dr. Farmer notes that between these three types, patulous eustachian tube dysfunction is more often linked to rapid weight loss, including in patients who take GLP-1 medications or those who have had gastric bypass surgery.
She adds that one “debilitating” sign of patulous tube dysfunction often prompts her to ask whether the patient has lost weight: autophony, or hearing your own voice or breathing loudly. “People describe it as feeling like they’re talking into a seashell. It makes them crazy. It’s all they can hear,” she says.
But if you experience this dysfunction, your doctor may be able to recommend one of several treatment options that could offer symptom relief, including a spray (such as saline, antihistamine, steroid, or hormonal). There are also nasal procedures that physically close the tube by surrounding it with a substance that Dr. Farmer compares to a cosmetic filler. In some cases, tubes may be indicated.
Dr. Farmer also suggests laying down when symptoms are feeling especially intense: “Think about it—when you lay your head down flat, what happens? You get more blood volume that comes to your head, more congestion around the eustachian tube.” It should be noted that for some individuals, certain positions could exacerbate the issue.
If the problem persists for more than two weeks, consult with your doctor to have your hearing checked and rule out other possible underlying conditions. Hormonal changes, allergies, sinusitis, post-nasal drip, and TMJ disorders, which affect the jaw joint connecting the skull and jawbone are just some of the other conditions known to cause eustachian tube dysfunction.
Dr. Farmer also encourages reaching out for further guidance: “Don’t be afraid to ask for help.”
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