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HIDDEN CAUSES OF WEIGHT GAIN

If you are doing everything right but still gaining weight, a medical problem could be to blame.  Here are five frequently missed culprits behind excess kilos.

If the needle in the bathroom scale starts creeping up or refuses to head down, you will probably suspect too many doughnuts, not diseases or drugs.  While the usual culprits – too much food, too little exercise – do account for most excess kilos, there are some surprisingly common medical conditions and widely used drugs that can add anywhere from a little to a lot of excess weight.  Here are some to watch for if you inexplicably find fat either packing on or unwilling to go.

1. Hormonal Havoc

You would think that 20 kilos or more would be a clue to something amiss.  Yet many of the 7-10% of premenopausal women with polycystic ovary syndrome often go for years unaware that their weight gain is in part due to this under diagnosed condition, in which the ovaries and sometimes the adrenal glands, for unknown reasons, pump out too much male hormone.  Because the kilos typically pile on gradually beginning around puberty, or sometimes don’t surface until post pregnancy weight refuses to budge, it is frequently not obvious to Polycystic Ovary Syndrome sufferers, or their doctors, that there is a medical trigger.  Possible tip offs; thinning hair, excess facial hair, severe acne, irregular periods, and impaired fertility – all hallmarks of excess male hormone.  It is not the male hormone that triggers the weight gain though.  So what does?  Short answer:  Nobody knows.  While there seems to be a genetic component to PCOS – it runs in families – and a genetic component associated weight gain, there is little to explain why some of those diagnosed develop weight problems while others do not.  It is clear that cultural and environmental factors play a part because Europeans and Americans on the coast who may feel more social pressure to be skinny, gain much less weight on average than do their (sometimes literal) sisters in Middle America or Europe.  The encouraging side of this is that while man women with PCOS feel like their weight is an immovable number studies show that almost any women with PCOS, treated or not, can, if put on a supervised diet and exercise program, lose 10% or more of body weight.  Dropping such a moderate amount of weight will often, in turn, push male hormone levels down, leading to a resumption of regular periods and improved chances of conception.

1. Thicker from thyroid?For the most part, blaming a sluggish thyroid for excess weight falls in the “you wish” category.  A lot of overweight people sort of hope they have hypothyroidism because it’s treatable, but it is rare to find someone who is significantly overweight because of an under active thyroid.  Even if there is decreased thyroid function, correcting it doesn’t cause much gain to begin with.  If weight creep is on a small scale – in the 2-5 kilo mark – it is possible that hypothyroidism is behind it, though.  If you have other telltale symptoms, such as brittle nails and hair, dry skin and a tendency to feel the cold, definitely get checked out.  If your thyroid is to blame, treatment should shrink you a bit, but not because of fat loss.  Another name for hypothyroidism is “myxedema”, which describes a kind of swelling from thick fluid like fluid that is a hallmark of chronic thyroid.  Most of thyroid-prompted weight gain, therefore, is actually due to excess fluid, not fat; correcting the thyroid problem banishes soggy tissue, along with its kilos, pretty effectively.

    

2. The weight of waterExtra kilos do not always equal fat, but are sometimes due to fluid retention – familiar to most women from premenstrual symptoms.  If puffiness isn’t related to the menstrual cycle, though, it should not be ignored, as you have to ensure that it is not heart or kidney related.  If you push a fingertip into your skin and it leaves a real indentation rather than springing back, that is a tip-off that it is fluid, not fat.  Other symptoms include shortness of breath (congestive heart disease), decreased urine output and loss of appetite (kidney failure), and fatigue and increased abdominal girth even without weight gain, for both.  Liver disease and certain cancers can cause abnormal fluid accumulation in the abdomen as well, so any big boost in your waist size, with or without weight gain, warrants a look by your doctor.

    

3. A knot in your stomachUnlikely, but worth mentioning.  If women have rapid unexplained weight gain, it is possible, though rare, that they have a tumour.  One example: ovarian tumours, some of which are benign, such as dermoid tumour, a weird conglomeration of various body tissues (sometimes including teeth) that grow in the abdomen.  Don’t ignore any disproportionate expansion of your middle – check it with a physician.

    

4. Rx that rounds you upDo you take any medicines on a regular basis?  Then there’s a chance that one of them may nudging your figure toward the fuller side.  Some medicines that commonly cause weight gain:
   • Antidepressants are probably the most common weight gain agents.  Of the widely prescribed SSRI’s (selective serotonin reuptake inhibitors) and SNRI’s (selective serotonin norepinephrine reuptake inhibitors), many researchers and clinicians believe that they tend to produce some weight gain, though typically not more than a few kilos.  Within each class of antidepressant are some that tend to produce more weight gain than others.
   • Anti-diabetes drugs  Ironically medications for Type 11 diabetes – the kind caused primarily by obesity – are often responsible for further weight gain, creating a vicious cycle.   However there are others that do not cause weight gain – some help with weight loss.
   • Oral contraception may plump you up a bit.  The low-dose pill commonly prescribed now won’t add more than a few kilos.
   • Steroids are among the literal heaviest hitters.  The most commonly prescribed to control severe autoimmune problems, including asthma, arthritis, lupus and inflammatory bowel disease.  Long-term use can increase appetite and hike weight by 10 kilos or more.  The symptoms these steroids alleviate are potentially life threatening, you do not have much choice but to be on them when you need to be.  However doctors should be vigilant about cycling patients off medication when they don’t need it, which can help them lose some of the weight they have accumulated.  Many people who are on a medication and start to gain weight often stop taking their medicine.  Don’t do that!  Keep taking it while you ask your doctor about switching to something else.  Whether a drug will cause you to gain weight is hard to predict.  An antidepressant that pushes one person’s weight up will push another’s down. Part of a person’s problem maybe unrestrained eating, and as the depression comes under control, so does the emotional eating.  If a medication is good for you, wait and see how it affects you, or look for another way to avoid weight gain.