4 medical causes behind unexplained weight gain

December 12, 2012

Losing weight isn’t the easiest thing in the world, obviously.

If there is an underlying reason that is causing the weight to stubbornly persist, it can be even more challenging, even for the most disciplined person.

For many women, weight loss can be a great challenge.

One of my patients lamented to me the other day that she has been on a strict diet for months, but does not see the needle on the weighing scale going down.

Another patient asked me why she still has flabby thighs and a big stomach despite all her exercising.

Their perceived failure to lose weight can be a source of crushing disappointment, and can damage their self-esteem.

Many women are very hard on themselves for being unable to lose weight, and their self-recrimination could destroy their motivation to continue with a healthy lifestyle.

There are many reasons weight loss strategies fail to be effective.

Sometimes, it may be because people are not doing it right – for instance, they may not be adopting the right dietary changes and may be doing more harm than good by going on a fad diet.

Or they may not be doing the right kind of cardiovascular and strength training exercises.

But it would not be fair to blame yourself entirely.

Weight loss is not completely dependent on behavioural change alone, as there may be something going on in your body that is inhibiting you from burning your fat.

Underlying condition

Certain underlying medical conditions can cause you to gain weight or hinder you from losing weight.

If your weight-loss methods have not been producing results, you may wish to see your doctor to uncover whether a medical condition is the real case of your weight gain.

For instance, if you are feeling stressed out all the time, whether because of anxiety, grief or anger, it can cause you to put on weight and have trouble getting it off!

The rationale behind it is more than just comfort eating.

Stress causes your body to react by producing certain chemical substances, such as the hormone cortisol.

This hormone increases your tendency of storing fat, especially around the abdomen, which hikes up your risk of serious health problems.

There are many other hormone-related conditions that could cause weight gain, including Cushing’s syndrome, hypothyroidism, polycystic ovary syndrome (PCOS), insulin resistance and female hormonal changes.

Cushing’s is a condition where the adrenal glands (which are found on top of the kidneys) produce too much cortisol.

Similar to when the body is under chronic stress, this syndrome will cause a buildup of fat in the abdomen, as well as in the face and upper back.

People with hypothyroidism (low thyroid levels) may also struggle with weight issues.

This condition is caused by a sluggish thyroid gland, which cannot produce enough thyroid hormones to burn stored fat, thus leading to slowed metabolism.

Another condition caused by hormonal imbalance is polycystic ovary syndrome (PCOS), which is common among women.

In this condition, women have numerous cysts along the outer edge of their ovaries, which lead to unexplained weight gain, as well as irregular menstrual bleeding, acne, excessive facial hair, thinning hair and difficulty conceiving.

Insulin resistance is another hormone condition that goes hand-in-hand with weight gain.

It is linked to chronic inflammation in the body because inflammatory chemical messengers (called cytokines) cause the body’s cells to stop “listening” to insulin and leptin.

When the insulin receptors of our cells become resistant to insulin, the glucose in our blood cannot be stored in cells to be used as energy.

Therefore, the glucose gets converted into fatty acids and stored as fat, instead of being used as energy.

This inflammation/obesity relationship is a vicious cycle, as fat cells themselves generate cytokines, which further increase insulin resistance.

Cytokines also cause leptin resistance, which means that the brain does not respond to the messages from leptin that you are full, so you do not know how to stop eating.

While the presence of fat cells can exacerbate inflammation in the body, it is also caused by chronic stress, overeating of junk food, lack of sleep, candida (a fungal infection) and toxin overload in the body.


Medications play a very central role in a person’s metabolism and weight maintenance.

There is a wide variety of medications that can cause weight gain, including diabetes medications (eg sulfonylureas), antidepressants (eg amitriptyline or Elavil, imipramine or Norpramin, and trazodone or Desyrel), birth control pills, corticosteroids taken for conditions like asthma and lupus, and anti-epileptics taken to control seizures, especially valproic acid (Depakene or Depakote) and carbamazepine (such as Tegretol).

Antipsychotic or schizophrenia medications can cause the appetite to increase, while lowering the metabolic rate.

These medications incude chlorpromazine (Thorazine), thioridazine (Mellaril), and olanzapine (Zyprexa).

Beta-blockers, which are prescribed for high blood pressure and heart disease, are also implicated in weight gain as they may lower metabolism by about 80 calories a day.

It can be frustrating if you are on long-term medication that causes weight gain as one of its side effects.

You should talk to your doctor about switching to another type of medication that won’t have the same effect, as weight gain will eventually exacerbate your health problems.

Fortunately, advanced medical science today is continuously improving its arsenal of medications, producing more effective medications that have fewer side effects.

Lifestyle and behaviour

Certain aspects of your lifestyle may be a stumbling block between you and weight loss.

Lack of sleep is one major lifestyle habit that needs to be checked.

If you are chronically sleep-deprived, your body’s hormone levels will be out of balance, causing increased hunger and appetite, while decreasing satiety so that you do not feel full after eating.

If you keep late nights, you are also more likely to be snacking and consuming unnecessary calories.

Quitting smoking is a wise lifestyle choice, but you should be aware that it can cause you to put on weight initially.

Without the intake of nicotine, you will tend to feel hungrier, find that food tastes better, and eat more, although this feeling should go away after several weeks.

Your metabolism will also reduce, so your body will burn fewer calories.

If you are consuming more calories than usual, this will definitely lead to weight gain.

This is not a reason to continue smoking, but rather, to be aware that weight gain is one of the side effects of quitting.

Fortunately, this effect can be counteracted by eating a healthier diet, watching your calories and getting more exercise – all of which will ultimately improve your overall health.

Eliminating inflammation

Apart from addressing any underlying medical conditions or intake of prescription medications that may be causing your weight gain, you should also look at decreasing the levels of inflammation in your body.

One important aspect of this is avoiding foods that promote inflammation, such as sugar, saturated fat and most types of processed foods.

To prevent inflammation, you should eat more natural, whole foods, such as fresh fruits, vegetables and whole grains.

Inflammation is also linked to certain gene variants in the body, so knowing your DNA profile (something I touched on in an earlier column) will help your doctor to advise you on the right diet and nutritional supplements to reduce inflammation.

Holistic approach

If you are having trouble with weight loss, the best thing to do is to discuss the problem with your doctor.

He or she can assess your overall health status, and help you figure out the best way to lose weight healthily without compromising your health.

The most important thing is that you do not blame yourself – losing weight takes more than just dieting, exercise or changing your medications.

It takes a positive attitude, and sometimes, you have to think outside the box!

Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK).

Source: The Star/ANN

Category: Education

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