Weight gain you can't control
The frustration of seeing extra pounds on the scale—or of a too-tight waistband that you know
used to fit—is understandable. But did you know that anything from a
hormonal imbalance to vitamin deficiencies to the prescription meds you
take can hold clues to what's making you gain weight? "A lot of people
make what we think are lifestyle choices but are actually our bodies
reacting to factors we can't control," says Robert J. Hedaya, MD,
clinical professor of psychiatry at Georgetown University Medical
Center.
"Whether it's hormonal, a medication side effect, or something else, too often we put the onus on the individual, and there are factors that sometimes justify a doctor's help."
"Whether it's hormonal, a medication side effect, or something else, too often we put the onus on the individual, and there are factors that sometimes justify a doctor's help."
Here, seven health issues that could be standing between you and your ideal weight—and how to fix them.
You're depressed
Many anti-depressant medications cause
weight gain—so if you're depressed and taking pills for it, expect to
see a bump in weight between 5 and 15 pounds, with continued gradual
accumulation over the years, says Dr. Hedaya, who is also the founder of
the National Center for Whole Psychiatry in Chevy Chase, MD.
If you're not taking pills, there’s evidence that feelings of
depression can correlate to weight gain. One 2010 study published in the
American Journal of Public Health found that people who feel
sad and lonely gain weight more quickly than those who report fewer
depression-related symptoms. "They may be eating more high-fat,
high-calorie comfort foods," says Belinda Needham, PhD, assistant
professor in the department of sociology at UAB and the lead author of
the study. "Or they may have [cut back their] physical activity."
Fix it: "If I see patients who are taking
anti-depressants and that could be the culprit of their weight gain, I
may wean them slowly off of the drug," says Dominique Fradin-Read, MD,
MPH, assistant clinical professor at the Loma Linda School of Medicine
in California. "I may then put them on Wellbutrin instead, which
actually helps with weight loss." If your meds are not to blame, seek
out some workout buddies or a support group. "Attending meetings, like
Weight Watchers, or working out with a group of friends is a great way
to increase social support," Dr. Needham says, "which can help
depression."
You're taking the wrong Rx
There's a long list of medications
that can cause weight gain: If you're taking birth control pills,
excess hormones for hormone therapy, steroids, beta-blockers for heart
disease and blood pressure, anti-seizure meds, breast cancer medications
like Tamoxifen, some treatments for rheumatoid arthritis, and even some
migraine and heartburn medications, you may notice pounds creeping on.
"When I see patients who are concerned about weight gain, I start
looking at their medications," says Steven D. Wittlin, MD. clinical
director of the endocrine-metabolism division at the University of
Rochester Medical Center in Rochester, NY. "That's a biggie. Some may
affect appetite; some may affect metabolism." Others may simply make you
feel better and thus regain your lost appetite.
Fix it: If you suspect your medication is affecting
your waistline, your doctor may be able to find an alternative treatment
that won't have that particular side effect.
Your gut is slow
Digestive issues, including slow bowel
movements, may also account for excess pounds. "Ideally, you eat, and
then, an hour or so later, you have a bowel movement," says Dr. Hedaya.
"But once or twice a day is still in the healthy range." If you're not
so regular, dehydration, medications, low fiber, or even a lack of good
flora in your gut could be to blame.
Fix it: If constipation is your only symptom, then
trying probiotics can help your digestive tract work properly. Staying
hydrated is key, along with a diet chock-full of fiber-rich foods. But
you can also try drinking a fiber powder, like Metamucil, mixed with
water. "It may even grab fat globules in your intestinal tract as it
scrubs out waste," says Dr. Hedaya. If you're still having trouble,
check with your doctor to rule out a range of disorders, including
hypothyroidism or a neurological issue.
Your body's missing certain nutrients
Being low in vitamin D,
magnesium, or iron can compromise your immune system, sap your energy
levels, or alter your metabolism in ways that make it harder to take
healthy-lifestyle steps. "You may compensate for low energy with
caffeine, sweets, and simple carbs," says Dr. Hedaya, "Or find that you
feel too run down or weak to exercise."
Fix it: While you can try to boost your iron levels
by eating red meat and spinach and increase magnesium by adding Brazil
nuts or almonds to your diet, it's nearly impossible to consume enough
milk or get enough sunlight to compensate for low vitamin D. "It's
important to know that it could take awhile to find your right dose of
vitamin D," says Dr. Hedaya. "If you take too much, you can get kidney
stones. You need to have your blood tested every three months, so your
doctor can make adjustments to the dose for you." Adding an iron
supplement is a little less tricky—but it's still wise to let your
doctor rule out hypothyroidism or other conditions that might cause
insulin resistance, and thus weight gain, before you start taking
supplements.
You're getting older
It's the one condition that's
unavoidable. "Often, I hear patients tell me they think their metabolism
is slowing down," says Dr. Fradin-Read. "This is real—we don't burn as
many calories at 40 or 50 as we used to burn at 20. So we need more
exercise—and less food—to keep metabolism going. Some studies show that
exercise might be even more important than the diet for long-term weight
maintenance."
Fix it: "Remember that all calories are not equal
when it comes to weight," says Dr. Fradin-Read. "Eating lean protein
will cause your body to burn calories more efficiently. On the other
hand, carbs are something your body tends to burn more slowly and even
store in your body more readily." Choosing low-fat proteins and reducing
carbs are good ways to help avoid unnecessary pounds.
You have Cushing's Syndrome
Weight gain accompanied by high
blood pressure, osteoporosis, and changes in your skin tone and quality,
including purple or silvery stretch marks on your abdomen and ruddy
cheeks, could be a sign that your body isn't processing nutrients the
way it should, due to a cortisol-producing tumor on one of your adrenal
glands. The syndrome affects only about 15 in every million adults
annually, so proceed with caution before demanding a battery of tests.
"Cushing's Syndrome is not terribly common," says Dr. Wittlin, "but one
of the telltale signs is that your fat distribution is more in the
midsection of your body, leaving your arms and legs looking more
slender."
Fix it: If you suspect you are gaining weight that
you can't attribute to your eating habits, medications, or lack of
exercise, a few tests—including a blood test and urinalysis, to get an
accurate check of your body's cortisol levels, will give your doctor the
first clues to this condition. If the levels are deemed excessively
high, then your doctor will order further tests, like a CT scan of your
pituitary and adrenal glands, to determine if such a tumor exists. If
the tumor is confirmed, doctors will likely perform surgery to remove
the tumor (and possibly the affected gland), followed by a course of
steroids to help regulate the remaining gland.