If you’re piling on the pounds and honestly haven’t a clue why, it’s possible your weight gain is being fuelled by an underlying medical condition. GP Dr Alasdair Wright explains why weight gain sometimes isn’t down to overeating.

If the bathroom scales are moving in the wrong direction and you’re really not pigging out and slumping in the armchair every night, you may have a health problem which is affecting your metabolism.

But, before you dig into another tub of ice cream, hold on.  This isn’t a ‘Get out of jail free’ card for overindulging and dodging the gym.
 
“By far the commonest cause for weight gain is excessive dietary calories and lack of exercise,” stresses GP Dr Alasdair Wright; “but there are a few medical conditions which can lead to obesity and, if you have any of the symptoms listed below, it may be worth asking your GP for some tests.”

What could be causing your weight gain?

Medical conditions which include weight gain include:

• Hypothyroidism: This is the medical name for an underactive thyroid gland. It is caused by lack of the production of the hormone called thyroxine which is essential for a normal metabolism. It’s more common in women, affecting 15 in every 1,000 women and only 1 in 1,000 men.
  
  Symptoms include: weight gain, tiredness, lethargy, low mood, a croaky voice, thinning hair, heavy periods/miscarriage and feeling cold.
  
  Your GP can run blood tests to test for low levels of thyroxine. The good news is that it can be easily treated with a daily dose of thyroxine, although it may take a few months to get the dosage right.

For more information, contact the British Thyroid Foundation – www.btf-thyroid.org 

• Metabolic syndrome: This results from the vicious cycle created by the body’s inability to respond to insulin caused partly by central abdominal obesity – that’s weight gain around your middle – plus raised cholesterol, raised blood pressure and associated cardiovascular risk.
  
  Weight loss regimes and medications to correct insulin insensitivity will help minimise the damage caused by this condition, so ask your GP for advice.

•  Cushing’s syndrome: This is caused by overproduction of corticosteroid hormones or effects caused by steroid replacement medications.
  
  Apart from weight gain, particularly on the chest, stomach and face, other symptoms include very slim arms and legs in comparison to the other parts of the body, skin changes including stretch marks and spots on the face, chest or shoulders. Women can also suffer from facial hair growth and irregular periods, and men suffer loss of libido, erectile dysfunction and infertility.
  
  The treatment for this problem may be either through medication, surgery or radiotherapy, depending on the underlying cause.

For more information, go to: http://acth-cushings.org.uk/

• Polycystic ovary syndrome: PCOS can result in insulin insensitivity and weight gain in women affected by this condition.
  
  It is caused by hormonal abnormalities, most notably high levels of the hormone testosterone, which causes small cysts to develop on the ovaries containing undeveloped egg follicles.
  
  Symptoms include weight gain especially around the middle, excess facial and body hair, irregular periods/infertility and acne.
  
  Dietary intervention and the use of a medication called ‘metformin’ can be helpful in preventing weight gain in polycystic ovary syndrome.  Reducing stress may also be helpful as stress increases production of testosterone which makes PCOS symptoms worse.

For more information, go to www.verity-pcos.org.uk

Other causes

• Depression: Weight gain and appetite changes can be a sign of depression if accompanied by other symptoms such as continuous low mood, feelings of sadness, tearfulness, lack of energy, anxiety and reduced sex drive. Symptoms can be treated with medication and/or talking therapies such as cognitive behavioural therapy or counselling.
• Hormone changes: Female menopause and male testosterone deficiency can also indirectly lead to weight gain through appetite changes.  Hormone treatments may help with symptoms of the female menopause or Testosterone Deficiency Syndrome (TDS) in men. 
• Drug side effects: There are a number of medications which can promote weight gain, including certain anti-depressants, ‘pizotifen’ used for migraine prevention, beta blockers and some steroids.

“Any chronic physical or mental health problem,” advises Dr Wright, “which results in overeating and inability to balance the calories through adequate exercise will eventually result in obesity.

“Whether the cause for weight gain is related to a medical problem or just incorrect lifestyle, it is always essential to stick to a healthy energy-balanced diet and try to get some form of regular exercise, if possible, to break this negative cycle.”


If you would like to know more about the medical conditions that can cause weight gain, then send a question to our panel of experts.