Stubborn Weight Gain
I have gained 40 pounds in the past two years and cannot seem to lose it. I have had my thyroid and adrenal function checked — all the normal blood work that would find a nonfunctioning organ, which could provide an answer to this weight gain. What in the world could it be? I was a size 6 all my life, and now I am a 16! I am only 36 years old. I seem really swollen — as if I am carrying around lots of excess fluid. Exercise and dieting do nothing for me — except build muscle, which makes me even heavier. Do you have any idea what could be the cause?
By Caroline Apovian, M.D., F.A.C.P., F.A.C.N.
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Unless there is something serious going on, such as congestive heart failure or the growth of a rare tumor, most people who gain this amount of weight over two years have had a stressful life event and/or the addition of a medication that is known to cause weight gain (such as an antidepressant or diabetes medication, or even a steroid for asthma or an antihistamine). Have you undergone a dramatic change in lifestyle? Some scenarios that can lead to an increase in energy intake (calories) or decrease in energy expenditure include moving to a different city with a new set of activities (or fewer activities); taking a different job with longer hours or more time at a desk; and different eating patterns due to new friends, a new boyfriend, a breakup, or a new marriage.
But, first, I'd make certain that nothing is going on medically. You need a full evaluation that is more extensive than just an endocrine workup, which is what it sounds like you've had. If you are not completely satisfied with your doctor's evaluation, you might consider getting a second opinion.
If you are cleared medically, you need to figure out what changed in your life to account for an alteration in your eating or activity patterns. Once you figure out what has changed, it will be easier to determine what needs to be done to tip the energy balance equation.
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