Weight gain is associated with physical and emotional distress. It results when caloric intake exceeds body requirement.
True weight gain is excess body fat. Weight gain can also occur as a result of fluid accumulation in the body in certain conditions, most importantly heart diseases, kidney and liver diseases.
Certain drugs can also result in weight gain. This can occur due to the appetizer effect of the drugs or the drugs causing fluid retention.
Most importantly obesity can be a symptom of certain endocrine disorders. This article focuses on a few important causes of unexplained weight gain.
The ten common Medical causes of unexplained weight gain:
This syndrome was previously called syndrome X. It consists of a group of disorders that affect metabolism. The main features of metabolic syndrome include
- Obesity (usually in the central abdomen),
- Hypertension (blood pressure greater than 135/85 mm Hg),
- Abnormal cholesterol levels (high low-density lipoprotein and triglyceride levels, low high-density lipoprotein level), and
- High insulin levels.
Physical inactivity, poor diet, and genetic factors all play their roles in metabolic syndrome.
Defective insulin function is probably the major culprit in causing metabolic syndrome. Overweight and obese patients should be investigated for metabolic syndrome.
These patients are at special risk of developing diabetes, heart diseases, hypertension, and strokes.
Treatment typically involves exercising, following a heart-healthy and low-calorie diet, and smoking cessation.
This is also a very common endocrine disorder causing weight gain. Thyroid hormone or thyroxine is released by the thyroid gland which is present in front of the neck.
Thyroid hormone is an essential chemical required for the metabolic activities in the body. Lack of thyroxine causes weight gain despite anorexia.
Clinical features of hypothyroidism:
Apart from gaining weight, patients feel tired and lethargic all the time. Patients feel cold, have constipation and slow mentation.
Females can have menorrhagia (heavy or frequent menstrual cycles). Patients have dry and sparse hair, cool skin and brittle nails. Because of the changes in extracellular proteins, patients develop swelling around the eyes and in legs.
Accumulation of these proteins in the airway can lead to hoarseness of voice. Muscle weakness and pain can occur especially muscles of the thighs, arms, and shoulders.
Patients have slow heart rates and may have fluid accumulation around the heart, in the lungs and abdominal cavity.
Patients with diabetes mellitus are usually overweight. Apart from the genetic factors, increased appetite can lead to weight gain.
Similarly, drugs used in diabetes may be responsible for increasing appetite and weight gain. Weight loss can also occur in poorly controlled diabetes patients and type 1 diabetes mellitus patients.
Acromegaly is an excess of growth hormone. Excess of growth hormone usually occurs in patients with pituitary tumors. Excess growth hormone affects multiple systems.
Apart from weight gain, patients with acromegaly have coarse facial features, enlarged tongue, hands, and feet.
The jaw protrudes forward. Patients have excessive sweating, oily skin, deep voice, back and joint pain, lethargy, sleepiness, and snoring. Patients are at risk of developing diabetes, hypertension and heart failure.
Cushing’s syndrome (hypercortisolism)
Cushing’s syndrome is an excess of cortisol in the body. Excess cortisol can be released either by the adrenal gland or indirectly by the pituitary gland.
Obesity in patients with Cushing’s syndrome is usually disproportionate. Fat accumulation occurs more over the trunk and back of the neck.
This is also called buffalo hump. Patients have thin limbs, moon facies, acne and excessive hair growth on face.
Muscle weakness is more marked in the proximal muscles i.e. muscles of the arms, shoulders, and thighs. Loss of subcutaneous fats and collagen leads to bruises under the skin and purplish striae (linear purplish marks).
Since cortisol is a steroid hormone, patients with Cushing’s syndrome have impaired immunity. Patients are at risk of developing diabetes, hypertension and bone fractures.
Insulin levels can increase in the body because the patient is injecting excess units of insulin or because of endogenous production of insulin secondary to a tumor of the pancreatic insulin-secreting cells.
This disorder increases appetite, leading to weight gain. Emotional lability, indigestion, weakness, excessive sweating, tachycardia, visual disturbances, and syncope also occur. Patients can also develop seizures due to very low sugars.
Hypogonadism is low levels of sex hormones in the body. Weight gain is common in this disorder. Prepubertal hypogonadism causes eunuchoid body proportions with relatively sparse facial and body hair and a high-pitched voice. Hypogonadism in adults is usually missed because of subtle symptoms and social reasons, manifested as loss of libido, impotence, and infertility.
Conditions such as Laurence-Moon-Biedl syndrome cause a voracious appetite and subsequent weight gain along with altered body temperature and sleep rhythms.
Most common in women who experience severe obstetric hemorrhage, this syndrome may cause weight gain caused by impaired pituitary gland function. The pituitary gland is responsible for producing thyroxine releasing hormone and sex hormones which can lead to hypothyroidism and hypogonadism causing obesity.
Corticosteroids, phenothiazines, and tricyclic antidepressants cause weight gain from fluid retention and increased appetite. Other drugs that can lead to weight gain include hormonal contraceptives, which cause fluid retention; cyproheptadine, which increases appetite; and lithium, which can induce hypothyroidism.
Obesity in children
Obesity in children can result from an endocrine disorder such as Cushing’s syndrome or from disorders that cause inactivity. These conditions include Prader-Willi syndrome, Down syndrome, Werdnig-Hoffmann disease, late stages of muscular dystrophy, and severe cerebral palsy.
The incidence of obesity is increasing among children. Non-pathologic causes include poor eating habits, sedentary lifestyle, and emotional problems, especially among adolescents. Regardless of the cause, discourage unhealthy diets and provide a balanced weight loss program.
Desired weight is associated with a lowest mortality rates in elderly patients.