Involuntary weight gain

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Alternative names
Weight gain - unintentional

Definition
Unintentional weight gain is an increase in body weight that occurs when caloric intake exceeds body requirements, causing increased fat storage.

Considerations
Almost 40% of all Americans are overweight. Aging, which is generally accompanied by a slower metabolism, can cause weight gain unless accompanied by a reduction in food intake or adequate exercise.

Weight gain can be a significant symptom of several endocrine diseases such as Cushing’s syndrome or hypothyroidism. It may also be caused by heart or lung disorders as well.

A progressive weight gain occurs with pregnancy; whereas, a periodic weight gain may occur with menstruation. A rapid weight gain may indicate dangerous fluid retention.

Common Causes

• overeating and lack of exercise
  
• poor eating habits (high-carbohydrate, high-calorie diet)
  
• emotional factors such as guilt, depression, and anxiety
  
• slower metabolism, which is normal with aging
  
• smoking cessation
  
• alcohol consumption
  
• hypothyroidism, primary
  
• endocrine disorders including Cushing’s syndrome or polycystic ovary syndrome
  
• drugs such as corticosteroids, cyproheptadine, lithium, tranquilizers, phenothiazines, and tricyclic antidepressants
  
• medications that increase fluid retention and cause edema (abnormal pooling of fluids in the tissues)

Home Care
Implement a proper diet and exercise program. Counseling or psychological help may be beneficial for some people.

Set realistic weight goals to maintain a weight consistent with good health. Consult with a health care provider about specific measures.

Call your health care provider if

• there is a change in vision with the weight gain.
  
• sensitivity to cold, constipation, and hair loss accompany weight gain.
  
• swollen feet and shortness of breath accompany the weight gain.
  
• there are times during the day when hunger is uncontrollable and accompanied by palpitations, tremor, and sweating.
  
• the weight gain is excessive and the reason for the weight gain is unknown.

What to expect at your health care provider’s office
Your health care provider will perform a physical examination, measure your weight, and ask questions about your weight gain, such as:

• time pattern
  o When did the weight gain begin?
  o Has it been sudden or gradual?
  
• quality
  o How much weight have you gained?
  o Has your appetite increased?
  o Has the amount or kind of food eaten changed?
  o Has physical activity level decreased?
  
• aggravating factors
  o Has physical activity been restricted due to illness or injury?
  o Has participation in social activities decreased?
  o Have stress or anxiety levels increased?
  
• accompanying symptoms
  o Is there fainting?
  o Is there uncontrollable hunger with palpitations, tremor, and sweating?
  o Is there a change in vision?
  o Is there increased sensitivity to cold?
  o Is there constipation?
  o Is there decreased urinary output?
  o Is there puffiness or swelling of face, feet and ankles?
  o Is there hair loss?
  o Is there shortness of breath ?
  o Are there change in sleep patterns, such as insomnia?
  o Is there muscle weakness?
  o Is there fatigue?
  
• additional important information for your physician:
  o What medications are being taken?
  o Do you use alcohol?
  o Do you use “street drugs”?
  o Is there a history of depression?
  o How is the body image--is there an awareness of weight gain? Does this cause much concern?

Diagnostic tests that may be performed are:

• nutritional assessment
  
• blood tests including chemistry profile
  
• if an endocrine disorder is suspected, hormone levels may be measured

Weight gain caused by emotional problems may require psychological counseling. There should be some discussion of an appropriate diet and exercise program as well as realistic weight loss goals. If weight gain is caused by a physical illness, treatment (if there is any) for the underlying cause will be prescribed.

If weight continues to be a problem despite diet and exercise, there should be some discussion with your health care provider about other treatment options including medications and surgery.

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