Medical Challenges to Weight Maintenance

I’m not looking for something to blame; I’m looking for something to explain.

This is how I feel about the medical conditions and medications that have an association with weight gain. If we can understand the reasons, we will be closer to finding the solutions.

Please speak with your own physician to find out if these, or many other conditions or situations, could be holding you back on weight maintenance journey. I have no medical background, so they will be better equipped to help you.

I never thought much about the medical reasons for weight gain, and how they can be addressed by medical providers. But when I finally got my appointment at the Mayo Clinic Bariatric Center in Jacksonville, Florida, I saw how they were so intent on finding contributing conditions. So I thought I’d share some of these ideas here.

If your doctor is unable to help you, please consider getting a second opinion or visiting a bariatric center that is associated with a hospital or other reputable, licensed provider. You don’t need to be alone in this.

Here are some possible reasons for weight gain or difficulty in maintaining a healthy weight:

• Medications – an obvious first culprit, as many medications have weight gain as a side effect if you read the accompanying literature. See if your doctor can prescribe an alternative if you feel your medications are contributing to your difficulties. I am on one myself, and there are no alternatives, so I must continue to take it or risk the return of cancer.
• Vitamin or mineral deficiencies – generally an easy fix for this one, but it requires your physician to order blood tests. My B 12 deficiency cleared up in just a few months, but each case is different. (While a B12 deficiency may not directly cause weight gain, this, and many other deficiencies, can cause fatigue which affects your activity level.)
• Sleep apnea – this one is particularly insidious. You are more likely to have sleep apnea if you are obese, and if you have untreated sleep apnea, it’s more difficult to lose weight. Insufficient sleep increases the hormones which make you feel hungry. In addition, studies have shown that all other things being equal, dieters who sleep fewer than 7 hours nightly lost less weight – even though they consumed an identical number of calories (1).
• Hormone imbalances – very complex and impossible for me to cover adequately, but there are many possibilities here! We often associate these with women’s health, but men are affected as well. Here are a few that may become culprits if they are out of balance: thyroid, estrogen, androgen, insulin, growth, cortisol, leptin, ghrelin, prolactin, and pituitary (2). For more on leptin and ghrelin, see my blog post Coursework: Understanding Obedity Unit 2: https://lindawbrowning.com/2023/01/19/coursework-understanding-obesity-unit-2-of-3/
• Genetics – not surprising that obesity seems more common in some families. But this is specific to our genes, not environmental or behavioral factors that play a role in eating habits (3). There are two main types of genetic obesity, monogenic and polygenic, but they share similar causes (4). They can appear early in life, particularly in the monogenetic type, or develop over a lifetime due to more subtle polygenic causes (4). If you suspect that genetics plays a role in your weight management challenges, it would be a good idea to speak to your doctor or a genetic counselor. (Keep in mind that single-gene syndromic and nonsyndromic disorders account for about 5% of obesity cases worldwide (5).)

If there are medical causes to your weight maintenance difficulties, see if there are treatments, dietary changes, or other steps you can take to help overcome them. The best way to do this is to seek medical advice from licensed, reputable providers. You and your health are too important to shortchange!

(1). https://www.webmd.com/connect-to-care/sleep-apnea/sleep-apnea-and-weight-gain

(2). https://www.endocrinewellness.com/hormonal-weight-gain/#toc-header-1

(3). https://www.cdc.gov/obesity/basics/causes.html

(4). https://www.nature.com/articles/s41576-021-00414-z

(5). https://academic.oup.com/ajcn/article/91/1/5/4597188