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Mystery Diagnosis: Weight Gain

Find out the 5 most common medical conditions that can cause unintended weight gain – plus one that even stumped the House Call Doctor!

By
Sanaz Majd, MD,
October 17, 2012
Episode #105

Page 1 of 2

Unintended weight gain is a big topic of conversation at the doctor’s office. I see patients on a daily basis who complain about their weight and the difficulty of shedding those extra pounds. Most of the time, it has a lot to do with our poor nutritional habits and lack of activity, and less to do with a medical condition causing it. As we all know, the U.S. is facing an obesity epidemic. Our busy lifestyles leave us little free time to exercise or prepare our own meals, which makes it so easy to head through the local fast food drive-thru. 

That’s why I’m rarely surprised when I see patients reporting difficulty with weight gain. However, as a doctor, I still need to investigate all the possible medical causes of weight gain when faced with this common health complaint. Today, I’d like to talk about a case in which I was truly surprised and that’s why it is this week’s mystery diagnosis.

Wendy is a 38-year-old gal who came to see me in the clinic 6 months after giving birth to a beautiful and healthy baby girl. She had gained 65 pounds with her pregnancy, and still had 35 pounds to lose.

“I’m here because I want a prescription for a weight loss medication,” she said. I heard the desperation in her voice. Wendy told me that she had been trying to lose weight for the past 3 months without any success. In fact, she was gaining instead of losing. “I can’t believe it – I’ve gained 5 pounds in the last 2 months, and I’m trying so hard.” She revealed that her self-esteem was so low that she wasn’t able to be intimate with her husband any longer and that it was affecting their relationship as a result.

The History

Patients often tell me they’ve been trying to lose weight, but upon dissecting the details, I often find that there is some room for improvement. So I got down to the nitty gritty with Wendy’s weight loss regimen. I started with her activity level -- she revealed that she was using the treadmill and elliptical machine for 1 to 1.5 hours per day, five days a week. Okay, so there’s no problem there. Wendy is getting enough physical exercise.

I thought to myself that this must be a nutritional issue. Yes, let’s ask her about that. “I eat half a piece of pita bread with my meals for my carbohydrate portion, and the rest of my plate is either a lean protein like turkey or chicken without the skin and half of my plate is comprised of vegetables.” 

It must be her drinks then. Yes, our liquid intake is often a great source of our calories. “Nope, I only drink water with a squeeze of lemon.” How about her snacking, you may be wondering? “I snack on carrot and celery sticks and dip them into nonfat yogurt.” Goodness, Wendy was eating a very well-balanced diet, and exercising plenty. She was obviously very determined to lose weight, so it didn’t make any sense to me.

She had a normal pregnancy, nothing out of the ordinary. She delivered vaginally, and her postpartum health was uneventful. She stopped breastfeeding 2 months ago since she started her weight loss regimen and her periods still have not returned.

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