Now, where did that come from, you wonder, zipping up your favourite fuchsia skirt only to see a roll of flesh escape over the top of the waistband. Actually, it's not the first time you've suspected you're dragging around a few extra pounds. Your snuggly pj's are too snug lately, and the buttons across the bust on your khaki shirt hang on to each other for dear life.
What gives? (Clearly, not your jeans.) Your eating habits haven't changed, and you're still making it to your weekly Ashtanga classes. Is it those antidepressants you just started taking? Could be. Here we review eight medications and conditions that can stealthily lead to weight gain even as they cure the more serious health problem underneath.
1. Hypothyroidism
What is it? A condition affecting mostly women (especially in middle age) in which the thyroid gland, found at the bottom of the neck, isn't making enough thyroid hormone, which is key in balancing our body's metabolism. As well as gaining weight, those with it feel cold constantly and suffer from fatigue, constipation, irregular menstrual cycles, reduced sex drive and other symptoms. "It's the most common disorder I see that's a cause of weight gain," says Dr. John Dornan, head of Active Living Clinic in Saint John, N.B., and an expert in thyroid-related conditions.
The gain explained: "Hypothyroidism slows the metabolic rate. It can also cause fatigue, and sometimes when people are tired, they think if they have something to eat, they might feel better," says Lorraine Watson, associate professor in the faculty of nursing at the University of Calgary and a weight-management expert.
What now? If your physician suspects you have hypothyroidism, she'll order a test to measure how effectively your thyroid gland is working. If diagnosed, you might be prescribed a medication such as Thyroxin, a thyroid replacement hormone. Once you're on that, Watson says the gain will likely level out. But you will still have to shed the pounds you've accumulated. "So if your thyroid levels are properly aligned, you need to figure out how to increase your activity level and lower your caloric intake," she says.
2. Polycystic ovary syndrome
What is it? Polycystic ovary syndrome (PCOS) is a hormonal imbalance that is associated with cysts, or sacs filled with fluid, in the ovaries. Affecting women mostly during their childbearing years, it can seriously complicate ovulation; it is also associated with increases in weight, menstrual irregularities, infertility, facial hair growth and sometimes acne, says Dornan. "And it's associated with insulin resistance." That insulin factor tenuously links it to another condition associated with weight gain: type 2 diabetes (a family history of that could mean future female members have PCOS).
The gain explained: While the link between PCOS and weight gain is still a bit foggy, what experts do know is that people with PCOS can have high levels of insulin, and those high levels are tied to other health risks such as obesity and high blood pressure. "The weight gain is around your abdomen," says Watson. "When you have excessive fat tissue in your abdominal area around the organs it is more detrimental to your health (than fat clinging to other areas, such as your rear end or upper thighs)." Apple-shaped people with abdominal fat are at higher risk for a heart attack than pear-shaped people, reports a 2005 Interheart study from McMaster University in Hamilton. PCOS-induced weight gain can also be fast and significant despite attempts to exercise.
What now: Medication options include Metformin, which regulates your metabolism again and balances the hormones, says Dornan. Or you may be prescribed a birth control pill as well, he says, to offset unfortunate side-effects such as acne and facial hair growth. "Sometimes the treatment is similar to that for diabetes: lifestyle changes, diet and weight loss, as well as a medication," says Dornan. Given the intricacies of PCOS, a dietitian might help you find a personalized calorie-reduced (and often insulin-balanced) diet.
3. Cushing's syndrome
What is it? Also known as hypercortisolism, this rare condition means there is too much of the hormone cortisol in the adrenal glands. Cortisol normally helps regulate blood pressure and metabolism. While weight gain is a big red flag, tiredness and troubles with the skin (bruises last longer than usual, for example) are also signs. While both children and adults can develop hypercortisolism, it's more common in women aged 25 to 45 years.
The gain explained: The weight gain tends to occur in the upper body and particularly around the face and neck area, similar to if you were receiving corticosteroid injections, says Watson. "A roundish face, an apple-shaped upper body, that's where the gain would come in," she says.
What now: There are a variety of reasons for too much cortisol in the body - you may have been taking medications for another condition, such as asthma, or there could be a noncancerous tumour causing the oversecretion. So treatment will vary and may include surgery, radiation or taking cortisol-inhibiting drugs. This levelling out will help regulate symptoms; losing the weight comes down to hard work. "There are no drugs that you can just give to counter the weight-gain effects," says Dornan. Instead, it's incorporating healthful meal choices - lean proteins, whole grains, fresh produce - and increasing your activity options whenever you can. Check out Health Canada's website (www.hc-sc.gc.ca) for easy activities you can do at home, work or outside.
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