Ever Ask Why?

Ever ask yourself why am I overweight? Why can I not lose weight? What am I doing wrong? You're following a weight-loss eating plan. You're exercising almost every day. You're proud of the new healthy habits you've learned. Yet week after week, the scale barely seems to budge. What gives? Maybe your food portion sizes have crept up? Are your workouts maybe not quite as intense as you think? If you know you've followed your reducing plan religiously, there's another possibility: A medical condition -- or medication -- may be to blame.


"If you haven't been able to lose weight and you can't understand why, you need to determine whether there's a medical condition underlying your weight problem," says Peter LePort, MD, director of the Smart Dimensions Bariatric Program at Orange Coast Memorial Medical Center in California. "You need to cure that problem first before you can address the weight issue."


Several conditions can cause weight gain or hinder weight loss, says Rebecca Kurth, MD, director of PrimeCare at Columbia-Presbyterian Eastside and associate professor of clinical medicine at Columbia University.


There are so many different things that factor into why someone is, was, or may become obese. From lack of exercise, stress, and medical issues, to medications, sleep habits, and much more. I will try to share information on some of the most important topics, if there is something more you are interested in, or you have something to add, or just simply a question about this blog or anything else, please feel free to use the ASK ME page above!

Goodness where to start - 

Emotional Eating

Some people eat more than usual when they're bored, angry, or stressed. Over time, overeating will lead to weight gain and may cause overweight or obesity. Many people respond to stress or depression by eating excessively. Sources of stress may not always be apparent, but may still affect eating habits and cause weight gain. SEE STRESSED BLOG

Lack Of Energy Balance

A lack of energy balance most often causes obesity. Energy balance means that your energy IN equals your energy OUT. Energy IN being the amount of energy or calories you get from food and drinks and energy OUT being the amount of energy your body uses for things like breathing, digesting, and being physically active. To maintain a healthy weight, your energy IN and OUT don't have to balance exactly every day. It's the balance over time that helps you maintain a healthy weight. Weight gain happens over a period of time when you take in more calories than you use.  An easy way to think about it is to remember that:

• The same amount of energy IN and energy OUT over time = weight stays the same
• More energy IN than energy OUT over time = weight gain
• More energy OUT than energy IN over time = weight loss

An Inactive Lifestyle

Many people in the US are not very physically active anymore, I blame the fact that people spend a lot more time in front of TVs and computers doing work, schoolwork, and leisure activities than they used to. In fact, more than 2 hours a day of regular TV viewing time has been linked to obesity. Other reasons for not being active include the fact that we tend to rely on cars instead of walking, have fewer physical demands at work or at home because of modern technology and conveniences, and the lack of physical education classes in schools for children. People who are less active are more likely to gain weight because they don't burn up the calories that they take in from food and drinks. An inactive lifestyle also raises your risk of  coronary heart disease, high blood pressure, diabetes, colon cancer, and other health problems.

Environment

Our environment doesn't always support healthy lifestyle habits; in fact, it encourages obesity in some situations. Some reasons include:

• Lack of neighborhood sidewalks and safe places for recreation. Not having area parks, trails, sidewalks, and affordable gyms makes it hard for people to be physically active.
• Work schedules. People often say that they don't have time to be physically active because of long work hours and time spent commuting.
• Oversized food portions. Americans especially are surrounded by huge food portions in restaurants, fast food places, gas stations, movie theaters, supermarkets, and even at home. Some of these meals and snacks can feed two or more people. Eating large portions means too much energy IN at once and over time, this will cause weight gain if it isn't balanced with physical activity. Some Food for thought - A normal ADULT meal is a kids meal at most fast food restaurants. 
• Lack of access to healthy foods. Some people don't live in neighborhoods that have supermarkets that sell healthy foods, such as fresh fruits and vegetables. Or, for some people, these healthy foods are too costly. It is sad it is cheaper to buy a bag of chips than a box of whole grain crackers.
• Food advertising. Americans are surrounded by ads from food companies. Often children are the targets of advertising for high-calorie/fat snacks and sugary drinks. The goal of these ads is to sway people to buy these unhealthy foods, and often they do.

Genes and Family History

Obesity tends to run in families. Your chances of being overweight are greater if one or both of your parents are overweight or obese. (Not that you should use that as an excuse, EVER, and remember that it doesn’t mean you can not fix it or change it either, you can.) Studies of identical twins who have been raised apart show that genes have a strong influence on a person's weight. Your genes also may affect the amount of fat you store in your body and where on your body you carry the extra fat. Because families also share food and physical activity habits, a link exists between genes and the environment. Children adopt the habits of their parents. A child who has overweight parents who eat high-calorie foods and are inactive will likely become overweight too. However, if the family adopts healthy food and physical activity habits, the child's chance of being overweight or obese is reduced.

Health Conditions 

Some hormone problems may cause overweight and obesity, such as under active thyroid (hypothyroidism), Cushing's syndrome, and polycystic ovarian syndrome (PCOS) and more, I will cover a few but shockingly there are at least 300 different medical conditions that can cause weight gain so I can not cover them all! If you think you may have any of these please consult a doctor!

1. Under active thyroid or hypothyroidism is a condition in which the thyroid gland doesn't make enough thyroid hormone.  Thyroid hormone deficiency can decrease metabolism of food, causing appetite loss and modest weight gain. Weight gain is from fat accumulation and fluid retention caused by protein deposits in the body.  Symptoms of hypothyroidism can include fatigue, lethargy, swelling of the face or around the eyes, dry, coarse skin, decreased sweating, poor memory, slow speech and hoarse voice, weakness, intolerance to cold and headache. 
2. Essential Fatty Acid Deficiency is a lack of essential fatty acids, such as in flaxseed oil, are good fats that are needed by the body to make hormones and maintain the body's metabolic rate. A deficiency may cause cravings, particularly for fatty foods. The first signs of deficiency are often dandruff, dry hair and dry, scaly skin. Deficiency is also associated with arthritis, eczema, heart disease, diabetes and premenstrual syndrome.
3. PCOS is a condition that affects about 5–10 percent of women of childbearing age. Women who have PCOS often are obese, have excess hair growth, and have reproductive problems and other health issues due to high levels of hormones called androgens.  
4. Kidney, Heart or Liver Disease can cause fluid retention, which appears as general puffiness all over the body, especially the eyes and ankles.
5. Food Sensitivity is a general term for reactions to certain foods and thee are not always immediate reactions. These reactions can occur many hours later as bloating and swelling in the hands, feet, ankles, abdomen, chin and around the eyes. Much of the weight gained is fluid retention caused by inflammation and the release of certain hormones. In addition, there is fermentation of foods, particularly carbohydrates, in the intestines which can result in a swollen distended belly and gas production. Symptoms of food sensitivity can include headache, indigestion or heartburn, fatigue, depression, joint pain or arthritis, canker sores, chronic respiratory symptoms such as wheezing, sinus congestion or bronchitis and chronic bowel problems such as diarrhea or constipation. 
6. Blood Sugar Imbalance is caused by eating simple, refined carbohydrates which can cause rapid fluctuations in blood sugar levels. For example, eating chocolate increases the amount of sugar in the blood. The hormone insulin is released which causes sugar to be stored away and blood sugar levels to be lowered, which can trigger cravings for more sweets in order to stabilize blood sugar balance.
7. Cushing's syndrome is a condition in which the body's adrenal glands make too much of the hormone cortisol. Cushing's syndrome also can develop if a person takes high doses of certain medicines, like prednisone, a steroid, for long periods of time. Cushing’s causes fat to accumulate in the face, abdomen and upper back, often producing a characteristic rounded "moon" face and "buffalo hump" while the arms and legs usually remain slender. Other symptoms of Cushing's Syndrome include muscle wasting and weakness, thin skin, poor wound healing, easy bruising, purple "stretch marks" on the abdomen, menstrual irregularities, high blood pressure, glucose intolerance and hair loss in women.
8. Weight gain can also be caused by organ enlargement, such as from an ovarian cyst, and obstruction of lymph fluid. 

Smoking

Some people gain weight when they stop smoking. One reason is that food often tastes and smells better after quitting smoking and another reason is because nicotine raises the rate at which your body burns calories, so you burn fewer calories when you stop smoking. I have also heard people say they eat because smoking was a such a habitual thing that eating or chewing gum is the way to get over that part of the habit. However, smoking is a serious health risk, and quitting is more important than possible weight gain.

Age

As you get older, your metabolism slows down and you tend to lose muscle, especially if you're less active. Muscle loss can slow down the rate at which your body burns calories. If you don't reduce your calorie intake as you get older, you may gain weight. Midlife weight gain in women is mainly due to aging and lifestyle, but menopause also plays a role. Many women gain around 5 pounds during menopause and have more fat around the waist than they did before.

Pregnancy

During pregnancy, women gain weight so that their babies get proper nourishment and develop normally. After giving birth, some women find it hard to lose the weight. This may lead to obesity, especially after a few pregnancies if you do not work on getting rid of it right away. The longer fat sits in your body the harder it is to get rid of it.

Lack of Sleep

Studies find that the less people sleep, the more likely they are to  gain weight. People who report sleeping 5 hours a night, for example, are much more likely to become obese compared with people who sleep 7–8 hours a night. People who sleep fewer hours also seem to prefer eating foods that are higher in calories and carbohydrates because it gives more of a temporary energy boost, which can lead to overeating, weight gain, and obesity over time. Hormones that are released during sleep also control appetite and the body's use of energy. For example, insulin controls the rise and fall of blood sugar levels during sleep. People who don't get enough sleep have insulin and blood sugar levels that are similar to those in people who are likely to have diabetes and  people who don't get enough sleep regularly seem to have high levels of a hormone called ghrelin (which causes hunger) and low levels of a hormone called leptin (which normally helps curb hunger).See? A reason to nap!

Last But Probably Most Asked About - 

Medicines

Certain medicines such as corticosteroids, antidepressants, steroids, no steroidal anti-inflammatory drugs (NSAIDs), antidepressants, diabetic medications, and seizure medicines can cause you to gain weight. These medicines can slow the rate at which your body burns calories, increase your appetite, or cause your body to hold on to extra water, and Hormone replacement therapy and oral contraceptives containing estrogen can cause fluid retention and increased appetite. All of those are factors can lead to weight gain. 

Metabolism changes: Some drugs change the body's metabolism, and calories are burned more slowly.

Corticosteroids: Corticosteroids are known to stimulate appetite while reducing the body's ability to absorb glucose, which can promote fat deposits in the midsection.

Beta-blockers: Beta-blockers can cause shortness of breath and fatigue, making it difficult for patients taking them to exercise.

Calcium channel blockers: Calcium channel blockers taken for high blood pressure can cause users to retain water.

Anti-psychotic medications: Drugs used to treat psychiatric conditions and mood disorders, like depression and bipolar disorder, are among those most closely associated with weight gain. It is so common with drugs like Paxil (paroxetine), Zoloft (sertraline), Clozaril (clozapine), Seroquel (quetiapine), Zyprexa (olanzapine) and Risperdal (risperidone) that researchers have called it "an epidemic within an epidemic." As a result, the FDA has, since 2004, required manufacturers of certain anti-psychotic medications to add a warning statement to doctors prescribing these drugs. The warning outlines the increased risk of diabetes and hyperglycemia that can result from use of the drugs.

Side Effects of Weight Gain From Medications

How much weight is gained varies from patient to patient and from drug to drug. Some patients may gain a few pounds over the course of a year; others experience weight gains in excess of 100 pounds in a matter of months. Because many of these drugs are taken for chronic conditions, their use over a period of several years can contribute to substantial weight gains patients often experience. In addition to the emotional and social dimension of weight gain, patients can also experience serious health conditions -- diabetes, high blood pressure, osteoarthritis, metabolic syndrome, high cholesterol -- that are created or made worse by added weight. Some healthcare providers proactively tell their patients about the potential for weight gain when prescribing certain drugs and advise the patients to moderate their diet and increase their aerobic exercise to offset any weight increases.

Perhaps the most serious result of drug-induced weight gain is that many patients stop taking their medication or decide on their own to switch to a lower dosage. As a result, potentially serious underlying health conditions may go untreated. Lack of compliance with a drug regimen because of weight gain has been cited as a particular problem with patients taking antipsychotic and antidepressant drugs.

Alternative Medications

All patients, regardless of condition, should talk to their healthcare provider before stopping medication or changing doses. In many cases, your doctor may be able to recommend a drug that works just as well without the added pounds. Or, your doctor may decide to prescribe an additional drug to treat any weight gain you might experience.