Could a Medical Condition Be to Blame for Weight Gain?

You're eating all the right foods and exercising several times a week. You've educated yourself on the ins and outs of healthy living, and you're committed to making small, sustainable changes to reach your goals. You feel better and your health is improving, but there's no change on the scale.

What gives?

While the scale is not the only measure of success, it's possible that certain medical conditions and medications might be making it more difficult to lose weight, despite being very active and following a strict healthy eating plan. Even if something outside your control is to blame, though, that doesn't mean you have to throw in the towel and give up on your weight-loss goals—especially if you treat the underlying problem while you're trying to lose weight.

If you think a medical reason is behind your scale's sudden derailment, be sure to speak with your doctor to get to the bottom of the issue. Your doctor will be able to safely guide you through managing your condition or medication while incorporating healthier habits into your life.

Medical Conditions You Should Know

1. Problems with your thyroid

"Hypothyroidism or lower functioning of the thyroid can be associated with unexplained weight gain as well as difficulty losing weight," explains Dr. Alexea Gaffney-Adams, M.D., who is board certified in infectious disease, internal medicine and pediatrics.

When discussing low thyroid function with patients, she describes the body as a car and the thyroid as the transmission. When the thyroid function is lower, the body tends to slow down or become sluggish. This leads to a slower metabolism and a tendency for your body to store more fat than you burn.

2. Polycystic Ovary Syndrome (PCOS)

Dr. Gaffney-Adams says that polycystic ovary syndrome is the result of a hormonal imbalance, a condition in which women experience an imbalance of their reproductive hormones. Experts believe the condition is caused by higher levels of insulin or when a woman's ovaries produce an excess of "male hormones" which can prevent the ovaries from releasing an egg during menstruation. As a result of PCOS, women experience menstrual irregularities, hirsutism or excess hair growth that mimics that of male patterns, acne, skin tags and difficulty losing weight.

3. Cushing's Syndrome

Dr. Susan Besser, M.D., a primary care provider at Mercy Personal Physicians in Maryland, says there are a lot of diseases involving the pituitary gland that can impact your weight. She says that since the pituitary gland is one of the "master control" glands, if it doesn't work well, neither will you.

Dr. Gaffney-Adams agrees that the pituitary gland plays a role in weight loss and gain, adding that certain hormones can come into play as well. Hormonal conditions such as Cushing's syndrome, for example, occur when your body is exposed to high levels of the hormone cortisol for a long period of time. This is associated with central obesity or an accumulation of fat in the abdominal cavity. She explains that Cushing's syndrome can also occur from excessive glucocorticoid (steroid) exposure. While rare, Cushing's syndrome and disease may require surgery to treat the symptoms.

4. Other Conditions Impacting Weight Loss

In addition to some of the more common medical reasons associated with stalled weight loss or weight gain, Dr. Besser also points to sleep disorders, such as sleep apnea or being a night worker, that could influence your health in a negative way. When your sleep is impacted, you are more likely to be hungry, experience an increase in cortisol levels and a decrease in metabolic rate.

To avoid falling victim to unhealthy habits due to a lack of sleep, aim for at least six to eight hours nightly. Besser says if you don't get enough sleep, your body's metabolism slows down. On the flip side, if you're sleeping too much, you're likely not getting the activity you need to burn calories and keep your body in fighting form.

Certain types of heart disease may also be to blame for some of your struggles. Dr. Besser recommends talking to your doctor if you're struggling with your weight and have heart disease.

The Medication Factor

There are several medications that lead to weight gain or make weight loss more challenging. Dr. Besser says some of the more frequently prescribed medications that cause problems with your weight include insulin, certain blood pressure medications (such as beta blockers which slow metabolism), prednisone, antidepressants (both directly and indirectly) and some antihistamines.

While taking the medication that is prescribed to you is essential in maintaining your health, you might want to have a conversation with your doctor to see if there is a suitable alternative you can try that may not have the same side effects. After all, your health is their priority.

How a Structured Diet and Exercise Program Can Help

Becky Kerkenbush, M.S., R.D., a member of the Wisconsin Academy of Nutrition and Dietetics, says the first step in overcoming weight-loss issues related to medical conditions is to see your physician or provider for a complete exam. During that appointment, ask for a referral to a registered dietitian for medical nutrition therapy. A registered dietitian can help to educate and counsel clients with these conditions.

Kerkenbush says that dietitians typically start by obtaining a diet recall and assessing a patient's current eating practices. They then provide education tailored to the patient's individual needs. Often getting medical conditions such as sleep disorder or diabetes under control will lead to weight loss as a secondary result.

If you're experiencing issues with losing weight due to a medical condition, Kerkenbush recommends incorporating the following tips into your routine. Working on your overall health can both improve your mood and help offset some of the weight gain caused by those aforementioned conditions.
  • Keep a food journal or log: You can't change what you don't recognize; keeping a food journal could be the key to recognizing unhealthy eating habits that have become second nature. Food journals should detail the time you eat, what you eat and the portion size of items. Also, include your feelings before and after the meal or snack. Did you feel unsatisfied, hungry, stuffed or sluggish after your meal? Why did you eat? Was it because it was that time of day, or were you stressed or bored?
  • Stay hydrated: Drink a glass of water when you wake up and before each meal. Sometimes we mistake hunger for thirst. Adequate hydration also helps with digestion and energy levels.
  • Increase your fruit and vegetable intake: "Strive for five." Aim for at least five combined servings of fruit and vegetables per day. Produce is high in fiber, vitamins and minerals while being low in calories, making them great items to include in meals and snacks. Eat a rainbow of color for optimal benefit.
  • Use the "My Plate" method: Make ¼ of your plate a lean protein (beans, legumes, poultry, fish, nuts/seeds or lean meat); ¼ of your plate a grain (preferably a whole grain, such as brown rice, wild rice, whole-wheat pasta, whole-wheat or rye bread or quinoa); and ½ your plate vegetables and fruit. Top it off with a glass of milk, a non-dairy substitute or water.
  • Exercise at least 10 minutes each day and look for ways to increase your steps throughout the day.
If you feel as though you're taking all the right steps and doing everything right, but the pounds just aren't coming off, talking to your doctor can be the best way to troubleshoot and find out if there's a bigger problem hiding underneath the surface. Take steps to take care of your body and your health will thank you in the end.