Gaining weight should not be taken lightly. Indeed, this can hide a real health problem and be directly associated with an underlying pathology, often endocrine, and/or a medical treatment.
Rapid weight gain and diseases (endocrine, hormone-related, autoimmune, etc.), what are we talking about?
Relatively rare, Cushing’s syndrome, due to hypersecretion of cortisol by the adrenal glands, is one of the classic but infrequent causes of weight gain. And even if this pathology is treatable relatively well thanks to screening by hormonal dosage, it must be admitted that this disease has quite unsightly consequences on the body: so-called “truncular” weight gain (localized on the upper part of the body), swollen face, redness, etc.
Polycystic ovarian syndrome
This syndrome is an abnormal disorder in women. It can be accompanied by one or more symptoms, such as hyperhair, amenorrhea or menstrual disorders. Weight gain is almost constant and mainly localized in the abdominal area. Hormonal treatment accompanied by dietary rebalancing will be indicated in the event of a proven diagnosis.
Does a thyroid disorder make you gain weight?
Yes, and unlike hyperthyroidism, which causes weight loss, hypothyroidism is often accompanied by weight gain due to a slowdown in metabolism, which facilitates the accumulation of fat and water in adipose tissue. For more or less obvious reasons (genetic predispositions, etc.), thyroid problems affect women 5 times more than men.
Certain rare genetic diseases, such as Prader-Willi syndrome, can cause excess weight in children. Weight gain is associated with the child being hungry almost all the time.
Which cancer is more common in people who are overweight?
There are several of them. In women, we can, for example, cite endometrial or breast cancer (after menopause), and in men, mainly that of the prostate. The colon, rectum and pancreas are combined in both sexes.
Drug treatments that influence weight gain
Beyond the diseases that directly influence weight gain, we must also address the pathologies for which the drug treatment acts on weight gain.
When prescribed in high doses for several weeks or months, corticosteroids frequently induce weight gain in patients: water retention, swelling of the face. However, this treatment with undesirable effects is often the most effective option. Indicated to treat certain inflammatory diseases such as polyarthritis or Horton’s disease, etc.)
Neuroleptics, indicated in patients with schizophrenia, bipolar disorders or hallucinatory psychosis, can be associated with sometimes very high weight gain, up to 15 kilos. In question: modifying the primary metabolism causes a desire for sweet tastes (sodas, cakes, etc.). In many cases, these heavy treatments and high doses will be essential to stabilize and cure these highly disabling disorders for the patient.
The first should be distinguished from neuroleptics since they will mainly be prescribed to treat depression. Among the antidepressants that can cause weight gain, we can cite so-called “imipramine” antidepressants (amitriptyline, doxepin, imipramine, etc.) and so-called “tetracyclic” antidepressants (mianserin, etc.). And if, in many situations, it will be challenging to do without it, talking to your doctor about these possible adverse effects on weight will allow you to moderate the dosage and thus limit weight gain.
To this list of medications that can impact weight gain, let us add, and to a lesser extent, certain antihistamines or treatments indicated for women, such as synthetic progestins but also insulin or sulfonamides in the context of diabetes. Repeated antibiotic therapy in the newborn/infant would also be a risk factor for subsequent overweight and obesity in negative interaction with cesarean section due to microbiota modification.
Menopause and weight gain: a particular case
If menopause is not an illness in the strict sense of the term but quite simply a natural mechanism of ageing in women, it is important to remember its link with weight gain. “This is mainly explained by body modification with a reduction in fat mass and a change in the distribution of adipose tissue in favour of abdominal-visceral adipose tissue.
Weight gain at menopause is not inevitable. Its management must include an incentive to increase physical activity and dietary advice. Diets are not recommended. However, it is necessary to carry out change in small steps.
How to lose weight linked to a pathology?
Whatever the cause (metabolism disease, taking medications, overeating, etc.), kilos that have settled over time will always be more challenging to dislodge. Indeed, the adipose tissue becomes inflammatory, and it becomes more difficult to reverse the weight curve.
Obesity is the most telling example, with the difficulty of getting out of it once and for all. The recurrence risks are numerous, and this chronic disease is also classified as a global epidemic. The WHO ( World Health Organization) also points out on its website that worldwide, the number of cases of obesity has almost tripled since 1975 (source 1).
Let’s also not forget that weight gain is associated with other of the most common factors:
Without forgetting, a lack of physical activity, which in many cases explains overweight or obesity.
Epigenetic factors and the microbiota: Certain extremely early events in utero, at birth and in the first months of life (stress, overnutrition, deficiencies in the mother, etc.) influence the child’s microbiota. And we know that the microbiota is an essential factor in weight gain and/or low-grade inflammation associated with being overweight.
The method of delivery: Delivery by cesarean section is a risk factor for subsequent overweight and obesity for the child, which would imply a modification of the microbiota transmitted by the mother to the newborn. Genetic factors are also an explanation for excess weight in individuals.
Life events: Sexual assault, incest, death, divorce, dismissal, smoking cessation, etc., are all reasons that can explain a weight imbalance.
The issue of stress, poor sleep, and the work rhythm (night shifts) also play a role in weight management; poor diets, including ultra-processed” products, are also accused by researchers of being real endocrine disruptors.