Piling on the pounds - how can my GP help?
Weight gain - what could be to blame?
Most of us battle with our weight at some point in our lives. But how can you tell if there's a medical cause - and what can you do if there isn't?
Medical causes of weight gain
Underactive thyroid problems
Your thyroid gland tells your body how fast to 'tick over'. If it isn't working properly, everything slows down. Common symptoms, then, include tiredness, putting on weight, constipation and feeling cold all the time. Women are much more prone than men to underactive thyroid problems, and it's one of the most common hormone problems among women.
The symptoms of an underactive thyroid tend to come on fairly gradually, so at first you may not notice anything is wrong. But if your weight gain is accompanied by these symptoms, it's worth asking your GP about getting a blood test to rule out underactive thyroid.
Polycystic ovary syndrome
Being overweight isn't the cause of this common condition, but it can make you more prone to putting on weight and make losing weight even more of a challenge than for other people. Other symptoms include irregular or absent periods, excess facial or body hair and developing spots. A blood test, or sometimes an ultrasound scan of your ovaries, can make the diagnosis. Even though weight loss may be difficult, it can help reduce all the symptoms of polycystic ovary syndrome.
There's a lot of debate about whether the hormone changes of the menopause necessarily cause weight gain. However, many women do start putting on more weight around their tummies after the menopause.
How can my GP help?
If you have an underactive thyroid, tablets can usually get your thyroid back in balance. This will help you lose excess weight and will certainly reduce the risk of putting on more.
Polycystic ovary syndrome condition can't be cured, but it's important to have the diagnosis because it can increase your risk of diabetes and heart disease. That means your doctor is likely to want to check you regularly for risks of these conditions.
Even if there is no medical cause for your weight gain, there is still lots that your GP can do to help. Most areas of the country now have a variety of services available, so that you and your GP can work out which one will suit you best. For instance, if you can't exercise because of physical problems, a dietician might suit you better than a 'lifestyle management' clinic. Options include:
- Practice nurse - anyone can see the practice nurse regularly for advice on diet and exercise, regular weigh-ins and support. Try keeping a food diary for a week before your first appointment
- Dietician - sadly there just aren't enough dieticians working in the NHS, but if you have diabetes or heart disease, or are obese (rather than 'just' overweight) you may well be able to see them for really detailed advice about diet
- Lifestyle management clinic - offers advice on exercise for weight loss as well as diet
- Bariatric surgery clinic - usually reserved for people who are very obese, these clinics offer a combination of intensive diet, exercise and psychological input. This is needed to help prepare you, if appropriate, for one of several surgical options for weight loss. You're only likely to be eligible if your BMI is over 40, or if it's between 35 and 40 and you have other weight-related health problems. Surgery for weight loss isn't a simple solution - it requires long-term follow up and lots of motivation, and isn't suitable for everyone.
Medicine made me put on weight!
Unfortunately, several medicines do make you more prone to weight gain. Some - including some tablets for diabetes, a depression treatment called mirtazapine and most medicines given for major mental health problems - can increase your appetite. Others - including tablets for epilepsy and nerve pain and many strong painkillers - make you more tired, so you're not as active. Beta-blocker tablets - given for heart problems - can make you physically less able to burn off calories with exercise.
Your doctor won't give you treatment if you don't need it. However, they may well be concentrating more on helping your condition improve than on what the side effects might be. So if you're worried about your weight, do check with your GP if it might be a side effect before they prescribe for you. They may well be able to come up with an alternative that will be just as effective but without the same side effect.
With thanks to 'My Weekly' magazine where this article was originally published.