Weight gain
Classification
When systematizing the variants of a symptom, regardless of its cause, the so-called body mass index (BMI, Quetelet index) is taken into account, defined as the ratio of weight (in kilograms) to height (in meters) squared. Normally, the figure is between 18.50 and 24.99. Taking into account BMI, pathological weight gain manifests itself in such forms as:
Preobesity (overweight): from 25.00 to 29.99.
Obesity I degree: from 30.00 to 34.99.
Obesity II degree: from 35.00 to 39.99.
Obesity III degree: more than 40.00.
Weight gain reasons
Binge eating
In healthy people, the most common cause of weight gain is regularly consuming more calories than is necessary for a given height and activity level. The qualitative composition of food is in second place - extra pounds appear when overeating both fats and carbohydrates, the excess of which also turns into lipids. The increase in mass occurs gradually, by 1-3 kg per month. A person notices that the usual clothes become tight, fatty folds are formed in the hips, arms, and abdomen. A rapid or sudden increase in volume is an indication for a visit to the doctor.
Stress
Prolonged emotional stress can lead to the release of adrenal hormones, changes in metabolic processes, which is manifested by increased fat deposition. These reasons are more likely to cause rapid weight gain in women who are more prone to mood swings. People who tend to "seize" their problems, with chronic stress, are able to gain 5-6 kilograms per month. At the same time, the proportions of the body are preserved, the deposition of fat occurs according to gender: in women in the lower abdomen and on the hips, in men - in the trunk area. White stretch marks form on the skin, it becomes pale and pasty.
Wrong way of life
Physical inactivity leads to weight gain even with normal calorie intake, while the qualitative composition of the body worsens - the percentage of body fat increases, and the number of muscles decreases. Weight can increase by only a few kilograms, but the appearance suffers noticeably: the skin looks flabby, cellulite appears, fatty folds appear on the abdomen, back, in the armpit. Extra pounds are formed with a lack of sleep due to insomnia or improper organization of the regimen, which is due to a slowdown in metabolism and sharp fluctuations in the level of leptin, which is responsible for the feeling of fullness.
Fluctuations in sex hormones
In adolescent girls, the formation of ovarian function occurs, therefore, during puberty, excessive fullness is often noted, which disappears after the normalization of the menstrual cycle. A drop in the amount of estrogen, fluid retention are the key reasons for a sharp noticeable weight gain before menstruation in women, especially significant in the edematous form of premenstrual syndrome. The mass increases 2-3 days before the onset of menstruation due to water, after the onset of bleeding, the weight returns to normal. The increase in volumes is also provoked by an increase in appetite in many women before critical days.
Weight gain is a characteristic sign of the onset of menopause. During this period, the production of estrogen rapidly decreases in the female body, as a result, the metabolic rate is disrupted and excessive fat deposition occurs. Patients suddenly gain 5-7 kg per month, large folds of fat form in the abdomen and thighs, and the body becomes loose and flabby. There is a variant of menopause in men, starting after 50 years, when the amount of testosterone decreases. This promotes the accumulation of fat in the upper torso and abdomen.
Itsenko-Cushing's disease
With an increase in the level of ACTH in the body, hyperproduction of hormones of the adrenal cortex occurs with a change in metabolic processes in the direction of synthesis and deposition of fats. An increase in volumes in Itsenko-Cushing's disease is detected mainly in the abdominal region, due to which the proportions of the body are violated: the abdominal circumference increases to 90-100 cm or more, the arms and legs seem thin compared to the body. Crimson stretch marks form on the skin of the thighs and abdomen. In addition to visible symptoms, disturbances in the work of internal organs develop: myocardial damage, hypertension, osteoporosis.
Hypothyroidism
With hypofunction of the thyroid gland, the synthesis of its hormones decreases, which causes a slowdown in metabolic processes and an increased deposition of lipids in the subcutaneous tissue. The formation of extra pounds is possible even with a moderate diet, weight gain is accompanied by other symptoms - constipation, cold snap and pallor of the skin. To the visible signs of hypothyroidism as a reason for the accumulation of extra pounds, asymmetry and an increase in the neck are often added, which is due to the proliferation of thyroid tissue.
Mental disorders
In schizophrenia, a rapid increase in volumes is associated with a violation of the nervous regulation of hunger and satiety, so the patient can eat every half hour or hour and still remain hungry. With dementia and senile dementia, polyphagia (gluttony) is also observed, which contributes to the appearance of excess weight. Sometimes overweight becomes a consequence of bulimia nervosa, when a person absorbs food in large quantities, and then in every possible way tries to cleanse the gastrointestinal tract (by vomiting, taking laxatives). With bulimia, the weight increases by no more than 3-5 kilograms.
Complications of pharmacotherapy
Long-term use of corticosteroids and female sex hormone medications are important causes of sudden weight gain. Patients gain 8-10 kilograms in a short time, side effects in the form of obesity are more pronounced with the use of maximum dosages of drugs. In addition, due to a significant increase in appetite, patients with type 2 diabetes mellitus overeat and gain excess weight when treated with sulfonylureas. Weight gain can be triggered by the appointment of loop and thiazide diuretics, beta-blockers for hypertension.
Rare Causes
Genetic diseases: Carpenter syndrome, Lawrence-Moon-Biedl syndrome.
Disorders of the hypothalamic-pituitary regulation: Pickwick's syndrome, adiposogenital dystrophy.
Volumetric lesions: insulinoma, polycystic ovary disease (PCOS).
Diagnostics
When gaining weight for no apparent reason, patients seek medical attention. The specialist collects a detailed history, performs somatoscopy and measures body parameters. Then, basic laboratory tests and instrumental methods are performed to identify possible etiological factors of weight gain. According to the indications, consultations of narrow specialists are prescribed. The most informative are:
Somatometry.
The standard method is to measure the body mass index, which detects the presence of excess weight. With an indicator value of 25 in adults, they talk about extra pounds, a value above 30 indicates the development of obesity. Be sure to measure the waist circumference - an indicator greater than 80 cm indicates visceral obesity.
Hormonal profile.
In women, estrogen and progesterone levels are examined to establish the cause of the sudden weight gain, which allows detecting PCOS in young patients, and confirming menopause at the age of 45 years. With a possible male menopause, the testosterone content is measured. Also determine the concentration of thyroid-stimulating hormones of the pituitary gland, free thyroxine,
glucocorticosteroids.
Ultrasound procedure. If the increase in mass is accompanied by signs of hypothyroidism, an ultrasound of the thyroid gland is necessary. During the study, areas of reduced echogenicity of the parenchyma, calcium deposits in the gland are identified. Women need to have an ultrasound scan of the pelvic organs to exclude tumor formations.
X-ray methods.
To diagnose hypothalamic-pituitary pathology, accompanied by weight gain, sighting radiography of the Turkish saddle is used. To clarify the diagnosis, CT or MRI of the brain is recommended. To assess the function of the thyroid gland, scintigraphy with a radioactive isotope of iodine is done.
Treatment
Pre-diagnosis help
If you gain weight as a result of a high-calorie diet or a sedentary lifestyle, you can manage it without medication on your own or with the aid of a nutritionist. Dietary changes are required: cereals and whole grains, fresh or stewed vegetables, lean meats, and fish should form the foundation of the diet. Meals are consumed 4-5 times every day. Make sure to increase your physical activity, but don't overwork yourself. The rationale for seeking a specialist's guidance is rapid weight gain for no apparent reason.
Conservative therapy
Specific drugs for the treatment of weight gain are indicated only in advanced stages, when it is impossible to achieve results with diet therapy and physical activity. These drugs have many side effects, so they are used under the constant supervision of a doctor. After the establishment of the disease that caused obesity, etiotropic therapy is prescribed. Most often, such medicinal products are used.
means like:
Calorie blockers. The drugs reduce the absorption of nutrients in the small intestine by inhibiting
specific enzymes, so most of the food is excreted unchanged. Taking medications is accompanied by dyspeptic disorders.
Centrally acting drugs. The funds act on the structures of the brain, due to which appetite is sharply reduced. The effect occurs quickly enough, but the use of medications has an exciting effect on the central nervous system.
Psychotropic drugs. Tranquilizers and antipsychotics are indicated for schizophrenia and other severe mental illnesses. To achieve a lasting effect, drugs are taken in long courses under the supervision of a specialist.
Cytostatics. They are used for neoplasms of the endocrine organs that cause an increase in mass. Cytostatics suppress hormonal secretion, reduce tumor volume. Medicines can be combined with radiation therapy.
Surgery
With large pituitary adenomas, they are removed transnasally. With neoplasms of the adrenal cortex, unilateral adrenalectomy is necessary. If large ovarian cysts are detected, laparotomic or laparoscopic oophorectomy is performed. Hypothyroidism with the formation of a large goiter, which makes breathing difficult, is an indication for subtotal resection of the thyroid gland.