Weight gain doesn’t necessarily arise from an unhealthy lifestyle or eating pattern. Sometimes, it could be a result of a health condition.
Obesity is a complex disorder/disease which involves excess amount of fat in the body. It is not just a cosmetic concern. It increases the risk of diseases and health problems like systemic heart disease, diabetes and blood pressure. There are genetic causes and behavioural causes associated with obesity. Beside lifestyle, unhealthy eating and inactivity, hormonal influences also lead to obesity.
Apart from these, there are certain medical conditions and medications which lead to weight gain. One such cause is reduced function of thyroid glands, called hypothyroidism, which results in weight gain. Dr Sheilja Singh, consultant internal medicine at Hinduja Healthcare Surgical, Mumbai, says, “That’s because thyroid is a hormone associated with basic metabolic activity. When thyroid is produced in the correct proportion, we burn calories quickly. On the other hand, too little hormone slows the metabolism and often causes weight gain.”
PCOS is a hormonal disorder wherein women have excess androgen levels in the body. They develop irregular menstrual cycles. “The hormonal disruption also affects metabolic activity. Along with other symptoms such as unusual hair growth and acne, women with PCOS tend to put on weight, particularly on their abdomen,” shares Dr Vaishali Lokhande, consultant, internal medicine, Apollo Hospitals, Mumbai.
When a person gets little to zero physical activity, he/she ends up with musculoskeletal conditions. People who have osteoarthritis, or arthritis due to other conditions, have difficulty exercising and live a largely sedentary lifestyle. Dr Singh says, “Moreover, some medications given for these conditions contribute to obesity. These include steroids, anti-epileptics, antipsychotics and several anti-depressants. They all contribute to weight gain if they are not compensated with proper diet and exercise.”
Oral contraceptive pills increase the level of estrogen in the body which, in turn, could also cause weight gain. “High estrogen contributes to fluid retention and a larger appetite, in addition to fat deposition. It is reversible if the pills are taken for short duration,” says Dr Lokhande.
Lipodystrophy, which is associated with HIV treatment, is linked to unusual fat deposits. “This is a condition where abnormal fat deposits form around the upper body, while fat loss happens over the face area,” says Dr Lokhande.
Common conditions like sleep deprivation or obstructive sleep apnea too cause weight gain and obesity. When a person sleeps less than six hours a night, two hormones called leptin and grelin come into play. Leptin, secreted by the brain, gives you satiety. While grelin hormone is secreted by the stomach, causes cravings for food. “When we sleep less, leptin reduces, and so does satiety. Also, grelin increases, because of which the person experiences frequent hunger. The choice of food in such cases tends to take a turn for the worse. In this way, sleep deprivation leads to obesity because of imbalance of these two hormones,” explains Dr Singh.
Now, coming to obstructive sleep apnea, people who are obese and also those who snore tend to have fragmented sleep. “Their oxygen level tends to go down because of fragmented sleep which eventually leads also leads to imbalance of these hormones,” says Dr Singh.
Some medications used for migraine can result in weight gain, more so in young women. “The results last as long as the medication continues but sometimes the effects may be permanent,” adds Dr Lokhande.
The feeling of ‘fullness’ or satiety is controlled by a part of the brain called the hypothalamus. From a young age, many Indian children are forced to over-eat which, over time affects the satiety centre in the hypothalamus. “A severely affected hypothalamus could lead to Hypothalamic Obesity Disorder, which is when the metabolism of the body focusses entirely on storing weight, leading to weight gain despite efforts to manage weight through diet changes and exercise interventions. Hypothalamic disorder is sometimes associated with brain surgery, or hypothyroidism or an acute insult to the brain,” explains Dr Lokhande.