Seeking Medical Help for Unexplained Weight Gain at 40

Q: Seeking Medical Help for Unexplained Weight Gain at 40

Dear Mr. Aqi： 1. Factors contributing to weight gain include diet, patterns of physical activity, and differences in energy metabolism; very few cases are due to single-gene mutations or specific genetic disorders. 2. Familial obesity may be influenced not

Abnormal weight gain

Hello: I am 40 years old, 170 cm tall, and currently eat one meal a day while walking 10,000 steps.
My lifestyle is regular.
I have gained 12 kg in the past six months, and my endocrine blood tests have shown no issues.
How should I seek medical assistance?

Aqi, 40~49 year old female. Ask Date: 2017/11/22

Dr. Xiao Yongxun reply Internal Medicine

Dear Mr.
Aqi:
1.
Factors contributing to weight gain include diet, patterns of physical activity, and differences in energy metabolism; very few cases are due to single-gene mutations or specific genetic disorders.

2.
Familial obesity may be influenced not only by genetic factors but also by shared lifestyle and environmental factors; therefore, a detailed assessment of family history is essential when discussing obesity.

3.
Other factors to consider include endocrine abnormalities (such as hypothyroidism, adrenal tumors, etc.), the effects of medications (antipsychotics, tricyclic antidepressants, antiepileptic drugs like Valproate or Carbamazepine, and corticosteroids), and weight gain after smoking cessation.

4.
Regarding weight loss methods, it is generally recommended to consume at least 1000-1200 calories per day to meet physiological needs.
Specifically, women aiming for weight loss should target an intake of around 1200-1500 calories per day or reduce their caloric intake by 500 calories daily, which could result in approximately 0.45 kg of weight loss per week.
To meet the body's nutritional requirements, including proteins, carbohydrates, fats, fiber, vitamins, and minerals, a variety of foods should be consumed to avoid harm; moderation is key.
The recommended macronutrient distribution, based on the results of the National Health Administration's dietary survey, is approximately 50% carbohydrates, 30% proteins, and 20% fats.
Rapid weight loss can sometimes lead to rebound weight gain.
An unbalanced diet may lead to muscle protein loss or accelerated fat accumulation, which are important to monitor.

5.
I personally recommend that you chew your food thoroughly during meals, avoid overeating (aim for about 80% fullness), and limit high-calorie, high-fat, and high-sugar foods or beverages.
Reduce intake of high-cholesterol and trans fats (often found in creamers, butter, ghee, instant coffee, milk tea, etc.) and high fructose corn syrup (commonly found in commercial beverages, desserts, sodas, and pastries).
These types of foods may be harder for the body to metabolize, may contain empty calories that do not provide satiety, and can lead to increased blood sugar levels.
On the other hand, it is important to develop a regular exercise routine, such as playing sports, jogging, swimming, or cycling; in fact, a good 30-60 minute walk after each meal can be very effective.
In terms of lifestyle, it is crucial to manage stress and ensure adequate sleep; this can help reduce the excessive secretion of related glucagon hormones and increase leptin secretion, aiding in weight control.

6.
You have gained 12 kg over the past six months, averaging 2 kg per month.
If weight gain continues, it would be advisable to discuss this in detail with your family physician, or you may directly consult an endocrinologist or obesity specialist to present your dietary and exercise patterns along with weight changes, which may help identify the underlying causes.

Reply Date: 2017/11/22

More Info

If you are experiencing unexplained weight gain of 12 kilograms over six months despite maintaining a regular lifestyle that includes walking 10,000 steps daily and eating only one meal a day, it is essential to take a systematic approach to seek medical assistance. Here are some steps you can follow:
1. Consult Your Primary Care Physician: Start by scheduling an appointment with your primary care doctor. They can perform a comprehensive evaluation of your health history, lifestyle, and any potential underlying conditions that may contribute to weight gain. Given that your endocrine tests have returned normal, your doctor may consider other factors such as metabolic rate, dietary habits, and psychological aspects.

2. Detailed Medical History: Be prepared to discuss your medical history in detail, including any medications you are taking, family history of obesity or metabolic disorders, and any recent changes in your life that could contribute to weight gain, such as stress or changes in sleep patterns.

3. Lifestyle Assessment: Your doctor may ask you to keep a food diary to track your daily caloric intake and nutritional quality. Eating only one meal a day may not provide sufficient nutrients or calories for your body’s needs, potentially leading to metabolic changes that could affect weight.

4. Consider Psychological Factors: Weight gain can sometimes be linked to psychological factors such as stress, anxiety, or depression. If you feel that emotional factors may be influencing your eating habits or lifestyle, discussing these with your doctor or a mental health professional could be beneficial.

5. Referral to Specialists: If your primary care physician cannot identify the cause of your weight gain, they may refer you to a specialist, such as an endocrinologist or a weight management clinic. These specialists can conduct further tests, including metabolic assessments, to determine if there are any hormonal imbalances or other medical conditions contributing to your weight gain.

6. Nutritional Counseling: Working with a registered dietitian can help you develop a balanced meal plan that meets your caloric and nutritional needs. They can help you understand portion sizes, the importance of macronutrients, and how to incorporate a variety of foods into your diet to promote weight management.

7. Regular Monitoring: Keep track of your weight and any changes in your body composition. Regular follow-ups with your healthcare provider can help monitor your progress and make necessary adjustments to your treatment plan.

8. Physical Activity: While you are already walking 10,000 steps a day, consider incorporating other forms of exercise, such as strength training or aerobic workouts, which can help boost your metabolism and promote weight loss.

9. Avoid Quick Fixes: Be cautious of fad diets or weight loss supplements that promise quick results. Sustainable weight management typically involves gradual lifestyle changes rather than drastic measures.

10. Stay Informed: Educate yourself about weight management and healthy eating habits. Understanding the science behind weight gain and loss can empower you to make informed decisions about your health.

In summary, seeking medical help for unexplained weight gain involves a comprehensive approach that includes consulting with your primary care physician, assessing your lifestyle and dietary habits, considering psychological factors, and possibly working with specialists. By taking these steps, you can identify the underlying causes of your weight gain and develop a personalized plan to address them effectively.

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