Weight Gain and Abdominal Changes: A Medical Perspective

Q: Weight Gain and Abdominal Changes: A Medical Perspective

Hello： Generally speaking, an increase in the intake of sugary beverages can easily lead to weight gain, so it is recommended that you start with dietary control. <br>As for whether steroids have an impact, it is advisable to discuss this with your rheumatology and immunology spe

Weight gain and body shape changes - increased abdominal fat?

Hello Dr.
Hou, I have a few questions regarding weight gain (I am 156 cm tall and weigh 48.4 kg).

1) Since the Lunar New Year, my weight has been steadily increasing (from 46 kg to the current 48.4 kg), and fat has started to accumulate around my abdomen and waist.
Previously, when I weighed 48 kg, my body shape was not like this (my stomach has started to protrude widely, and I even feel like my upper body and legs are gaining weight; before, I only noticed some bulging around my waist and thicker thighs).
Therefore, I would like to consult with you about the possible reasons.
I have a habit of staying up late (but I usually get about 8 hours of sleep).
Additionally, I have been treated for lupus erythematosus since 2012 and increased my medication three years ago (from 3 to 5 steroid pills).
However, due to my late-night habits, I often take the steroids in the afternoon (I heard from a doctor that taking steroids after 3 PM will definitely cause weight gain?!).
Regarding my diet, I consume about 1.4 to 1.9 liters of fluids daily.
Over the past six months, I have almost completely stopped eating toast for breakfast, but my intake of icy treats (shaved ice) has increased from once every two to three weeks to as much as twice a week (with condensed milk and jelly).
I used to drink fresh milk tea, but I have stopped consuming caffeine for the past few months, so I no longer drink it.
During the transition period of quitting caffeine over the last two months, I have been drinking winter melon milk and honey aloe vera drinks (up to 2-3 cups a week at most).
Occasionally, I eat cake and similar foods, but in smaller portions than before.
In terms of exercise, I have also reduced my activity over the past two months; I walk for 30 minutes 3-4 days a week and do yoga stretching in the morning and evening (previously, I would do a 15-minute yoga session that made me sweat in the morning).
I would like to understand the impact of medication side effects (I am unsure how long it takes for side effects to become noticeable) or if this is simply due to lifestyle habits and diet.
2) After gaining weight this time, when I tense my stomach, I can see uneven, grainy skin from the inside.
I would like to ask if that is fat? (I have never seen this before).
Thank you! Ann

Ann, 30~39 year old female. Ask Date: 2022/09/06

Dr. Hou Angting reply Family Medicine

Hello: Generally speaking, an increase in the intake of sugary beverages can easily lead to weight gain, so it is recommended that you start with dietary control.
As for whether steroids have an impact, it is advisable to discuss this with your rheumatology and immunology specialist for evaluation.
Wishing you good health.

Reply Date: 2022/09/06

More Info

Understanding weight gain and changes in body shape, particularly around the abdomen, can be complex and multifaceted. Based on the information provided, several factors could be contributing to your recent weight gain and the accumulation of fat in your abdominal area.

1. Hormonal and Medication Influences
You mentioned that you have been diagnosed with lupus erythematosus and have been on corticosteroids for treatment. Corticosteroids are known to cause weight gain and changes in body fat distribution, particularly leading to increased abdominal fat. This phenomenon is often referred to as "Cushingoid" appearance, characterized by a rounded face, increased fat around the neck, and abdominal obesity. The timing of your medication intake can also play a role; taking corticosteroids later in the day may lead to increased appetite and weight gain, as these medications can stimulate appetite and alter metabolism.

2. Dietary Changes
Your dietary habits have shifted, with a reduction in certain foods and an increase in others, such as ice desserts. While you have reduced your intake of bread, the consumption of high-sugar items like shaved ice can contribute to weight gain, especially if they are consumed frequently. Additionally, the transition from caffeinated beverages to sweetened drinks can also lead to increased caloric intake. It’s essential to monitor not just the quantity of food but also the quality of the calories consumed. Foods high in sugar and low in nutritional value can lead to weight gain, particularly when combined with a sedentary lifestyle.

3. Physical Activity Levels
You noted a decrease in your physical activity over the past two months. Regular exercise is crucial for maintaining a healthy weight and preventing fat accumulation, especially in the abdominal area. While walking and yoga are beneficial, they may not be sufficient if your overall activity level has significantly decreased. Engaging in more vigorous forms of exercise, such as aerobic workouts or strength training, can help counteract weight gain and improve body composition.

4. Sleep Patterns and Stress
Although you mentioned getting around eight hours of sleep, the quality of sleep and sleep patterns can significantly impact weight. Poor sleep quality and irregular sleep schedules can lead to hormonal imbalances that promote weight gain. Additionally, stress can influence eating behaviors and fat storage, particularly in the abdominal region.

5. Physical Changes and Body Awareness
You expressed concern about noticing unevenness in your abdomen when tensing your muscles. This could be related to fat distribution or changes in muscle tone. It’s not uncommon for individuals to notice changes in their body as they gain weight, especially if the fat is accumulating in specific areas. If you are concerned about these changes, it may be beneficial to consult a healthcare professional for a physical examination.

Conclusion
In summary, your weight gain and changes in body shape are likely influenced by a combination of medication effects, dietary choices, physical activity levels, and possibly sleep quality. It would be advisable to discuss your concerns with your healthcare provider, particularly regarding the effects of corticosteroids and any necessary adjustments to your treatment plan. Additionally, consider working with a nutritionist to develop a balanced eating plan that supports your health goals while managing your lupus. Regular physical activity tailored to your abilities can also help mitigate weight gain and improve overall well-being.

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