Medical Conditions Which Affect Weight: Separating Fact From Fiction

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PeachyCarol
PeachyCarol Posts: 8,029 Member
edited November 2015 in Health and Weight Loss
First let me say I know this can be a delicate topic, so I'd really hope to keep this discussion as civil as possible.

For example, I have hypothyroidism, but I know that undiagnosed hypothyroidism is only responsible for a slowed metabolism which accounts for a minor weight gain. Overall caloric intake will ultimately determine how much weight is gained before diagnosis.

Some people with conditions which account for only minor metabolic slow downs gain a lot of weight and it's frustrating for them, so that's why I'd like the discussion to tread lightly.

With that in mind...

A lot of medical issues/medications effect weight and are mentioned on the boards frequently. But there are a lot of misunderstandings and misconceptions surrounding them and their ultimate impact on weight loss.

I know we have members of the medical and scientific communities among us, I'm hoping they weigh in on this thread with some real knowledge to get information out there.

I should mention that this thread is for conditions which impact weight in any way, including those which include rapid weight loss.

For example, I have celiac disease. When it reached a crisis point before diagnosis, I lost 30 pounds in 2 months due to malabsorption issues. It was not a pleasant experience, I literally was not fully digesting food or liquid and was constantly dehydrated. My body turned to its fat stores for energy. At the time, I had a starting weigh of 160 pounds.

So, weigh in (see what I did there?) with your experiences and expertise so we can, together, separate fact from fiction!

[Edited at OP request]
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Replies

  • KT_3009
    KT_3009 Posts: 1,042 Member
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    I have/had hypothyroidism after a bad neck injury. I believe that yes it may "contribute" to minor weight gain but ultimately exercise and a defecit will stop that from happening! In my case I never had to take medication but I do find that I definitely used hypothyroidism as a bit of an excuse to my unhealthy eating habits..
    Anxiety medication on the other hand can be a huge factor (In my opinion) with weightloss and weight gain. The first week I was on medication I barely had no appetite and was feeling physically ill to try and eat the recommend intake. But it also can make you have crazy food urges as well
  • zoeysasha37
    zoeysasha37 Posts: 7,089 Member
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    Great thread carol !

    I have nothing to add as far as medical conditions but would like to mention prescription medicine .

    When I was first starting out, I went to the doctor and said " my depo birth control shot is causing me not to lose weight !"

    He said, that's actually a myth. Google the words" birth control and weight gain" , you'll see thousands saying the same thing but its only because that's how misunderstood people are. He explained that it can cause an increased appetite , thus causing people to eat at a surplus and gain weight. But people like to leave out the surplus part and go straight to the weight gain part . if you ask 100 girls did they gain weight on depo, 75 will say yes and zero will admit to overeating. So that's how the " weight gain from depo " thing goes.

    It came down to calories. Not the shot . once I truly was ready to give up the excuses, I was able to lose weight.

    There Will always be people who enjoy having an excuse. They really don't want it. I was once one of those people so I know all about it.


    Its often very hard for people to let go off the myths and excuses. Weight loss will always come down to calories . some will have to work a little harder then others but it still comes down to calories .
  • brendak76
    brendak76 Posts: 241 Member
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    I'm fascinated with cortisol levels right now. I've had a significant amount of trauma in my life the last 2 months. I'm also type 1 diabetic. I went to my endocrinologist this week to help with my suddenly out of control high blood sugars. I also asked her about the 8 pounds I gained almost overnight despite diligently counting calories, weighing food, exercising, etc. The weight gain, high blood sugars are all stress/cortisol induced. She gave a very scientific explanation of how excess cortisol causes weight gain even when you do not change your eating habits. So I'm still weighing my food and eating at a deficit but I'm also actively trying to reduce cortisol levels.
  • kattis81
    kattis81 Posts: 10 Member
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    Hmm this is a bit swings and roundabouts. Hypothyroidism may slow your metabolic rate and make you burn less calories. True but it also makes you cold and tired that ultimately has more impact as it's hard to get up from sofa and go running when you feel already tired and freezing and it's raining outside. Being cold also makes you want to eat warm things that are not made of salad. This is as real effect of hypothyroidism as metabolic slowdown so overlooking it is not helpful. Correct diagnosis and sufficient replacement therapy to treat the condition are the way forward not ignoring it or it's impact on health as whole.
  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
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    Cortisol can have an impact on weight for sure. One reason I think a lot of people don't gain as much weight as they might expect on a vacation is because they lowered their cortisol levels by being relaxed.

    One of the reasons it's suggested to take breaks from eating at a deficit is that long term dieting is itself a stressor. I think I might be coming to this point myself.
  • ki4eld
    ki4eld Posts: 1,215 Member
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    Sometimes, it's also not one medical condition, but a confluence of them that causes an issue. Maybe you handled it with one condition, but when a second came on, everything took a turn.

    That was my case. I was doing ok, then another condition hit and I was suddenly swamped, which caused another condition that added to it. From a healthy, active 220 to a borderline dying 306 in 20 months. That's why when someone says, "I've always been heavy but healthy. Suddenly, things took a turn," my first thought is "medical" not "you're overeating."

    Great thread @PeachyCarol
  • EvgeniZyntx
    EvgeniZyntx Posts: 24,208 Member
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    Perhaps what you are trying to do is reduce the short cuts people make?

    I'll take an example - I have a friend that became wheelchair bound four years ago (lateral paralysis) - this had led to her being obese. Obviously the chair didn't CAUSE the obesity but the conditions of difficulty in limiting consumption, depression, reduced mobility and the associated difficulty of increasing energy expenditure for someone that has difficulty moving resulted in consuming more calories than those expended.

    What 'fiction' do you think needs to be addressed?


  • MKEgal
    MKEgal Posts: 3,250 Member
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    None cause (effect) weight, though some can influence (affect) it, if people don't change how they eat.

    That seems to have been adequately addressed in this thread...
    as well as the myriad of others saying exactly the same thing.
  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
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    Perhaps what you are trying to do is reduce the short cuts people make?

    I'll take an example - I have a friend that became wheelchair bound four years ago (lateral paralysis) - this had led to her being obese. Obviously the chair didn't CAUSE the obesity but the conditions of difficulty in limiting consumption, depression, reduced mobility and the associated difficulty of increasing energy expenditure for someone that has difficulty moving resulted in consuming more calories than those expended.

    What 'fiction' do you think needs to be addressed?


    I think the fiction is dependent on the condition, Ev. There was a recent thread where someone brought up his own DKA, and he grossly misstated the mechanism of it and implied a medically impossible outcome of it. That's one type of fiction.

    Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.

    Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.

    I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.
  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
    edited November 2015
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    MKEgal wrote: »
    None cause (effect) weight, though some can influence (affect) it, if people don't change how they eat.

    That seems to have been adequately addressed in this thread...
    as well as the myriad of others saying exactly the same thing.

    You feel that they've been adequately addressed? I see so many thyroid and PCOS threads with misinformation in them every day on this forum. Both conditions lead to marginal weight issues, but you wouldn't think that from some of what you see here.

    Neither of them necessarily call for a special diet, except by choice either.

    I know I've seen studies to back up what I'm saying. I'll try to find them in a bit and post them.
  • EvgeniZyntx
    EvgeniZyntx Posts: 24,208 Member
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    Perhaps what you are trying to do is reduce the short cuts people make?

    I'll take an example - I have a friend that became wheelchair bound four years ago (lateral paralysis) - this had led to her being obese. Obviously the chair didn't CAUSE the obesity but the conditions of difficulty in limiting consumption, depression, reduced mobility and the associated difficulty of increasing energy expenditure for someone that has difficulty moving resulted in consuming more calories than those expended.

    What 'fiction' do you think needs to be addressed?


    I think the fiction is dependent on the condition, Ev. There was a recent thread where someone brought up his own DKA, and he grossly misstated the mechanism of it and implied a medically impossible outcome of it. That's one type of fiction.

    Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.

    Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.

    I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.

    Ah, I missed that thread - but saw some of the fallout.

    I agree with you - few drugs cause direct weight gain (or some of that weight gain is transient from oedema).
    Ok, I understand better what is your intent. I'll pop in with a few examples or can explain some physiological effects.

    Here is another breakdown example: How hyperthyroidism might lead to weight gain.

    Initially, untreated hyperthyroidism leads to rapid weight loss. It tends to down-regulate hunger and significantly up regulate metabolism directly - a person, like my ex, can experience 10-20lbs of weight loss per month (or even more), directly. This type of rapid weight loss not only results in fat loss but also screws up hormones and muscle mass.

    Almost systematically, when the hyperthyroidism is treated (chemically or surgically destroying the thyroid) and replacement therapy occurs - the effects on satiety hormones, energy levels, mood and also reduced metabolism due to prior weight loss tend to lead to weight gain beyond the weight loss. It is very hard, in the absence of strict calorie management, to self regulate during this rollercoaster. The person ends up with a 10-40 lb gain without the relevant LBM gains and might struggle with mood and energy still.

    Can it be avoided? Yes. But not without drastic calorie management methods.
  • Liftng4Lis
    Liftng4Lis Posts: 15,150 Member
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    Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.

    Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.

    I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.

    BOOM!

    It's disturbing to so often see people say "blah blah" caused my weight gain. NO, eating too much causes weight gain. You may have different caloric needs now, for whatever reason, but it still comes down to CICO.
  • ActiveApril
    ActiveApril Posts: 73 Member
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    kattis81 wrote: »
    Hmm this is a bit swings and roundabouts. Hypothyroidism may slow your metabolic rate and make you burn less calories. True but it also makes you cold and tired that ultimately has more impact as it's hard to get up from sofa and go running when you feel already tired and freezing and it's raining outside. Being cold also makes you want to eat warm things that are not made of salad. This is as real effect of hypothyroidism as metabolic slowdown so overlooking it is not helpful. Correct diagnosis and sufficient replacement therapy to treat the condition are the way forward not ignoring it or it's impact on health as whole.

    Haha... I love this "warm things not made of salad" - I've definitely been there!!
  • Sabine_Stroehm
    Sabine_Stroehm Posts: 19,263 Member
    edited November 2015
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    Liftng4Lis wrote: »
    Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.

    Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.

    I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.

    BOOM!

    It's disturbing to so often see people say "blah blah" caused my weight gain. NO, eating too much causes weight gain. You may have different caloric needs now, for whatever reason, but it still comes down to CICO.

    People attribute their weight gain to many things, don't they? I see threads here all the time where new jobs or break ups "caused" weight gain.
    I do wonder if we truly know the effect of some medicines, however. So I'll reserve comment on that.
    I do believe that with some conditions caloric needs may not remain constant, thus making it even harder to find the sweet spot for losing.

    With most things like this I take a "mile in your shoes" approach. I can't imagine how frustrating it must be for folks with underlying medical conditions who ARE finding it tough to shift the weight. As a menopausal woman, I have only a tiny glimpse of what it must be like. cheers to all who do find it hard.

  • Liftng4Lis
    Liftng4Lis Posts: 15,150 Member
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    Liftng4Lis wrote: »
    Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.

    Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.

    I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.

    BOOM!

    It's disturbing to so often see people say "blah blah" caused my weight gain. NO, eating too much causes weight gain. You may have different caloric needs now, for whatever reason, but it still comes down to CICO.

    People attribute their weight gain to many things, don't they? I see threads here all the time where new jobs or break ups "caused" weight gain.
    I don wonder if we truly know the effect of some medicines, however. So I'll reserve comment on those.
    I do believe that with some conditions caloric needs may not remain constant, thus making it even harder to find the sweet spot for losing.

    Yes. People blame all sorts of things on weight gain. On the opposite side of the coin, (I'll use myself as an example), when going through my second divorce with my husband (two young kids), I had dropped 40 pounds in 3 months. I was to a very, unhealthy weight for my size and it was a very scary time, when I could actually see this. The point is that "divorce" didn't make me lose weight. NOT eating did. Again, it comes down to CICO.
  • abatonfan
    abatonfan Posts: 1,123 Member
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    I'm a type 1 diabetic (I just realized I was diagnosed two years ago today), which can manipulate what nutrients are absorbed within my body. Prior to my diagnosis, I lost 55 pounds in less than 3-4 months, because many cells in my body were unable to use carbohydrates for energy due to my pancreas not producing any insulin (insulin is the "key" that allows glucose into the cells). Of course, this led to a ton of other issues which would have killed me had I not be diagnosed when I was.

    With the insulin, it promotes the uptake of glucose by the liver and adipose cells. Within two months of beginning insulin therapy, I gained 15 pounds while eating below my "maintenance calories" as my glycogen stores were replenished (which makes sense, because the body can store about 500g of glycogen. With the increase in glycogen, my water weight also increased as glucose is very osmotically dense -about 4g water per g glycogen) and my body recovered from being starved for months. Even now, I realized that I lost a ton of muscle mass due to the diabetes, and my TDEE is likely to be lower than the average person with my stats (decreased CO).

    Now that I have been on insulin for a while, I need to be very careful of how much I take in relationship to my weight loss/maintenance and calorie goals. If I take too much insulin, my blood glucose can drop to dangerously low levels and requires me to eat fast-acting carbs. If those carbs push me above my maintenance, I gain weight (CI>CO). If I don't take enough insulin, my blood sugar rises, and some of the calories I consume might not be utilized by the body (the kidneys will filter out glucose into the urine if BG levels are high enough), which means that I might lose weight if I am trying to maintain (CI<CO). Of course, a type 1 diabetic can really slash her insulin dosages and lose a ton of weight quickly -it is actually qualified as an eating disorder under the DSM5 (diabulemia)- but then that person also risks developing a ton of microvascular and macrovascular complications due to the prolonged high BG. I would much rather be fat and losing the "old fashion way" than be blind/on dialysis/without a foot.

    Honestly, it's still CICO. I simply need to adjust to the fact that my CO is a bit lower than average and my CI is dependent on my BG. I'm not a special snowflake.
  • Sabine_Stroehm
    Sabine_Stroehm Posts: 19,263 Member
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    Liftng4Lis wrote: »
    Liftng4Lis wrote: »
    Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.

    Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.

    I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.

    BOOM!

    It's disturbing to so often see people say "blah blah" caused my weight gain. NO, eating too much causes weight gain. You may have different caloric needs now, for whatever reason, but it still comes down to CICO.

    People attribute their weight gain to many things, don't they? I see threads here all the time where new jobs or break ups "caused" weight gain.
    I don wonder if we truly know the effect of some medicines, however. So I'll reserve comment on those.
    I do believe that with some conditions caloric needs may not remain constant, thus making it even harder to find the sweet spot for losing.

    Yes. People blame all sorts of things on weight gain. On the opposite side of the coin, (I'll use myself as an example), when going through my second divorce with my husband (two young kids), I had dropped 40 pounds in 3 months. I was to a very, unhealthy weight for my size and it was a very scary time, when I could actually see this. The point is that "divorce" didn't make me lose weight. NOT eating did. Again, it comes down to CICO.

    Thanks for illustrating that point. Wow. 40LBS is a lot.
  • Liftng4Lis
    Liftng4Lis Posts: 15,150 Member
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    Liftng4Lis wrote: »
    Liftng4Lis wrote: »
    Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.

    Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.

    I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.

    BOOM!

    It's disturbing to so often see people say "blah blah" caused my weight gain. NO, eating too much causes weight gain. You may have different caloric needs now, for whatever reason, but it still comes down to CICO.

    People attribute their weight gain to many things, don't they? I see threads here all the time where new jobs or break ups "caused" weight gain.
    I don wonder if we truly know the effect of some medicines, however. So I'll reserve comment on those.
    I do believe that with some conditions caloric needs may not remain constant, thus making it even harder to find the sweet spot for losing.

    Yes. People blame all sorts of things on weight gain. On the opposite side of the coin, (I'll use myself as an example), when going through my second divorce with my husband (two young kids), I had dropped 40 pounds in 3 months. I was to a very, unhealthy weight for my size and it was a very scary time, when I could actually see this. The point is that "divorce" didn't make me lose weight. NOT eating did. Again, it comes down to CICO.

    Thanks for illustrating that point. Wow. 40LBS is a lot.
    When I was starting out at 145, yes. It took me a long time to recover my lady curves....shiver. Okay it was gross!
  • EvgeniZyntx
    EvgeniZyntx Posts: 24,208 Member
    edited November 2015
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    Liftng4Lis wrote: »
    Liftng4Lis wrote: »
    Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.

    Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.

    I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.

    BOOM!

    It's disturbing to so often see people say "blah blah" caused my weight gain. NO, eating too much causes weight gain. You may have different caloric needs now, for whatever reason, but it still comes down to CICO.

    People attribute their weight gain to many things, don't they? I see threads here all the time where new jobs or break ups "caused" weight gain.
    I don wonder if we truly know the effect of some medicines, however. So I'll reserve comment on those.
    I do believe that with some conditions caloric needs may not remain constant, thus making it even harder to find the sweet spot for losing.

    Yes. People blame all sorts of things on weight gain. On the opposite side of the coin, (I'll use myself as an example), when going through my second divorce with my husband (two young kids), I had dropped 40 pounds in 3 months. I was to a very, unhealthy weight for my size and it was a very scary time, when I could actually see this. The point is that "divorce" didn't make me lose weight. NOT eating did. Again, it comes down to CICO.

    Calorie needs are never constant, they are affected by such a variety of factors that CICO isn't as simple as many seem to present here.

    It's like saying it is all due to breathing and oxidation reactions! (Which is true.) But it doesn't explain how that is regulated.

    What part of the CICO equation describes HOW your divorce affected HOW MUCH you ate?

    Imagine if we could reduce all autopsy to "well the heart stopped, and then the brain signal stopped too". How is important. Oh, but it all comes down to heart and brain function!!

    CICO is only part of the process and a complex part at that.

    PS - glad you recovered.
  • DeguelloTex
    DeguelloTex Posts: 6,658 Member
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    kattis81 wrote: »
    Hmm this is a bit swings and roundabouts. Hypothyroidism may slow your metabolic rate and make you burn less calories. True but it also makes you cold and tired that ultimately has more impact as it's hard to get up from sofa and go running when you feel already tired and freezing and it's raining outside. Being cold also makes you want to eat warm things that are not made of salad. This is as real effect of hypothyroidism as metabolic slowdown so overlooking it is not helpful. Correct diagnosis and sufficient replacement therapy to treat the condition are the way forward not ignoring it or it's impact on health as whole.
    There are a lot of warm foods that can fit in a caloric deficit and a lot of salads that might not.

    It's not hard to see how that could be seen as just a long list of excuses more than anything else.