As anyone who’s worked to lose weight knows, it can take a while to see progress, especially if you’re making sure to lose weight at a steady pace. But what about if you feel as if you’re plateauing, no matter how much food and exercise tracking you do?
Or even more frustrating, what about if you might be gaining weight when your goal is to head in the opposite direction?
In some cases, it’s not your strategy that’s the culprit — weight gain may actually be a symptom of a larger issue. Here are some conditions that tend to cause weight gain, along with tips on next steps.
MEDICAL ISSUES THAT CAN CAUSE WEIGHT GAIN
DEPRESSION
The relationship between weight gain and depression is actually highly complex. Depression can impact appetite and food cravings, as well as change the way your body reacts to rewards. Additionally, depression is linked to disordered eating, which can also impact weight. The bottom line is that the biochemical changes that cause depression can also affect how you consume food, leading to unintended weight gain.
Additionally, many medications prescribed for depression have weight gain as a side effect. This includes serotonin reuptake inhibitors (SSRIs) like Celexa, Prozac, Zoloft, and Paxil.
HYPOTHYROIDISM
When there’s significant weight gain or loss, especially within a short timeframe, one of the first conditions doctors consider is a thyroid disorder. With hypothyroidism, when your thyroid gland isn’t producing hormones, weight gain can be a symptom along with fatigue, mood swings, feeling cold and stiff joints.
“This condition can slow your metabolism, and that often results in weight gain,” says Dr. Benjamin O’Donnell, an endocrinologist at The Ohio State University Wexner Medical Center. “Often, people might feel stressed or frustrated by that, which can worsen the problem.”
POLYCYSTIC OVARY SYNDROME
Known as PCOS, this condition affects how the ovaries work, according to Dr. Sherry Ross, an OB/GYN at Providence Saint John’s Health Center in Santa Monica, California. Although it can cause loss of periods or irregular cycles, it can also lead to heavy flow due to hormonal shifts and can be exacerbated by weight gain.
With PCOS, women can have a resistance to insulin, leading them to put on weight in the abdomen. This can be exacerbated by the overproduction of androgen, a male hormone connected to weight in the midsection.
In addition to weight fluctuations, Ross says common symptoms include excess body hair, missed or irregular periods, oily skin or acne, and dark patches of skin on the back of the neck, in the armpits, and under the breasts.
CUSHING SYNDROME
Cushing syndrome is a rare condition where there is an abnormally high amount of cortisol, the “fight-or-flight” hormone, in the body. It’s usually caused by a tumor on the pituitary gland and can cause rapid unexplained weight gain, a hump on the back of the neck, and skin changes like acne, abnormal facial hair, and easy bruising.
It’s worth noting that Cushing syndrome is pretty rare and unlikely to be the root of weight gain unless the symptoms listed above are also present. On a related note, chronic stress can cause a milder overproduction of cortisol and may be a contributing factor to weight gain. If you think this is the case, it’s still worth mentioning to your doctor.
NEXT STEPS
Even if you don’t have concerns about any of the conditions on your list, there are others that might be in play. For example, bloating may be caused by several potential issues, from irritable bowel syndrome to ovarian cancer to kidney disease. Even a lack of sleep, stress and poor liver function could be factors.
Dr. Michelle Ogunwole, a specialist in internal medicine and research fellow at The Johns Hopkins University School of Medicine, suggests making a list of symptoms. This can include weight fluctuations, water retention or bloating, headaches, energy levels, any changes in food, as well as any allergens. It’s also important to jot down your medications — both prescription and over-the-counter — because some of them can play an outsized role in weight gain.
“Coming to a doctor’s appointment with as much information as possible is always very helpful, because it helps to identify trends, and that can narrow down what’s going on,” she says. “It’s a great first step in taking charge of your health and being an active member of your healthcare team.”
Originally published March 2021, updated August 2022
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