Regular weight gain or a health issue?
Posted on 17 November 2020

We all know weight gain is related to calories in versus calories out. However, the true nature of the human body is much more complex than that. Here’s when it could be a sign to see your doctor.
‘It was the annoyance of recurrent bladder and ear infections that finally got me to a doctor,’ says Susan Barrett, 42. ‘I’d previously ignored the symptoms of what I later found out was Hashimoto’s disease [when your immune system attacks your thyroid gland, causing hypothyroidism (underactive thyroid)]. I’d chalked these symptoms up to age, general body decline, and some kind of midlife depression.’ During the consultation, Susan mentioned something that prompted her GP to run thyroid tests. ‘When the results came back, she referred me to an endocrinologist, who booked me into hospital for more tests and monitoring. I had a conclusive Hashimoto’s disease diagnosis within a week.’
When weight gain isn’t normal
As was the case for Susan, it’s easy to assume that gaining weight is just part of getting older. And to an extent, it is. ‘It’s common for adults, particularly in middle age, to gain approximately 0.5kg to 1kg per year,’ says Dr Gail Ashford, a specialist family physician at Wits Donald Gordon Medical Centre in Joburg.
But it can indicate a host of underlying conditions. ‘Common conditions include hypothyroidism, diabetes, perimenopause and menopause, or even pregnancy (yes, it’s still a possibility!), medication-related side-effects, stress and depression,’ says Dr Ashford.
How to tell if there’s a problem
‘When it comes to weight gain, a holistic approach is always needed,’ says Dr Ashford. First, the doctor will rule out diet, exercise, lifestyle factors, such as poor sleep hygiene, and medication.
Looking back, Susan’s weight gain was a warning sign. ‘It defied everything I’d ever learnt working on a health magazine,’ she says. ‘I picked up about 10kg, and it happened rapidly – I was probably picking up a kilogram or two a week. It was alarming.’ She’d always been naturally lean, didn’t overeat and exercised regularly. Had she seen a doctor sooner, they would have asked about other symptoms.
A pattern of symptoms
‘Symptoms to indicate possible underactive thyroid include fatigue, mental health changes, including depression and anxiety, palpitations, a slowed pulse rate, a goitre in the neck that may become larger or painful, constipation, swelling of the ankles, hair loss and brittle or weak nails,’ says Dr Ashford. Susan could tick all of these. ‘There’s often a family history of hypothyroidism, and it’s more common in women,’ Dr Ashford adds. Again, Susan has a close female relative who also has the disease.
Since being diagnosed and treated, Susan’s weight has stabilised. ‘I’ve lost five of those 10kg and I’m very happy with the balance. The weight literally just fell off when my numbers started to stabilise.’
Other signs to watch out for
Sudden or uncharacteristic weight gain could also be a sign of diabetes. See your doctor if you also have increased thirst and need for water, increased urination, fungal infections, pigmented patches on your skin (especially the armpits and neck), increased appetite and cravings for sweet or starchy foods, or increased blood pressure, says Dr Ashford. In women, look out for changes in your menstrual cycle, which could indicate perimenopause.
Don’t put off that doctor appointment
‘It’s important for anyone with health concerns to reach out to their GP,’ says Dr Ashford. ‘Many GPs are offering telemedicine consults because of COVID-19 and it may be helpful to request this first, so that you can avoid the need to go into the rooms.’ If you do go in, however, you can expect strict safety measures to be in place, she says.