Patient: My wife cannot lose weight she exercises daily and tries to eat sensibly. She powerwalks 7-8 miles a day at least 4 days per week. Nothing seems to work not only is she not losing she gains weight could she have a medical problem?
Doctor: Weight gain may not only be an increase in body fat; it can also be caused by increased muscle mass or increased body fl uid/water. Body fat will be stored if calories consumed in food are greater than the calorie expenditure in exercise activity. Several medical conditions can promote weight gain including: hormone imbalances (hypothyroidism, Cushings disease, pregnancy, polycystic ovarian syndrome); organ dysfunction (heart, liver or kidney disease can promote fluid retention); rare pancreatic disorders (insulinoma) and the use of prescribed drugs (oral contraceptive pill, HRT, steroids, antidepressants, diabetic medications, alcohol, and smoking cessation). I advise that your wife should attend her family doctor for a full history and clinical examination. He may investigate this problem with a series of blood tests to exclude any of the above causes.