Almost 40% of all Americans are overweight. As we age, our metabolism slows, which can cause weight gain unless we also reduce food intake and get adequate exercise.

Weight gain can also be a significant symptom of several endocrine diseases such as Cushing syndrome or hypothyroidism. It may also be caused by heart or lung disorders as well.

A continued weight gain occurs with pregnancy, whereas a periodic weight gain may occur with menstruation. A rapid weight gain may be a sign of dangerous fluid retention.

• Alcohol use
• Certain drugs such as corticosteroids, cyproheptadine, lithium, tranquilizers, phenothiazines, some antidepressants, and medicines that increase fluid retention and cause edema
• Cushing syndrome
• Eating too much and not exercising enough
• Emotional factors such as guilt, depression, and anxiety
• High-carbohydrate, high-calorie diet
• Hypothyroidism
• Polycystic ovary syndrome
• Slower metabolism, which is normal with aging
• Smoking cessation

Take action by starting a proper diet and exercise program. Counseling may be helpful.

Set realistic weight goals to maintain a healthy weight. Consult with a health care provider about specific measures.

Contact your health care provider if the following symptoms occur along with the weight gain:

• Constipation
• Excessive weight gain without a known cause
• Hair loss
• Sensitivity to cold
• Swollen feet and shortness of breath
• Uncontrollable hunger accompanied by palpitations, tremor, and sweating
• Vision changes

Your health care provider will perform a physical examination, measure your weight, and ask questions about your weight gain, such as:

• How much weight have you gained?
• When did the weight gain begin?
• Did it come on suddenly or slowly?
• Have there been changes in your diet or appetite?
• Has your physical activity been restricted due to illness or injury?
• Has your participation in social activities decreased?
• Are you anxious, depressed, or under stress?
• Do you have a history of depression?
• What other symptoms do you have?
• What medications do you take?
• Do you use alcohol or street drugs?
• Doe the weight gain cause you much concern?

Tests that may be done include:

• Nutritional assessment
• Blood tests including chemistry profile
• Measurement of hormone levels

Weight gain caused by emotional problems may require psychological counseling. Talk to your provider about an appropriate diet and exercise program and realistic weight loss goals. If weight gain is caused by a physical illness, treatment (if there is any) for the underlying cause will be prescribed.

If weight continues to be a problem despite diet and exercise, talk with your health care provider about other treatment options, including medications and surgery.

National Institutes of Health. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. Obes Res. 1998 Sep;6 Suppl 2:51S-209S.