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In South Africa, according to the World Health Organisation, 26.8% of our adult population are obese, and an additional 27.1% are overweight. While much of this can be attributed to lifestyle factors, such as inactivity and overeating, there are some people who gain weight no matter what they eat, and struggle to lose it, no matter how much they diet or exercise.
To find out about the other factors that contribute to weight gain and retention, we spoke to Tabitha Hume, a registered dietician. She revealed the following reasons:
You’re stressed or depressed Anxiety, depression, stress or grief can cause your body to produce cortisol, or other hormones, that make your body more likely to store fat – especially around the waist. Weight gain can make you more depressed, and many people comfort eat when they are sad or anxious, so this makes for a vicious circle.
What to do: Treat the root cause of the weight gain, which is your depression. Exercise is a fantastic remedy for both depression and weight gain, but depression often prevents people from doing what’s best for them. See your doctor or a psychiatrist if you feel that you can’t recover on your own.
You’re not sleeping enough Recent studies have shown that not getting enough sleep affects the hormones that relate to hunger and stimulate the appetite. Another reason that people who don’t sleep enough seem to pack on the kilos is that fatigue leads to inactivity - so fewer calories are being burnt during the day.
What to do: Fortunately, this is reasonably straightforward to solve. Try these tips to address the issues that are robbing you of sleep, and hopefully everything else will fall into place.
There are a number of lifestyle or diet habits that can also result in difficulty losing weight.
Your diet habits are working against you Tabitha says that there are a number of lifestyle or diet habits that can also result in difficulty losing weight. These can include having been on a carb-free diet for too long, combining a carb-free diet with insulin sensitisers, not eating in the day then binge eating at night, yoyo dieting (doing one fad diet after another), diet and exercise monotony, and combining a low-GI, low-fat and low-carb diet – you can’t pick and choose, you have to go with one!
What to do: It is important to get the correct advice from a registered dietician when you embark on any diet programme and to be honest about your existing lifestyle. Some of these issues can be treated with a combination of intense exercise and very controlled diets, others will require insulin sensitisers - your dietician will refer you for a script for these.
The medical reasons
Polycystic ovarian syndrome (PCOS) Women with PCOS have irregular periods, excess androgen, which is the male hormone, and enlarged follicles on their ovaries. This combination of factors can result in acne, excess body hair, infertility and weight gain. Women with PCOS find it difficult to lose the weight that they so easily gained.
What to do: PCOS is generally treated symptomatically, depending on which combination of symptoms the patient exhibits. If you suspect you have PCOS, check your symptoms, then speak to a dietician who will work with your GP or gynae to decide on the best course of action for weight gain – it may involve a combination of lifestyle changes and insulin-sensitising medication.
Cushing’s syndrome Cushing’s syndrome involves the overproduction of cortisol by the adrenal glands, which leads to weight gain on the face, upper back and abdomen. People usually get Cushing’s syndrome from prolonged use of steroid medication, for conditions like asthma, rheumatoid arthritis, lupus or an organ transplant. It can, however, also be caused by a tumour on the pituitary gland. Other symptoms include muscle weakness, depression and fatigue.
What to do: If you have the symptoms of Cushing’s syndrome and are on a type of medication that could have caused it, visit your GP who can advise you how to treat it. It can be treated – especially if it’s caused by medication. If it is caused by a tumour, your doctor will advise you on the best course of action.
Insulin resistance If you have insulin resistance, it means your body has become resistant to the insulin it produces, which causes overproduction of insulin, which in turn causes your body to store any fat you may eat at each meal, and puts you at risk of developing type 2 diabetes in future. There are no obvious symptoms other than weight gain. A good indicator is your waist circumference. In men, insulin resistance is indicated with a waist circumference of more than 102cm, and in women at more than 88cm. A two-hour glucose tolerance test with insulin will also indicate whether you have this condition.
What to do: If you are insulin resistant, your clinical dietician and endocrinologist will advise lifestyle changes including exercise and diet, and could possibly put you on insulin sensitising medication.
An underactive thyroid Thyroid hormones are responsible for the regulation of heart and digestive function, muscle control, brain development and bone maintenance as well as your body’s metabolic rate. Some people with an underactive thyroid, or hypothyroidism, have an autoimmune disease called Hashimoto’s disease. Others simply have a sluggish thyroid that fails to produce sufficient hormones. If you are trying to lose weight with hypothyroidism, your body is literally working against you.
What to do: If you think you might have an underactive thyroid, check your possible symptoms here, and ask your GP for a blood test of your TSH and T4 levels. If it turns out that you are not producing the hormones that you should be, your doctor can prescribe a supplement of synthetic thyroid hormones. Be warned, though, these won’t make you lose the weight you’ve gained, but they will stop you from gaining more weight and help you to lose it through diet and exercise.
You can beat it! Weight gain, for various reasons, often forms part of a vicious cycle that makes it harder to lose the more you gain. If you’ve tried everything and are feeling defeated, consider visiting a registered dietician, who will work with a specialist if necessary, for a discussion about what could be causing your stubborn weight retention – and take their advice about the next steps.
