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Obesity and Weight Management

Unexplained weight gain

10/23/2006

Question:

I have gained 90 pounds in less than a year. I eat 1200 calories a day and exercise 6 days a week 1 to 2 hours at a time. One doctor diagnosed me with hypothyroidism and prescribed Levothyroxine 75 MCG 6 months ago and not one pound came off.

A month ago another doctor prescribed phentermine cause he doesn`t think that I have a thyroid problem and once again no weight loss what so ever. I was reading something about weight gain and hydrocortisone and steriods and in the last 60 pounds of weight gain I was gettin epidurals of cortisone in my spine and foot for pain relief. I also have a very bad hip, 7 bad discs and bone arthritis in my neck.

I am so frusturated. I`ve never weighed this much and I`m getting rashes from my skin rubbing together and had to alter my workouts and lifestyle to accomidate the extra weight. Please help me if you can. Any suggestions are greatly appreciated.

Answer:

You may benefit from a structured weight loss program under a doctor's supervision. These programs are hospital-based or community programs such as Weight Watchers, Physician Weight Loss, or Jenny Craig. One thing to realize and try to be patient with is that weight loss is supposed to be slow (about 1 to 2 pounds per week). If you have hit a plateau where no weight is coming off, it means that your calorie intake is equal to what you are burning; so you need to either lower your daily calories by 500 or increase your exercise to create a calorie deficit and promote weight loss.

It sounds as if you are not able to exercise to a level that will burn calories given your musculoskeletal problems. It is true that steroids, especially long-term and/or high dose use, will contribute to weight gain. Usually, this can be reversed once the steroids are stopped.

I would follow-up with you doctor to make sure your thyroid is under control because it will make weight loss a bit easier. Also, keep a food diary of all the things that you are eating and drinking in order to share with you doctor. That way he or she can review with you ways to trim more calories and how to eat to achieve better weight loss.

Final note: do not get frustrated; try and be patient with yourself; the goal really is to live a healthier lifestyle so eat lots of fruits and vegetables, lean meat, whole grans, low fat and low sodium, drink lots of water, get regular exercise (30 minutes daily) and adequate sleep (at least 8 hours).  It is not to be thin.

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Response by:

Esa M Davis, MD, MPH Esa M Davis, MD, MPH
Adjunct Assistant Professor of Family Medicine
School of Medicine
Case Western Reserve University