Many drugs are linked to weight gain, including anti-depressants, prescriptions for migraine, diabetes, high blood pressure and the Pill
As obesity levels continue their inexorable rise, the Government’s official weight-loss message is still focused on four words: eat less, move more.
But if you are one of the estimated 20 per cent of people who are on a permanent diet, or one of the 40 per cent of men and 30 per cent of women who regularly exercise and still can’t seem to lose weight, it could be very tempting to start to wonder whether perhaps there’s something else going on.
In fact, there are many common illnesses, lifestyle habits, even medications that — without you realising it — could be scuppering your best weight-loss intentions.
Here, the experts reveal the tell-tale symptoms that show the real reason you’re fat.
First, look for the description that best matches your experience, and discover what the problem could be…
COULD BE: Slow metabolism or extreme dieting.
After the age of 30, your metabolism (the rate at which we burn calories while we are at  rest) slows down by as much as 5 per cent per decade.
You’ll burn 100 fewer calories per day at the age of 35 than you did at 25, and 200 fewer at 45. This could be enough to trigger an annual weight gain of 8-12lb.
Strict (or yo-yo) dieting makes this process worse (whatever your age), as the body slows the metabolism to avoid wasting any energy while it is dealing with what it considers to be a famine.
After the age of 30, your metabolism (the rate at which we burn calories while we are at rest) slows down by as much as 5 per cent per decade
WHO’S AT RISK? Anyone over 30; dieters.
WEIGHT-LOSS SOLUTION: As well as being generally more active, incorporate weight-training into your exercise routine twice a week to build muscle mass, because this will boost your metabolic rate.
Muscle burns 25 to 33 per cent more calories than body fat does, and each pound of muscle boosts your metabolic rate when resting.
If you replace 10lb of fat with 10lb of muscle, your body will burn roughly 40 more calories a day at rest. This doesn’t sound like much, but it accumulates to become 280 extra calories burned a week, and 1,120 a month — that’s enough to lose weight without dieting.
So add a few press-ups, squats and lunges to your fitness programme, or try an exercise DVD that incorporates resistance bands or weights (whether that’s using bottles of water or dumbbells), or alternate your aerobics class with something such as Body Pump, which is weight-training to music.
COULD BE: Medication-related side-effect.
Many drugs are linked to weight gain, including anti-depressants, prescriptions for migraine (Pizotifen, Valproate), diabetes (gliclazide, glimepiride, glipizide, Nateglinide, repaglinide, glitazones — e.g. pioglitazone), high blood pressure (beta-blockers) and the Pill.
WHO’S AT RISK? Anyone taking the medication listed above, though while some drugs push one person’s weight up, they might push another’s down.
WEIGHT-LOSS SOLUTION: ‘If you are convinced that your weight has increased only since you’ve been taking the medication, check the side-effect profile,’ says Dr Rob Hicks, a London GP.
‘If “possible weight gain” is listed, ask your GP if you can try a suitable alternative. But don’t stop taking them without seeking medical advice.’
There are 40 per cent of men and 30 per cent of women who regularly exercise and still can’t seem to lose weight
COULD BE: The wrong kind of exercise.
If you don’t change your gym routine, fitness levels can quickly plateau, and your body will adapt, meaning fat and calorie-burning efficiency dramatically drops.
WEIGHT-LOSS SOLUTION: The key is to vary your routine and also introduce more intense sessions within your exercise programme.
A rigorous exercise plan, which incorporates short bursts of high-intensity exercise (such as sprints), will switch on the body’s metabolism, for up to 24 hours later.
Dr Ulf Ekelund, who is a specialist on exercise and obesity with the Medical Research Council, says that by simply switching from walking to jogging, you can increase your calorie burn by 100 per cent and halve the amount of time you need to spend doing it.
COULD BE: Lipoedema.
This swelling in the legs and thighs is caused by abnormal accumulation of fat cells in the tissues under the skin, and a build-up of fluid in those fat cells.
Another tell-tale sign is that the legs often feel very tender (it is also called ‘painful fat syndrome’) and bruise easily. They may also have a cellulite appearance.
‘Many doctors confuse it with weight gain or it can be confused with lymphoedema, which is caused by a problem with the lymphatic drainage system,’ explains Constantinos Kyriakides, a vascular surgeon at Barts and London NHS trust.
‘Lipoedema tends to concentrate in the calves, knees, thighs and lower girth, whereas lymphoedema can affect other parts of the body.
‘Weight seems to have no bearing on the condition, so you can have a very slim upper body, but very heavy buttocks, thighs and lower legs.’
WHO’S AT RISK? It affects 5 to 10 per cent of the female population. No one knows what triggers it, but a family link has been found in roughly a fifth of cases.
WEIGHT-LOSS SOLUTION: There is no cure, but special bandaging (compression garments) can support the tissues and encourage the lymph system to drain excess water.
COULD BE: Food intolerance.
Other tell-tale signs include flatulence, nausea, diarrhoea and discomfort after eating, possibly combined with fatigue and aching joints.
If your body is intolerant to certain foods, it finds them difficult to digest and they will stay in the digestive tract partially digested, bubbling and fizzing with bacteria.
Wheat and milk are common triggers. According to GP Dr Rob Hicks, intolerance to the lactose in milk and dairy products is ‘hugely under-diagnosed’.
He adds: ‘I believe that many people who have been told they probably have IBS (irritable bowel  syndrome) may, in fact, be lactose-intolerant.’
WHO’S AT RISK? We all produce less of the enzyme lactase (which should break down the lactose in dairy products in the gut) from the age of two. In some people, the levels drop faster than others.
Lactose intolerance is more common in older adults.
WEIGHT-LOSS SOLUTION: Keep a food diary of everything you eat and drink, including any medication, and, in a separate column, jot down details of symptoms.
According to Lindsay McManus, spokesperson for Allergy UK, food intolerance symptoms may be delayed (unlike allergy symptoms, which can be immediate). But after a few weeks, you may begin to see a pattern emerging.
If you identify possible triggers (wheat, milk and eggs are the most common intolerances) experiment by excluding one (only one at a time) from your diet for a few days.
‘If you have an intolerance, you should feel better within one to two weeks,’ says Ms McManus.
‘You can double check by putting the food group back to “challenge” your intolerance. Any reaction will normally be swifter and more extreme than before.’
If symptoms are severe, take your food diary to your GP and ask to be referred to a dietitian, who may supervise an exclusion diet and advise on a replacement to ensure nutritional balance.
COULD BE: Middle-aged hormone changes.
Around 90 per cent of menopausal women find they gain up to a stone in weight very gradually during their peri-menopausal years (which can start in the late 30s).
The excess weight will normally target the middle of the body. Men may be similarly affected, according to U.S. gynaecologist and pharmacist, Dr C. W. Randolph. He says this is the result of an imbalance of the sex hormones: oestrogen, progesterone and testosterone.
Both men and women experience a sharp drop in progesterone, men also see a drop in testosterone.
In both cases, this allows the hormone oestrogen to become dominant. Dr Randolph says too much oestrogen increases body fat, makes the body better at storing fat, and inhibits its ability to use fat stores effectively for energy.
‘The result is extra weight that won’t go away, even with more exercise or less  eating,’ he says.
WHO’S AT RISK? The over-40s.
WEIGHT-LOSS SOLUTION: A healthy diet and active lifestyle . . . and a degree of acceptance.
For women particularly, oestrogen from the fat cells can lessen other symptoms associated with the menopause, such as anxiety and hot flushes, and offers at least some protection against osteoporosis.
Polycystic ovary syndrome is a hormone-related condition
COULD BE: Polycystic ovary syndrome.
This is a hormone-related condition that affects 5 to 10 per cent of women of childbearing age.
It can appear at any time after puberty and usually eases off by the menopause.
The fat generally appears around the middle — on the tummy, chest and back.
Other tell-tale signs include irregular or absent periods, acne, excess hair on the face and thighs. Most of the symptoms are triggered by too much testosterone and other male hormones.
Sufferers very often also have a condition called insulin resistance, which makes them gain weight very easily — only to find losing it very difficult, too. If you are insulin-resistant, the cells react sluggishly to the hormone insulin — which mops up excess blood sugar.
The blood sugar is instead sent to your liver and converted into body fat, which is then deposited usually around the middle of the body (so it is close to the major organs to be instantly accessed if needed).
WHO’S AT RISK? Women of childbearing age. While no one knows what causes it, there is thought to be a genetic link.
WEIGHT-LOSS SOLUTION: If your weight gain comes with irregular or absent periods, acne, excess hair on the face and thinning hair, ask your GP for a blood test; you may also be offered an ultrasound scan of your ovaries.
There is no cure for the condition, but medical treatments (such as the Pill and the diabetes drug, metformin) can ease symptoms.
Switching to a low GI diet can help to control excess insulin (and therefore reduce weight gain and many other symptoms).
COULD BE: An under-active  thyroid gland.
The thyroid gland (situated in the neck) is responsible for controlling metabolism through the release of certain hormones (thyroxine and triiodothyronine) — these influence heart rate and body temperature and help convert food into energy.
Symptoms include brittle hair and nails, little energy, dry skin and a tendency to feel cold. If your thyroid is not functioning properly, your body can produce too much of a gel-like substance, called mucopolysaccharides, which will make you puffy (most noticeable around the face).
WHO’S AT RISK? Women are ten times more likely to develop this than men; most often it strikes after pregnancy or the menopause. Poor nutrition can affect your thyroid gland, says the support group Thyroid UK.
More commonly, it’s linked to the immune system attacking the thyroid gland. It tends to run in families, says Dr Mark Vanderpump, an endocrinologist at the Royal Free Hampstead NHS Trust, in London.
‘You may be born with a susceptibility and then meet something in the environment such as a virus, stress or pregnancy which triggers it,’ he explains.
WEIGHT-LOSS SOLUTION: Ask your GP for a blood test. If you are found to have a sluggish thyroid (hypothyroidism) you may be prescribed levothyroxine (a synthetic version of the hormone thyroxine).
COULD BE: Water retention (or possible liver or kidney failure).
Intermittent swelling or water retention is normal (‘it’s not a problem if it comes and goes,’ says Dr Hicks) in both sexes.
However, persistent swelling could be a sign of something that is more worrying.
Other common symptoms include swollen ankles and lower legs and areas of tightness.
‘You can pinch areas of fat,’ explains Dr Hicks. ‘But waterlogged areas will be much firmer, and not so easy to pinch.
‘If the kidneys or liver are failing, they will be unable to flush salts out of the body. Fluid is then drawn into the tissues in an attempt to dilute it.’
Who’s at risk? People with poorly or uncontrolled hypertension (high blood pressure) diabetes (which can cause kidney failure), or excess alcohol consumption/hepatitis (which can trigger liver failure).
WEIGHT-LOSS SOLUTION:  With intermittent water retention, increased activity might help, as can cutting down on salt and drinking lots of water.
However, persistent water retention should be checked by your GP.
COULD BE: Genetic.
Numerous studies have sought to identify specific genes linked to weight gain — most recently Scottish researchers have found a gene which encourages fat storage.
‘We’ve known for a long time that there’s a strong genetic component to being overweight, and studies have shown genes can control appetite,’ says Dr Nik Morton, of  Edinburgh University, whose team led the research.
‘Our study suggests genes in  fat tissue determine the  breakdown or putting down of fat, regardless of diet.’
Last year, U.S. scientists reported that they’d found a gene — Arrdc3 — that causes weight gain in men as they age.
WHO’S AT RISK? An estimated one in six people has a vulnerable genetic make-up and as a result weighs an average of 3kg (7lb) more than those who don’t, with around 15 per cent more body fat.
WEIGHT-LOSS SOLUTION: You just have to work a bit harder than everyone else. There is clearly a component to obesity that is genetic,’ says Mark McCarthy, professor of genetics at Oxford University.
‘But many people with this variant are not overweight. Being overweight is probably a combination of genes and other factors, and people still have control over these other factors and can still lose weight.’
Studies show that men and women are prone to ‘weight contagion’, whereby our attitude to food, weight and dieting is influenced by the people around us.
One large, long-term U.S. study found that if a man has a male friend who becomes fat, his risk of becoming overweight is doubled.
Interestingly, however, having an overweight wife does not appear to have as strong an effect.
Weight-loss solution: Join a running group or gym with an active social life and include slim, fit people in your social circle. They will motivate you and stop you from thinking your extra weight is OK.
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