Weight gain

There are basically 4 reasons/associations for why patients gain weight (fat gain) which are diagnose-able by a physician. 

3. Severe thyroid disease: hypothyroidism or hyperthyroidism
4. Medication induced

Our physicians can help you evaluate for these 4 concepts. Beyond these causes, there are numerous genetic causes for weight gain for which there are usually not tests available, nor are there any specific treatments for those gene disorders. We cannot test for genetic causes in our clinic and nor can we treat for those. Even if you have all 4 above issues you can still maintain a normal weight with or without medications. Out Out of our scope are other causes of weight gain that are related to fluid fluctuations (unrelated to fat gain). 


There are essentially 4 ways you can try to lose weight (with the assistance of your physician) but three of which don't work well

1. Calorie restriction. Restricting when and how much is the best and most proven way to lose weight if a person sticks with the dietary changes for life. Basically eat less. Remember that the common denominator for all "diets" is calories. It really should not matter what you are eating as long as there is a reasonable calorie deficit, which your physician can help you decide upon for  your individual case based on your history and body muscle mass and your basal metabolic rate.  In general don't drink your calories  (just drink water if you are thirsty) and eat lots of plants. Eating healthy is recommended and a good source of information is the book and movie "In Defense of Food: An Eater's Manifesto" by Michael Pollan. Also consider reading the Obesity Code by Dr. Jason Fung. 
2. Exercise - there are two types. muscle building and aerobic. It takes A LOT of exercise to lose weight and many studies show that exercise is  generally NOT effective for weight loss so there is controversy. There are many other benefits to physical activity however including cardiac and cancer benefits
3. Weight loss medications- generally these are NOT a long term solution to weight loss and have MANY side effects. Our clinic generally does not prescribe these medications. Best case scenario in the published studies for these medication is 5-15 pound weight loss after 1 year of use. 
4. Gastric surgery- in some cases this may be indicated a patient has obesity co-morbidities and your physician can help your decide if this is worthwhile.
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