Q&A: Causes Of Unintentional Weight Gain

Unintentional weight gain occurs when you put on weight without increasing your consumption of food or liquid and without decreasing your activity. This occurs when you’re not trying to gain weight. It’s often due to fluid retention, abnormal growths, constipation, or pregnancy. Unintentional weight gain can be periodic, continuous, or rapid.

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In this article:
Types of unintentional weight gain
MCQ: clinical scenario
MCQ: answer
MCQ: explanation

Types of unintentional weight gain

Periodic unintentional weight gain describes regular fluctuations in weight such as that experienced during a woman’s monthly menstrual cycle. Periodic, but longer-term unintentional weight gain is most commonly due to pregnancy, lasting nine months. Rapid unintentional weight gain may be due to medication side effects. Many cases of unintentional weight gain are harmless. But some symptoms experienced along with rapid weight gain may signal a medical emergency.

MCQ: clinical scenario

A 34 year old complains of fatigue and weight gain. On examination she is found to have dry skin and a bitemporal hemianopia. The cause of her weight gain is most likely to be:

a) Pickwickian syndrome
b) Cushing's syndrome
c) Laurence-Moon-Bardet-Biedl Syndrome
d) Stein-Leventhal Syndrome
e) Secondary hypothyroidism
f) Hypothalamic disorder

MCQ: answer

The correct answer is E.

MCQ: explanation

Secondary hypothyroidism should be suspected when, in the setting of overt hypothyroidism, the TSH level is inappropriately low. Concurrent amenorrhea, galactorrhea, postural hypotension, or visual field cut also suggests pituitary-hypothalamic pathology. Imaging of the sellar region is indicated. Computed tomography (CT) scan is best for detection of small lesions within the sella; magnetic resonance imaging (MRI) is best for imaging the suprasellar region. TRH stimulation is sometimes used to confirm secondary hypothyroidism, but the test often fails to distinguish among secondary causes.

Reference(s)
1). Mayo Clinic Staff (2016). Menopause weight gain: Stop the middle age spread. Available online: https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menopause-weight-gain/art-20046058