Why Your Weight Keeps Increasing — A Physician Explains Weight Gain

Unexplained or gradual weight gain is a common concern across all age groups. Many people blame diet alone, but weight regulation is a complex interaction between hormones, metabolism, lifestyle, and mental health. Understanding the underlying causes helps prevent frustration and unhealthy weight-control practices.

General Readers
Weight gain often occurs slowly and may go unnoticed until clothes no longer fit comfortably. It may affect different body areas, particularly the abdomen, hips, and thighs. In many individuals, weight gain is not due to overeating alone.

Common contributing factors include:
• Reduced physical activity
• Increased portion sizes
• Poor sleep
• Chronic stress
• Hormonal changes
• Certain medications
Even small daily imbalances accumulate over time.

Medical Students
Weight gain may be physiological or pathological. Endocrine causes, metabolic adaptations, and medication effects must be considered. Insulin resistance, hypothyroidism, and cortisol excess are classical associations.

Important concepts:
• Basal metabolic rate variability
• Adaptive thermogenesis
• Neurohormonal appetite regulation
• Leptin and insulin signaling
Lifestyle remains the cornerstone of management.

Young Doctors
A non-judgmental approach is essential. Explore dietary habits, activity levels, sleep patterns, and psychosocial factors. Screen for secondary causes when weight gain is rapid or disproportionate.

Initial evaluation may include:
• Thyroid function tests
• Fasting glucose
• Lipid profile
• Blood pressure assessment
Avoid attributing weight gain solely to “lack of willpower.”

General Practitioners
In primary care, weight gain is frequently linked to sedentary habits, emotional eating, menopause, and medication side effects. Patients often seek quick solutions, but long-term success depends on sustainable change.
Management emphasizes realistic goals, gradual weight loss, and continuous support rather than extreme diets.

Pathophysiology
Weight gain results from a sustained positive energy balance, influenced by:
• Hormonal dysregulation
• Reduced metabolic efficiency
• Increased fat storage signals
• Chronic low-grade inflammation
• Stress-induced cortisol elevation
The body actively resists rapid weight loss, making prevention crucial.

When to See the Doctor
Medical evaluation is advised if weight gain:
• Is rapid or unexplained
• Occurs despite lifestyle control
• Is associated with fatigue, swelling, or menstrual changes
• Appears with breathlessness or joint pain
• Raises concern about metabolic disease
Early assessment prevents long-term complications.

Weight gain is rarely a single-cause problem. Addressing sleep, stress, diet, and physical activity together produces better results than focusing on calories alone. Compassionate understanding leads to sustainable health improvements.

Dos and Don’ts

Do
• Monitor weight periodically
• Eat balanced, regular meals
• Stay physically active
• Sleep adequately
• Seek professional guidance

Don’t
• Follow extreme diets
• Skip meals
• Depend on supplements alone
• Ignore gradual weight changes
• Blame yourself without understanding causes

FAQs
Is weight gain always due to overeating?
No, hormones, sleep, and stress play major roles.

Can medications cause weight gain?
Yes, some drugs affect appetite and metabolism.

Is abdominal weight more dangerous?
Yes, it is associated with higher metabolic risk.

Can stress lead to weight gain?
Yes, through hormonal and behavioral pathways.

Is slow weight loss better than rapid loss?
Yes, slow loss is more sustainable and healthier.

By Dr. Mohammed Tanweer Khan
A Proactive/Holistic Physician
Founder of WithinTheBody.com