metaboliq
Rekha is 43 and teaches at a girls' college in Ghaziabad. Her husband Sanjay, 45, runs a paint distribution business. Over the past two years they have both put on weight: Rekha about seven kilos, mostly around her middle, and Sanjay five. Rekha thinks her thyroid is the reason. Sanjay blames his new office chair. They want to know which of them is right, and what else could be going on. Rekha and Sanjay are composites of the readers who ask this, not real patients.
Most weight gain in adults comes from slow, everyday changes: more food from packets and sweet drinks, less movement and shorter sleep. Medical causes are real but less common. They include an underactive thyroid, PCOS, the menopause transition and some treatments. Sudden gain over days usually means fluid and needs a doctor promptly.
What causes most weight gain in adults?
Small changes repeated for years. Dariush Mozaffarian's team at Harvard followed more than 120,000 American adults and tracked what changed alongside their weight every four years. Weight gain was linked most strongly to more potato chips, potatoes, sugary drinks and red and processed meat. More vegetables, whole grains, fruit, nuts and yoghurt were linked to less gain, as were more activity and better sleep.
The Indian version of that list is easy to write. Sanjay's day now includes a packet of bhujia at the office, two cold drinks with lunch during summer, and dinner at 10.30 after the last delivery is logged. Rekha's college canteen added samosas and cream rolls to the menu last year, and she has one most afternoons with tea. None of these feels like overeating. Together they add up to a couple of hundred calories a day, which is enough to explain both of their scales.
Sources: [1]
Can processed food make you gain weight without eating more?
It makes eating more very easy. Kevin Hall's inpatient trial at the US National Institutes of Health offered volunteers two diets, one ultra-processed and one minimally processed, matched for sugar, fat, fibre and salt. On the ultra-processed one they ate about 500 calories a day more, ate faster, and put on weight within two weeks.
Sanjay's warehouse office has a steel cupboard of bhujia, biscuits and instant noodles for the staff. He eats from it while on calls, a handful at a time, and would swear he barely snacks. At home his food is dal, sabzi and roti, which takes longer to eat and fills him up. He has asked the office boy to keep the cupboard stocked with roasted chana and peanuts in the shell instead. Shelling peanuts slows him down, which is half the point.
Sources: [6]
Does age itself cause weight gain?
Age moves fat more than it adds it. Jennifer Kuk's review found that as adults get older, fat shifts towards the abdomen and around the organs. The fat under the skin of the hips and thighs shrinks, sometimes with little change on the scale. Muscle quietly declines too, unless it is worked.
Rekha has noticed this in her saree blouses. Her weight is up seven kilos, but her waist measurement has grown by more than that would suggest, while her arms look thinner than they did at 35. She has started joining the staff badminton on Wednesdays and doing squats and wall push-ups at home on Sundays and Thursdays, because muscle is what she is losing.
We should say where we stand, since you are reading this on our site. Metaboliq is a doctor-led weight programme, and the aim we set with members is "Lose up to 20% of your body weight — and keep your muscle". Results vary; your doctor decides what is right for you. It starts with a home blood test that a doctor reads, because Rekha's thyroid and sugar results would change how her plan is built.
Sources: [7]
Can thyroid problems cause weight gain?
They can, though usually a few kilos rather than ten. Peter Laurberg's review describes the link as running both ways. An underactive thyroid adds some weight, much of it held water, and carrying extra fat can itself push TSH slightly up.
Rekha's guess is worth testing, because an underactive thyroid is common in Indian women in their forties and easy to miss. She does feel cold in the staff room when others switch on the fan, and her hair has thinned at the parting. A TSH test at the lab near her college costs a few hundred rupees and takes one morning. If it is high, treatment will lift her energy, and the seven kilos will still need the walking and the smaller canteen snack. If it is normal, she and Sanjay are probably gaining weight for the same reasons.
Sources: [2]
Why do women gain weight with PCOS and menopause?
Rekha's younger sister Neetu, 34, has PCOS. She has always found weight harder to shift than her friends. Mamaru Awoke's long Australian study backs her up: women with PCOS gained more weight over the years, and diet and exercise explained only part of the difference. Neetu's irregular periods and the dark patch on the back of her neck were what led her doctor to the diagnosis.
Rekha's own change is probably the menopause transition. Her periods have come at odd intervals since March. Gail Greendale's analysis of the SWAN study found that fat gain speeds up and lean mass starts falling as the transition begins, usually in the mid-forties. Her protein at each meal and the Wednesday badminton count for more now than they would have at 35.
How does poor sleep cause weight gain?
Short nights raise appetite, and over years they add belly fat. Jean-Philippe Chaput's six-year study in Quebec found that adults sleeping six hours or less gained more visceral fat than those sleeping seven or eight. The adults who lengthened their sleep during the study gained less.
Sanjay is a textbook case. He logs the day's deliveries until 10.30, eats dinner, scrolls cricket news in bed and falls asleep after midnight. The morning dispatch has him up at six. On those five and a half hours he is hungrier all day and reaches for the bhujia at 4 pm without thinking. If he stops work at 9.30 and eats by 9.45, he gets close to seven hours. That costs him nothing, and it may move his weight more than a new chair would.
Sources: [5]
Does alcohol cause weight gain around the stomach?
It can, especially in men who drink a fair amount. Anne Bendsen's review of beer and waist size found the evidence mostly pointed to a positive link or none, with intakes above about half a litre a day possibly linked to a larger waist. Alcohol adds its own calories, and the snacks that arrive with it add more.
Sanjay meets his distributors for drinks most Saturdays. Three large pegs of whisky with soda, a plate of chicken tikka and a bowl of masala peanuts come to well over a thousand calories, and Sunday's late breakfast of aloo parathas follows. He could cut to two pegs, swap the peanuts for salad and grilled paneer, and drink a glass of water between rounds. That takes a large bite out of his weekend without making him skip the meetings.
Sources: [8]
Which treatments can cause weight gain?
Several common ones can, in some people. Long-term steroids are the best known. Some treatments for depression, epilepsy and severe mental illness, some older diabetes treatments and certain hormonal contraceptives can also add weight. Stopping smoking usually adds a few kilos, and quitting is still the far better choice.
Sanjay's father put on six kilos in the year after he started a new treatment for his knees. He assumed it was age. At his next visit Sanjay mentioned the timing, the doctor changed the treatment to a gentler one, and the gain stopped. The lesson for anyone in the same spot is to raise the timing with the doctor who started the treatment, and to keep taking it until they have discussed it.
Sources: [1]
When does weight gain need a doctor quickly?
When it arrives over days rather than months. Two or three kilos in a week, with swollen ankles, puffy eyes in the morning, breathlessness when lying flat or less urine than usual, suggests the body is holding fluid. The heart, kidneys or liver can cause that, and it should be seen within a day or two, not at the next routine check-up.
Slower gain deserves a look when other signs come with it. Rekha's irregular periods and her worry about her thyroid, and Sanjay's father's diabetes at 52, are both good reasons for a basic panel of bloods this winter. Between them, TSH, HbA1c, fasting insulin and a lipid profile would tell the couple whether their kilos are only about bhujia and late dinners, or something more.
Sources: [2]