— Sheri, Florida Yes, Nexium and other heartburn drugs may cause weight gain — as can other drugs, such as certain antidepressants, beta-blockers, and antihistamines. You should talk to your doctor or pharmacist before starting any medication so you understand all the potential side effects of any drug you take. That way, you can better manage your expectations and not be surprised should strange stuff start to happen. What is interesting about the scenario you describe is that the symptom of heartburn can be ameliorated by weight loss. So if you are able to lose some weight, you may not need the Nexium after all. In fact, just a 10 percent drop in weight can reduce the need for heartburn drugs in most patients who are overweight. If you don’t know where to start, ask your doctor or a nutritionist to recommend a sensible eating plan, and make sure to include regular physical activity. Q2. I weigh more now than I ever have in my life, despite the fact that I started working out two months ago, try to eat four small meals a day, and feel like I’m in good health otherwise. I usually have one or two glasses of red wine in the evening, especially lately because I’ve been stressed about my mother’s health and a program I’m taking — some evenings I’ve had more than two glasses. Could this be the cause of my weight issues? — Mary, California Alcohol can be a major source of calories, so this may be the cause of your weight gain. One glass of wine contains about 120 calories (and as many as 150 calories for a larger glass). If you drink two to three glasses of wine every evening, you may be consuming 300 to 450 extra calories per day. This can result in a pound of weight gain every one or two weeks! Also, alcohol may whet your appetite, causing you to eat more than you normally would at dinner. So your caloric intake may go up because of eating more, in addition to the two to three glasses of wine that you are drinking. I would try to stick to one glass of wine and substitute water for the second glass, or perhaps avoid alcohol altogether on a daily basis. Permit yourself a glass or two on weekends only. Q3. I am 41 years old, 4 feet 7 inches tall, and weigh about 81.5 pounds. Is there anything I can do to gain weight? I have Crohn’s disease, so I can’t have any fresh fruits or vegetables, and I eat only an ounce of dairy or less a day. I usually have soy products instead of dairy. – Lori, Rhode Island That’s a tough situation, but there some things you can do to try to put on a few pounds. Protein shakes with a lot of “goodies” in them would be a great place to start — in addition to your usual three meals a day. If you like soy, I suggest mixing a soy-based product (soy milk) with avocados and frozen blueberries, and perhaps adding wheat germ and protein powder. Try it. If you like it, that’s great. If not, try other healthful ingredients from your local grocery, health food store, or even a vitamin shop. You can also try prepackaged supplements like Boost, Ensure, and others. Some actually taste great. Try to consume three shakes of some sort every day, either homemade or store-bought. But remember, the shakes should be added to what you already eat. If this doesn’t work, a visit to a good dietitian at an academic medical center is definitely in order. Q4. At what weight is someone considered obese? When is the right time to see a doctor about it? — Vanessa, England Obesity is defined as a body mass index (BMI) greater than or equal to 30.
Using the metric system, the formula for BMI is weight (in kilograms) divided by height (in meters) squared.To find your BMI using pounds and inches, take your weight (in pounds) and divide it by your height in inches squared. Then multiply by a conversion factor of 703.
You are overweight if your BMI is greater than or equal to 25. The right time to see a doctor is when your BMI becomes 25 or greater. Doctors can treat overweight or obesity with diet and exercise suggestions and sometimes weight-loss medications. If your BMI is between 18 and 24 you are within the normal range; however, if you have gained a lot of weight recently, you may still want to see your doctor. Studies show that people who gain even as little as 4-5 kilograms (10 pounds) have an increased risk of developing type 2 diabetes. Q5. I have gained 40 pounds in the past two years and cannot seem to lose it. I have had my thyroid and adrenal function checked — all the normal blood work that would find a nonfunctioning organ, which could provide an answer to this weight gain. What in the world could it be? I was a size 6 all my life, and now I am a 16! I am only 36 years old. I seem really swollen — as if I am carrying around lots of excess fluid. Exercise and dieting do nothing for me — except build muscle, which makes me even heavier. Do you have any idea what could be the cause? Unless there is something serious going on, such as congestive heart failure or the growth of a rare tumor, most people who gain this amount of weight over two years have had a stressful life event and/or the addition of a medication that is known to cause weight gain (such as an antidepressant or diabetes medication, or even a steroid for asthma or an antihistamine). Have you undergone a dramatic change in lifestyle? Some scenarios that can lead to an increase in energy intake (calories) or decrease in energy expenditure include moving to a different city with a new set of activities (or fewer activities); taking a different job with longer hours or more time at a desk; and different eating patterns due to new friends, a new boyfriend, a breakup, or a new marriage. But, first, I’d make certain that nothing is going on medically. You need a full evaluation that is more extensive than just an endocrine workup, which is what it sounds like you’ve had. If you are not completely satisfied with your doctor’s evaluation, you might consider getting a second opinion. If you are cleared medically, you need to figure out what changed in your life to account for an alteration in your eating or activity patterns. Once you figure out what has changed, it will be easier to determine what needs to be done to tip the energy balance equation. Q6. I had acute lymphocytic leukemia when I was a child. I have been fighting weight gain for what seems like all of my adult years. It seems as if everything I eat causes me to gain weight, but it doesn’t ever come off no matter how hard I try. Could this be an aftereffect from all the chemo treatments I had? No one else in my family has any problems maintaining their weight. — Lana, Iowa I do not think that chemo treatments affect weight gain, but they are known to cause weight loss. However, I think it is a good idea to have your thyroid checked in case chemo did affect your thyroid. It is possible that you could be hypothyroid right now, and that is a very common and often hidden cause of weight gain. My advice is to see an endocrinologist as soon as possible. If your thyroid turns out to be normal, I would continue to watch your caloric intake and, if you haven’t already, embark on a sound exercise program that includes one hour of aerobic exercise three times per week, or a half hour of aerobic exercise five or six times per week. You should also incorporate strength training into your regimen since that builds muscle mass, which in turn, boosts your metabolism. Q7. I am 45 years old. I have exercised all my life. Recently, I have put on a few pounds, and nothing has changed. Is there any weight loss pill for “the change of life”? Also, what is your opinion on Cortisol, which is supposed to help with weight in the mid-section due to stress? Does this work? – Nancy, North Carolina No, it doesn’t. Here’s some background: Cortisol is a hormone we produce naturally when the body is under stress. Some researchers believe that because many of us are in a constant state of stress due to our lifestyle, we are also in a constant state of excess cortisol production. That, in turn, stimulates glucose production and excess glucose is typically converted into fat. Why do we store this fat in our midsections? Because the fat cells in our abdomens are highly sensitive to insulin, and are particularly good at storing energy. Don’t be lured by the herbal over-the-counter industry, which is not policed by the FDA in the same way as the prescription medication industry. Claims made about Cortisol and other substances like it are not backed by sound medical evidence; essentially, these products do not help you lose weight. They can actually even be harmful, which is true of many over-the-counter weight loss remedies. The truth remains that these supplements do little to affect weight loss, and may even pose a health threat if you ignore underlying signs of heart disease or high blood pressure. There is no magic pill that can prevent weight loss during the change of life, but there are some steps you can take to help keep the pounds from piling on. First, the more exercise you do during and after this period, the better your chances of maintaining your usual weight or even building muscle and losing fat. Plus, exercise is a great way to reduce stress, and that improves your body’s ability to maintain healthy insulin levels. Regular physical activity — for example, a brisk 30-60 minute walk most days of the week — helps cells respond more effectively to insulin and that reduces the amount of excess glucose in the bloodstream before it is stored as fat. Other stress reduction techniques can be effective as well. Now is a good time for you to try yoga, Pilates, tai chi, massage, meditation, or breathing exercises. Getting enough sleep is also important since chronic sleep deprivation increases your chances of being overweight. And, of course, don’t forget to watch what you eat. A reduction in simple carbohydrates, as well as an overall reduction in calories will help reduce insulin levels and help you stay slim. Learn more in the Everyday Health Diet and Nutrition Center.
