Issue link: http://cp.revolio.com/i/1520
May/Jun 2009 | www.MyFamilyDoctorMag.com | 23 Q housecalls medicine chest When the Weight Just Won't Come Off By EVa F. BRiGGS, M.D. I am thinking of joining Weight Watchers; however, I don't seem to lose very well. Could medications be responsible? —d.s., via www.MyFaMilydoctoR Mag.coM AnSWER By their very nature, medicines cause all sorts of changes in your body. So it's no surprise that weight gain is a side effect from some. In another part of your letter, you mention the drugs you're tak- ing. Of those, the only likely culprit is Toprol XL, a beta-blocker, which slows heart rate and perhaps metabo- lism. But its effect on weight gain is small, usually only a few pounds. Aside from the medicines you listed, many diabetes drugs, such as insulin, metformin, and sulfonylureas, cause weight gain. It seems unfair since excess weight worsens diabetes, but these drugs lower blood sugar by letting the body use the excess sugar in the bloodstream. You then store it as fat! Certain antipsychotic drugs also cause weight gain, especially olanzap- ine (Zyprexa). Antidepressants can, too. Don't stop medication without talking to your health-care provider. Quitting Toprol cold turkey, for ex- ample, can cause a heart attack. FRIEnDS FIGHTInG FAT With or without weight-causing medication, changing your lifestyle is hard. That's where an organized group like Weight Watchers really helps. You get the moral support of people who are fighting the same bat- tle. You benefit from tips, tricks and wisdom others have discovered so you don't need to reinvent the wheel. Regular weekly weigh-ins really do motivate people to succeed. After all, if it's just yourself, it's easy to put off change until next week, and then one more week, and then a month, or forever. Weight Watchers and similar Beyond the Meds if you've tried everything and still can't lose weight, you could have one of these problems. Hypothyroidism: the thyroid isn't producing enough metabolism-controlling hor- mones. symptoms include sluggishness and being cold all the time. Untreated, it can lead to heart disease, miscarriage or coma. Polycystic ovarian syndrome: a leading reason for female infertility. eggs fail to mature and be released, accumulating as cysts in the ovaries. symptoms include irregu- lar or no periods and increased or male-pattern hair growth. Cushing's syndrome: too much of the stress hormone cortisol. can come from cer- tain tumors and taking long-term corticosteroids. causes upper-body or central obesity with thin arms and legs; a red, rounded face; and fat between the shoulders or around the neck. it's dangerous—potentially deadly—if untreated. sleep deprivation, stress and depression can also wreak havoc with your hormones, causing weight gain. and then there's your family. scientists aren't sure what role genes play. they're even looking at the possibility of an obesity virus. programs have developed systems to simplify the daunting task of tracking calories and activity. Of course, you can calculate the calories you're eat- ing and burning on your own. But counting points keeps you from bogging down in the confusing details. I recommend joining an organized weight-loss group to maximize your chances for success. Weight control requires a lifetime commitment, and organized groups have the best track record for successfully steering people along that route. eva F. bRiggs, M.d., is a board-certified family doctor with Cayuga Medical Center, with urgent-care centers in Ithaca and Cort- land, N.Y. She's also a member of the JHMFD editorial board.