Ask the Doctor: Why can’t I lose weight?

I am 27 years old and to be honest, quite huge for my age. I have always been a little chubby but now I’m obese. I started gaining serious weight around 2007. I haven’t been in a relationship in God knows how long and I’m beginning to think men are repulsed by my size. I have tried every remedy in the book to lose a few kilogrammes but nothing seems to work. I swim, I walk, I jog - I even gave up red meat which was hard for me. I try to follow great diets but if anything, it looks like I’m getting bigger. What the hell is wrong with me doctor? I want to settle down and have kids but I can’t seem to attract any guy - even the fat ones! It’s depressing. Is there anything else you can recommend? Desperate Susan Dear Susan, You have not specified your weight and height. Because being obese is not related to age. It is determined by body mass index (BMI) which depends on height and weight. As you say you have tried everything that means you have tried to resort to dieting and physical exercise. But have you been consistent with that? Because taking a slimming diet for some days associated with binges of overeating or indiscretion in food upsets any gains from dieting the other days. Once the body grows in size, need for food also increases as a greater number of body cells need food. Hence it is important to take the necessary number of calories as per the height, weight and level of physical activity. In fact starvation itself can lead to increased body weight initially as the body releases its fat deposits in blood to meet energy requirement of daily work. Same goes for exercise. Benefits are obtained only when exercise is done consistently. Then there are certain disorders like hypothyroidism, cushing’s syndrome hypopituitarism, depression, e.t.c which can lead to increase in body weight. Medications like sulphonylureas and insulin used for diabetes, antidepressants, antiepileptics like sodium valproate, dilantin sodium,corticosteroids, hormonal contraceptives, which if taken for a long time can cause weight gain. Apart from these factors, a genetic component also exists for determining the body build of an individual. Weight reducing drugs are associated with multiple adverse effects like liver and kidney toxicity, damage to heart valves, e.t.c. Therefore they are not recommended as a good choice to reduce body weight. Surgical options are available for removing extra fat from the body. But these are associated with major risks for any other major surgery like bleeding, infection, e.t.c. There is also a risk of relapse if underlying causes for obesity remain unchecked. First off all get tested for any hormonal or metabolic disorder to detect a curable medical cause for obesity. Regarding the diet, it is not only to avoid fats but also to include more of fiber in food like increased intake of vegetables and fruits. Soft sodas, processed bottled juices and beer also contribute much to obesity, hence should be avoided. Drinking more water is also useful. Apart from doing regular physical exercise, one should avoid being sedentary, i.e. sitting for long hours continuously. If the work involves sitting at a desk for 6-8 hours daily, try getting up and moving around in between the work for at least 15-20 minutes regularly. About the last problem, I am sure you shall find a guy who will like you for your true worth and not for the body size. Dr. Rachna Pande is a Specialist in Internal Medicine at Ruhengeri Hospital

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Ask the Doctor: Why can’t I lose weight?