Ten pound weight gain troubles reader

March 21, 2013 By

Q: I am an 86-year-old female. I have started taking Namenda two times a day. The doctor says I have extremely mild dementia and it is only to maintain my current mental status. I’m very tired and have gained 10 pounds but am still gaining. This weight seems to be going directly to my stomach. I am small framed and 10 pounds is making me quite uncomfortable. I also take 5 mg Norvasc, 40 mg pantoprazole and 2 mg of clonazepam on a daily basis. Do you think this weight gain will stop or am I stuck with this discomfort?

Thank you for your wonderful articles.

A: As a general rule, Namenda is prescribed to treat moderate to severe dementia such as is seen with Alzheimer’s but it may be used for other purposes, as well. The recommended starting dosing is 5 mg a day and advancing to 20 mg which you are on. Side effects can include confusion, hallucinations, fainting, easy bruising, difficulties concentrating, elevated blood pressure readings and more. Less serious side effects noted include fatigue, and weight loss (not gain) from having a diminished appetite.

Norvasc is a calcium channel blocker that treats high blood pressure, angina and other conditions caused by coronary artery disease. Side effects can include edema of the extremities, chest flutter, and less commonly fatigue, abdominal pain, headache and a drowsy feeling.

Pantoprazole decreases esophagitis and other conditions caused by excess stomach acid production. Side effects can include a rapid heart rate, muscle cramps, headache, memory problems, loss of appetite, fainting, hallucinations, insomnia and weight changes.

Clonazepam is prescribed to treat symptoms of anxiety or panic, seizure disorders, and other purposes. This drug is produced in doses as small as 0.125 and as strong as 2 mg. Initial dosing should not exceed 1.5 mg per day, divided into three doses; however, to reduce the effect of drowsiness, this drug may be ordered as one dose at bedtime. Side effects can include fatigue, loss of appetite, diarrhea/constipation, confusion, pounding heartbeats and weight changes.

So, as you can see, except for your Namenda, the balance of your medications can produce relatively similar side effects but are not likely linked with your weight gain. Further, if you admit to being tired, I wonder if you are less active than you once were, are more sedentary sitting to watch television or reading, and if you may be retaining fluids. As such, I recommend you speak with your prescribing physician to determine if you can reduce the dosing on any or your meds (one at a time) under his or her direction and can simultaneously initiate a plan of exercise. I’m not referring to working out on an elliptical machine but you might begin by joining a friend for a walk around the block once or twice a day. If you’re not a walker, consider other activity you might have enjoyed a few years ago and, if appropriate and again, only with your doctor’s approval, initiate it once more. Reduce your consumption of sodium (salt) in your daily diet by reading labels when you shop. As an example, the ingredients in processed foods may contribute to your high blood pressure. Modifications may allow you to reduce or eliminate one of your medications. Then request a referral to a dietitian for direction on what foods would help you lose your 10 pounds and ultimately maintain a desired weight. You shouldn’t have to be “stuck with the discomfort” of weight gain.

Other readers who would like related information can order Dr. Gott’s Health Report “A Strategy for Losing Weight: An Introduction to the No Flour, No Sugar Diet ” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Dr. Gott’s Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.

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The skinny on being skinny

January 10, 2013 By

Q: I am a 31-year-old woman in good health but I can’t gain weight. My primary doctor told me I am about 20 pounds under. I’m 5’9” and weigh 110 pounds. I have a very healthy appetite and do normal exercise (household and work). I’ve had my thyroid tested and it was normal. I’ve always been this way since childhood. The only time I did gain weight was with my pregnancies. What else can I do to gain weight or find out why I can’t?

A: I can already envision countless individuals who will respond with “boy, I wish I had her problem”. We are so focused on losing weight that we forget to consider those individuals who cannot gain weight and this is a major issue for those involved. The rate at which people burn energy has a great deal to do with body weight. Those with a high metabolism might discover they burn energy from the foods they consume very rapidly, preventing weight gain. While exercise is extremely important, you might consider strength training that will increase your muscle density and your appetite.. This form of exercise can be as easy as adding weights to an exercise routine. And, while the thyroid gland is one consideration, you have already ruled that out. Considerations for this inability can include having liver disease, infection, or a metabolic disorder. While it appears extremely easy to eat more in an effort to gain weight, it’s important to consume the right foods such as peanut butter, eggs, avocados, nuts, cheese, and pastas – the very items overweight individuals should avoid. The trick here is to eat the proper foods and add to muscle tissue rather than fat deposits in the abdomen, thighs and buttocks. If you currently eat three meals a day, you might consider increasing healthy snacks between those meals, or eating four to six meals each day. If you find yourself otherwise involved in doing laundry [Read more...]

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120 pound weight gain leads to depression

August 16, 2012 By

DEAR DR. GOTT: My diagnosis is clinical depression and schizo-affective disorder. I have been taking clozapine since 1990 and Mirapex, levothyroxine, omeprazole, Cymbalta and bupropion for about six years. I am severely overweight now – 270 pounds. I used to be no more than 150.

I have been unable to work steadily, except as a retail shop clerk. I’ve had a college degree since 1981. My family (brothers, nieces, nephew and cousins) are all very successful. My parents are 88 and 90 years old and have been helping financially. When they are gone I don’t know what I’ll do.

Do you have any advice for me?
[Read more...]

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Hypertensive drug to blame for weight gain

August 7, 2012 By

DEAR DR. GOTT: I am a female with ESRD, stage 4. My doctor prescribed 100 mg metoprolol approximately 2 ½ years ago. Before that he had prescribed another high blood pressure medicine. My problem is that I am slowly gaining weight, over 20 pounds in two years, and lately I have frequent diarrhea. I am also tired most of the time. I am an older woman and realize that my metabolism is slower and may be contributing to my weight gain. However, I try to stay away from fried foods and processed foods. I exercise about three to four times a week for 30 minutes. Could the metoprolol be causing weight gain and is there a better blood pressure medicine that my doctor could prescribe? Thank you.

DEAR READER: For other readers who may be unaware, ESRD stands for end-stage renal disease, a condition that signifies the almost complete failure of the kidneys to work efficiently. It is likely your kidneys may have begun slowing down 10 or even 20 years before you entered this stage. [Read more...]

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Endometriosis may be cause of weight gain

July 4, 2012 By

DEAR DR. GOTT: I am an almost 49-year-old female, 5’9” and 150 pounds. I am still having regular periods. My problem is recent, rapid weight gain, most of which is very obviously fluid retention as my legs are swollen by the end of the day. I gained 15 pounds in a three month period between February and April.

I have had testing. My appendix was removed because it was misshaped and there was a concern about a possible tumor. During the CT and colonoscopy, it was discovered that they couldn’t put the scope into me and had to do a virtual colonscopy.

It turned out that the appendix was filled with endometriosis. My abdomen is filled with it as well. I am fortunate in that [Read more...]

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Weight gain may be due to menopause

March 26, 2012 By

DEAR DR. GOTT: I am a 57-year-old post-menopausal woman. I have been gaining weight despite the fact that my diet includes plenty of fruits and vegetables, eating meat as a condiment rather than the main event, drinking lots of water and getting regular exercise. Several times a week I bicycle 12 miles, walk three miles a day and use the stairs to my 4th floor office. Despite all this, I continue to gain weight. Is there a supplement I should consider taking or something else I should be doing? Until my mid-40s, I was slim and fit.

DEAR READER: My first thought for your weight gain was menopause. In the peri-menopause phase leading up to menopause, symptoms can include vaginal dryness, decreased fertility, irregular periods, mood swings, thinning hair, loss of breast fullness, hot flashes, sleep disturbances, [Read more...]

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Weight gain blamed on prescription drug

February 2, 2012 By

DEAR DR. GOTT: I am a 32-year-old male who has been struggling with weight ever since I started on Nardil in 2004. During that time my weight ballooned from 180 to 220 pounds, despite lowering my caloric intake to 1500 calories a day and doing two hours of high intensity cardio five days a week. The Nardil gave me a heightened energy level so it wasn’t difficult to maintain, though I didn’t experience any weight loss.

Since going off Nardil in 2009 I have had low energy and sleep disruptions. My weight has dropped to 210, fluctuating occasionally between 205 and 215. Despite my best efforts, I cannot drop my weight any further, though adding vitamin B has helped with my energy. Hormone tests have come back normal, so there is not an issue there.
[Read more...]

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Eat before or after exercise?

September 10, 2010 By

DEAR DR. GOTT: I walk about two miles every morning to keep in shape. I’ve developed a paunch and what my wife calls a bicycle tire around my middle. To get rid of the paunch and tire, is it better to do the morning walk on an empty stomach or to walk after I’ve eaten something?

Twenty years ago, I would run three or four miles every morning right after I got up, consuming nothing but water, and it seemed to work fine.

DEAR READER: The key words here are “twenty years ago.” Unfortunately, our metabolism changes as we age, and what worked then for most of us probably won’t work as easily now.
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Despite strict diet and exercise, weight gain still a problem

May 16, 2010 By

DEAR DR. GOTT: I’m beginning to think I’m crazy. I’m five-feet-nine, 41 years old, about to tip to 200 pounds, and am unable to lose weight. Everyone talks about challenges in weight loss, but I have seriously made giant efforts and do not see any results. I’m beyond frustrated.

I swam competitively in high school with up to four hours per day of heavy training, ate as little as possible, and still gained. I continued to swim in college and met with doctors, trainers and nutritionists who claimed I had a healthful and appropriate diet and got plenty of exercise despite my ever increasing weight.
[Read more...]

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Sunday Column

March 16, 2008 By

DEAR DR. GOTT:
I hope you can give me an answer to my problem which is about to drive me nuts!

I am a 50-year-old male, 5’9” tall, somewhat well muscled yet, have a 36” waist, and weigh 190 pounds. I drink alcohol on occasion, never smoked, have no health problems and take no medication. My daily diet consists of coffee and one cookie in the morning, water and a sandwich with mustard for lunch, and a well-balanced supper.

I don’t use sugar in my coffee or tea. I don’t drink soda or sugary juices and don’t eat iced cream, baked goods, chips, junk or fast food.

I work at a seasonal job doing turf maintenance from April until the end of October. In that time, I will lose ½ to ¾ pound each week until I get laid off in October. During November my weight loss levels off and is maintained easily because I am quite active outdoors hunting and the like. Sometimes I’ll lose a pound or two during that time. Then comes December! I’ll gain a pound per day (almost all belly fat) for the first two weeks and then will gain between two and five pounds more the last two weeks. The weight gain then stops and I have to work like heck to get it off. This has been going on for almost ten years and only happens in December. Nothing in my diet changes. In fact, the only change in my lifestyle is that I do not get up every day at 4:30 AM. Otherwise, I’m just as active as when I’m working.

Is it possible that a genetic or chemical trigger is set off in me because of the shortness of daylight or could it be something else? I’m ready to explode because I’m so frustrated. I wish I could skip December altogether or go into hibernation.

DEAR READER:
A person will ordinarily gain weight when the caloric input exceeds the caloric needs. Your conscientious approach to a healthful lifestyle is remarkable; in fact, your caloric intake is far from being extreme. I’m tempted to blame your “belly fat” on stress, a condition that causes increased waistlines for most of us. With your obvious concern about your end-of-year annual weight gain, you may enter December with trepidation and your system may adversely react and cause you to store excess fat despite your diet and activity level.

Do you attend many family or community parties during the holidays that might provide empty calories? If not, perhaps something as simple as additional coffee ingested daily during the winter months might slow your calorie consumption. To explore this possibility you may want to write down everything you eat and drink in December, as well as your exercise habits, to determine if there is an alteration in your daily routine. Perhaps you are consuming more or are less active than you think. By keeping a journal you can go back and review it. You may even find a pattern of which you were completely unaware.

I recommend that you address your concerns with your family physician. For instance, you may want to have your metabolism checked with a thyroid blood test. In fact, after taking your history, your physician might consider other blood tests that may provide the missing pieces to your puzzling weight gain. At the very least, your doctor can follow your weight loss/gain to identify any reasonable cause for it.

It appears that you are healthy. Your weight depends on calories. This relation can have a genetic basis. Were either of your parents or your siblings troubled by inexplicable weight alterations? If so, treatment for your pattern would be different. Maybe it’s time to relax and not be perturbed by your modest winter alterations. What you gain in December is basically what you are losing in the summer. I don’t believe you need to worry about your loss/gain pattern. However, your family physician can help you.

To give you related information, I am sending you a copy of my Health Report “A Strategy for Losing Weight”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

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