When the Scale Moves the Wrong Way: What Might Be Behind Unexpected Weight Gain

“I’m eating well and exercising regularly to lose some weight, but the scale is going the wrong way. What’s the deal?!” Many people have or will experience unexplained weight gain at some point in their lives. There are many reasons for this potentially frustrating situation, which could include eating too many calories and/or decreased physical activity, medical conditions, other lifestyle factors, aging, yo-yo dieting or medication side effects. Let’s break this down.

Possible Causes of Unexplained Weight Gain

Energy Intake Imbalance

One potential reason for weight gain may include hidden calories in the diet or not enough physical activity.  Take these factors into consideration when examining your lifestyle.

Ultra processed foods

Eating a diet high in ultra processed foods (UPFs) and low in whole foods could lead to higher calorie intake and unexplained weight gain. UPFs are defined by the Nova classification system as industrial formulations composed of refined ingredients, additives, and minimal to no whole foods. This involves a wide variety of foods in which some provide key nutrients, but many are high in calories, salt, saturated fat and added sugar, which can lead to weight gain. Instead, focus on including more nutrient dense whole foods into your diet (fruits, vegetables, nuts, seeds, legumes, meat, poultry and fish and whole grains).

Liquid calories

Calories from beverages like regular sodas, sugar sweetened coffee drinks, energy drinks and alcohol are often forgotten because they don’t keep us full like foods with satiating nutrients like fiber, protein and fat.

Portion sizes

Taking stock of your portion sizes at home and when eating out may uncover unwanted calories creeping into your diet. Myplate.gov provides portion size information for each food group. Portion sizes vary depending on individual needs.

Sedentary lifestyle

As we age, we tend to be less active due to desk jobs, playing chauffeur to kids and more life responsibilities that take away from active time. Being busy doesn’t always equate to physical activity.  Check out the American Heart Association recommendations for physical activity for more information.

Factors like physical activity levels, age, disease states, gender and more play a role in individual nutrient needs. Talk with a registered dietitian for more customized information on these diet related topics.

Medical Conditions

Unexplained weight gain may be a symptom of underlying medical conditions. Here are a few diagnoses that may contribute to unexplained weight gain.

Hypothyroidism

This condition occurs when the thyroid gland doesn’t produce enough thyroid hormones. This is also known as an underactive thyroid. Weight gain is a common symptom of this condition, along with fatigue, constipation, thinning hair and depression.

Depression

Dealing with depression can be associated with weight gain due to decreased physical activity, side effects from some medications used to treat the condition, undesirable food choices, and overeating.

Polycystic Ovary Syndrome (PCOS)

A condition that affects those assigned as female at birth of reproductive age due to an imbalance of hormones. Weight gain, especially around the abdomen, is a common symptom.

Edema

Cardiovascular, liver, lung and kidney diseases can cause swelling or excess fluid to accumulate in your body tissues. Swelling in the ankles, feet and abdomen and/or a weight gain of more than 3 pounds in a day or 5 pounds in a week may be signs of an underlying health condition.

Hormonal changes

While puberty, menstruation, pregnancy and menopause are life stages rather than medical conditions, they are associated with weight gain. Growth spurts and fluid retention drive weight gain during puberty and menstruation. A healthy weight gain during pregnancy for a person who was at a healthy weight before pregnancy is 25-35 lb. During menopause weight gain and or redistribution to the midsection is common and normal. However, focusing on a healthy dietary pattern including nutrient dense foods with limited added sugar, saturated fat and sodium is recommended to maintain a healthy weight. Limiting alcohol is recommended as well. These recommendations are aligned with the 2020-2025 Dietary Guidelines for Americans.

Contact your healthcare provider to evaluate the possibility of unexplained weight gain associated with a medical condition.

Other Lifestyle Factors

Sleep

Sleep is our body’s way of recovering. Poor sleep has been associated with eating more frequently, eating foods higher in carbohydrates and limited physical activity, all of which can lead to unexplained weight gain. The Centers for Disease Control and Prevention recommends adults get at least 7 hours of sleep each day.

Stress

We all experience stress in our lives. However, stress that is chronic can affect your weight. Your body releases cortisol when you are stressed. Too much of this hormone can increase your appetite, especially for comforting high fat, high sugar foods, which can lead to weight gain.

Smoking cessation

Nicotine can suppress appetite, taste and smell. After kicking the habit, you may feel hungrier and food may be more enjoyable, which can increase your intake. For some people, eating becomes a substitute for smoking to deal with stress and boredom. Focus on staying hydrated, portion control, regular exercise, eating mindfully and other ways to cope with stress to prevent weight gain.

Aging

Gaining weight as we age is normal. Research shows that metabolism starts to decline around the age of 60 due to cellular changes, decreased muscle mass and bone loss. Focusing on a nutrient-dense diet within your calorie needs, along with regular physical activity, can help you maintain muscle and bone mass and a healthy lifestyle as you age.

Yo-yo Dieting

If your past efforts to lose weight include cycles of restrictive fad diets resulting in repeated extreme weight loss and then unintentional weight regain, this could be a contributor to unexplained weight gain. “Yo-yo dieting” not only impacts your relationship with food, but it can increase your risk for weight gain over time too. Changes in hunger hormones may increase your appetite and make it more difficult to feel full. A repeated loss of muscle mass is associated with an increased fat percentage versus muscle when weight is regained. This can impact metabolism, and result in gaining more weight than was previously lost.  Consistent sustainable lifestyle changes are key to maintaining a healthy weight and relationship with food over your life span.

Medications

Weight gain can be a side effect of some medications. The most common culprits include these categories of prescribed medications.

Antipsychotics

These medications are commonly prescribed to treat conditions like schizophrenia, bipolar disorder and depression and may cause an increased appetite. Clozaril, Zyprexa, Seroquel and Risperdal are more likely to cause weight gain than others in this category.

Antidepressants and mood stabilizers

Weight gain in these medications varies widely by individual. These include Amitriptyline and Nortriptyline, Mirtazapine, Paroxetine and Lithium.

Diabetes medications

Some medications used to treat diabetes may cause weight gain due to an increased absorption of glucose from your bloodstream, which is converted to fat. These include Insulin, sulfonylureas, glitazones and pioglitazone, and glinides.

Corticosteroids

Weight gain is a common side effect of these medications (not including topicals) when used long term. Corticosteroids act like cortisol in the body, stimulating your appetite. They also may cause fluid accumulation, leading to weight gain. Prednisone is a common corticosteroid.

There are many reasons individuals might experience unexplained weight gain. Sometimes it can be a combination of many of these factors. Focus on a balanced diet including a variety of whole foods and regular exercise. These can help manage other issues like poor sleep and stress. Tackling these issues can seem overwhelming, but you aren’t alone. Work with your healthcare provider to evaluate possible medical conditions or medications that are contributing to unexplained weight gain. For help with sustainable dietary changes, schedule an appointment with our nutrition experts, the Kroger health dietitians.