Have you ever gained weight and just didn't know why? Your diet and exercise seemed the same, and yet the scale kept climbing. Sometimes there's an underlying medical condition, so if you have sudden, severe, unexplained weight gain, always see your doctor. But if you're just struggling to lose some unwanted pounds or slowly watching your weight creep up, check out these hidden causes.
1. You're not getting enough sleep
Are work and life crowding out your sleep? Suffering from insomnia, waking frequently, or getting poor-quality rest? When we don't sleep enough, our stress hormone (cortisol) rises. At the same time, leptin — the hormone that helps us feel full — drops, and ghrelin — the hormone that tells us we're hungry — increases.
The result: you tend to be hungrier, eat and snack more, and reach for foods higher in fat and carbs. Studies also show that when dieting, sleep-deprived people lose less fat than those who sleep enough. Aim for at least 8 hours a night, and if you're having trouble sleeping, talk to your doctor.
2. You're anxious or depressed
Increased appetite can be a symptom of anxiety or depression. Some people lose their appetite; others want to eat everything ("eating your feelings"). If you've been eating when you aren't hungry, or reaching for comfort foods, ask yourself whether you have other symptoms of a mood disorder, such as:
- Anxious, depressed, or irritable mood
- Sleeping too much or too little
- Loss of interest in things you usually enjoy
- Excessive worrying
- Feelings of guilt or worthlessness
If these describe you, talk to your doctor — treating the anxiety or depression may help.
3. You're on medications that cause weight gain
Some medications can cause weight gain, so check your list. Common examples include:
- Beta-blockers — metoprolol, atenolol, labetalol, propranolol
- SSRIs — paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa)
- Mirtazapine (Remeron)
- Tricyclic antidepressants — amitriptyline (Elavil), imipramine (Tofranil), doxepin
- Antipsychotics — thioridazine (Thorazine), clozapine (Clozaril), olanzapine (Zyprexa), risperidone (Risperdal)
- Anti-seizure medications — valproic acid (Depakote), gabapentin (Neurontin), carbamazepine (Tegretol)
- Corticosteroids — prednisone, prednisolone
- Diabetes medications — pioglitazone (Actos), rosiglitazone (Avandia), insulin
- Birth control — Depo-Provera, Nexplanon
Never stop a medication without talking to your doctor first. Some you may not be able to stop — but sometimes your doctor can switch you to an alternative that doesn't affect your weight. So ask.
4. Your gut microbiome is off
The microbiome is the community of good bacteria that naturally live in our intestines and function as part of our immune and endocrine systems. Studies show an inverse relationship between the number of bacterial strains in the gut and BMI — people who struggle with weight tend to have fewer strains of good bacteria.
While we can't yet say which comes first, eating plenty of fiber and taking prebiotics and probiotics can all improve gut health. Early evidence suggests these may help with weight loss and insulin resistance.
5. You're under a lot of stress (and not coping well)
Who doesn't have stress? Interestingly, studies show it's not the amount of stress but how we handle it that matters. Some people are more reactive — their bodies produce a lot of cortisol, which increases appetite and leads to weight gain. Others don't get the same spike. If you're feeling stressed, eating more, and gaining weight, consider seeing a therapist to work on coping strategies.
6. You're consuming artificial sweeteners
Switched to diet soda to skip the calories? Studies show that artificial sweeteners can alter glucose metabolism, lead to insulin resistance, and may even cause weight gain — possibly by disrupting the gut microbiome. If you want to avoid sugar, natural plant-based sweeteners like stevia and monk fruit appear to be safer choices.
What should I do now?
If you're struggling with weight gain, see your doctor. I'm accepting patients in my virtual clinic who live in states where I'm licensed, and I'd love to help.