Makindo Medical Notes"One small step for man, one large step for Makindo" |
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โ๏ธ Unintentional or persistent weight gain can result from lifestyle, medical, psychological, or endocrine causes. ๐ It is important to distinguish between increased adiposity (fat gain), fluid retention (e.g., heart failure), and secondary causes (e.g., endocrine disorders). ๐ A systematic approach ensures reversible and serious causes are not missed.
Cause | Investigations | Management |
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Hypothyroidism | TFTs, thyroid antibodies | Levothyroxine, monitor TFTs |
Cushingโs Syndrome | 24-hr urinary cortisol, dexamethasone suppression, ACTH, pituitary/adrenal imaging | Adrenalectomy/pituitary surgery, cortisol-blocking drugs |
PCOS | Hormone profile, pelvic ultrasound, glucose tolerance | Lifestyle, metformin, hormonal contraception |
Heart Failure | Echocardiogram, BNP, CXR, ECG | Diuretics, ACE inhibitors, fluid/salt restriction |
Medication-related | Medication review, BMI monitoring | Adjust/switch agent, add lifestyle support |
Psychiatric Disorders | Psychiatric assessment, PHQ-9, GAD-7 | CBT, antidepressant switch, lifestyle therapy |
Genetic/Syndromic | Genetic testing, hormonal profile | Behavioural therapy, dietary control, growth hormone therapy (e.g., Prader-Willi) |
Lifestyle/Overeating | Food diaries, physical activity logs, BMI | Dietary changes, physical activity, structured weight-loss programme |