Whether you ever gave eating less and moving more a fair try is a question about effort. One part of the argument at home can be checked: whether another medicine you take may be affecting your weight, since some medicines can make you hungry or make your body burn fewer calories. Ask a health care professional to review the ones you take to see whether they may be affecting your weight.
What can affect a person's weight
Your eating and activity are one part of what affects your weight. Many factors can affect it, including lifestyle habits, where you live, work, play and worship, how much sleep you get, medicines, health problems, and family history and genes. Each row below gives a few examples, not every one.
| Group | Some of what it includes |
|---|---|
| Lifestyle habits | What you eat and drink and how active you are. Eating or drinking a lot of foods and drinks high in calories, sugar and fat, and spending a lot of time sitting or lying down, may lead to weight gain. |
| Where you live, work, play and worship | Healthier choices may be easier with a grocery store nearby that sells healthy, affordable food, a kitchen at work for meals brought from home, a job that does not keep you sitting, and safe places to walk. |
| How much sleep you get | Adults aged 18 to 64 are advised to get 7 to 9 hours a night, and adults 65 and older 7 to 8. Too little sleep may make you feel hungrier and eat more calories. |
| Medicines | Medicines that may contribute to weight gain include some used for epilepsy, depression or psychotic disorders, steroids, and some diabetes, blood pressure and allergy medicines. |
| Health problems | Some hormone conditions, such as polycystic ovary syndrome, Cushing's syndrome and an underactive thyroid, as well as depression, long-term stress, and some eating disorders. |
| Family history and genes | The chances of having overweight or obesity are greater if one or both of your parents have it. Genes may affect how much fat you store and where, your appetite, and how active you are. |
If you keep taking in more calories than you use, over time you will likely gain weight. Long-term stress can trigger your body to make high levels of hormones such as cortisol, which help regulate hunger, and high levels of them can increase your appetite.
Who can say whether you gave it a real try
In treatment, the question you and a health care professional look at is whether lifestyle changes have been enough for weight loss, or for keeping weight off. When they have not, a professional may prescribe a medicine as part of your weight-control program. Weight loss can be difficult to achieve and maintain. At a visit about weight, a professional may ask about your eating, drinking and physical activity habits.
A weight-loss program is more than a book or app that promises weight loss. It is a formal program giving ongoing guidance and support to build healthy lifestyle habits that may promote weight loss, and safe and successful programs typically include:
- 14 or more weight-loss counseling sessions over 6 months
- an eating plan based on the calories and nutrients your body needs
- at least 150 minutes a week of moderate-intensity aerobic activity, such as brisk walking or cycling
- daily tracking of what you eat and how active you are, and a weekly weigh-in
- regular feedback and support from specialists
Most of that list comes from outside a household: the counseling, the specialists and the feedback. A health care professional may work with you to develop a program tailored to your needs and preferences, or refer you to a registered dietitian or a specific program. If what you tried before was on your own, ask your doctor whether one of those is open to you.
Does a weight medicine replace eating and moving?
No medicine for weight replaces physical activity or healthy eating habits as a way to lose weight, so taking one is no way out of them. Take one only to support your healthy eating and physical activity program, and because obesity is a chronic disease, you may need to keep those habits up for years, or for life.
For many adults, treating overweight and obesity starts with lifestyle changes. Overweight and obesity may also be treated with weight-loss medicines and weight-loss surgery, and health care professionals most often recommend lifestyle changes along with medicines or surgery, so the lifestyle changes carry on when a medicine is added.
A health care professional uses your body mass index (BMI), a measure of your weight in relation to your height, and any weight-related health problems such as high blood pressure or type 2 diabetes, to help decide whether a medicine for weight might benefit you, and these medicines are not for everyone with a high BMI. You decide with your health care professional whether to use one, and which.
Questions an appointment can answer
At an appointment about your weight, questions to ask a health care professional can include:
- "Am I at a healthy weight?"
- "How is my weight affecting my health?"
- "Will losing weight improve my general health, as well as specific health problems I have?"
Add a fourth about everything you take: could any medicine or supplement you take be affecting your weight? At a visit about weight, a professional may review the medical problems you have and the medicines or dietary supplements you take, to see whether they may be affecting your weight or making weight loss harder, and may measure your BMI and other health factors. Some depression medicines may contribute to weight gain (see Could your antidepressant be part of the weight gain?).
Health care professionals sometimes do not bring up weight during a general office visit, so you may need to raise it yourself. If talking about your weight makes you uneasy, practice saying your concerns before the visit and bring your questions with you. Until then, do not change or stop any medicine on your own: doing that can be dangerous and could make your condition worse, so check with whoever prescribed it first.
If mental health symptoms such as difficulty sleeping, difficulty getting out of bed in the morning because of mood, or loss of interest in things you usually enjoy have lasted 2 weeks or more and feel severe or distressing, talk to a primary care provider about how you feel; they can refer you to a mental health professional. People taking certain weight-loss medicines have reported suicidal thoughts or actions, and the FDA continues to look into whether the medicines cause them. Thoughts of suicide need the Suicide & Crisis Lifeline now: call or text 988, and call 911 when a life is in danger. If you take a weight medicine, also tell the health care professional who prescribed it about those thoughts.
The NicoCares eligibility check asks about your health, so that a physician licensed to practice in your state can make a clinical decision, which can be that treatment is not appropriate for you. Once you are a NicoCares patient, ask the fourth question in the Spruce app, where your care team answers, and list there every other medicine and supplement you take. The care team's answers come with no set time, so for thoughts of suicide, use 988 or 911 rather than the app.
