Last week I talked about weight loss and heart health, and how a focus on healthy habits like eating a more Mediterranean-style diet is likely to be more beneficial to your long-term health than a focus on weight loss. This week I’d like to add a few thoughts about weight gain.
When people come to me with concerns about their weight, one of the first things I do, after exploring their underlying goals as we talked about last week, is to ask about trends. How has your weight changed in the past 6 months? Year? 5 years? If you don’t weigh yourself, your clothes can give you a sense of where things are going.
While weight is not a great health indicator, weight gain might be a sign of a problem. (Or it might not!) But if health indicators like blood pressure and sugars are rising, you might want to start by figuring out and if possible, addressing what’s driving it.
Talk to your doctor?
Ideally this conversation would be had with your doctor, but unfortunately some of them lack the time, expertise, or inclination. Weight bias, stigma, and discrimination are still too prevalent in healthcare. 
If you’re in Calgary, you can refer yourself to this clinic for an Alberta Healthcare covered assessment from a compassionate, non-judgemental doctor who really understands the complexity of weight. (I have no affiliation except that I’ve seen their Medical Director speak a number of times, and I’ve had good feedback from referring to her.)
In other parts of Canada, you can look here for credible medical support, or look for a physician with an American Board of Obesity Medicine (ABOM) certification. And if you’re not treated with respect and kindness, head for the door. You deserve better.
Common contributors to adult weight gain
That said, I’ll list some of the most common contributors to weight gain here. Some you may have (some) control over, and addressing them may help slow or stop the weight gain and improve your wellbeing, even if they don’t translate into long-term weight loss.
Some you will have little to no control over, but acknowledging them can help you stop blaming yourself.
Genetics – Given similar circumstances, some people tend to put on weight, some not so much. Maddening isn’t it? The influence of genetics can account for up to 70-80% of our weight.
Age and life stage – Adults, at least in our culture, gain a pound or two a year on average, with extra at stages like childbirth and menopause.
Medical problems – Chronic pain, chronic obstructive pulmonary disease (COPD), obstructive sleep apnea, reflux disease, irritable bowel syndrome (IBS), hypothyroidism, and polycystic ovary syndrome (PCOS) are some of the more common conditions associated with weight gain.
Mental health – Similarly, a number of mental health conditions are connected to weight gain, including depression, binge eating disorder, attention-deficit-disorder (even in adults!), seasonal affective disorder (SAD), anxiety disorders, and more.
Life events – Trauma, loss of a loved one, abuse, or other crises can often trigger weight gain. If this is you, sending you a virtual hug.
Injuries – Whether they sideline you from sports, exercise, or just daily activities like walking, injuries often trigger weight gain, as you burn fewer calories but (maybe) continue eating as usual.
Medications – Many are implicated in weight gain. In my experience, most, but not all doctors are aware of this. Talk to your doctor or pharmacist if you’re wondering about any of yours. Often the benefits still outweigh that downside, but it’s good to know. (This is an example of where those doctors I referenced above could be helpful.)
Recent weight loss – If you’ve lost weight, your body may be fighting to return to your “set weight” — whatever weight you’ve been the most in your life. Sorry to say, the body is hard-wired against weight loss. What you perceive as a good thing, your body perceives as a threat to survival. “Uh oh, not getting enough food here… let’s burn fewer calories and crank up the hunger.”
Smoking cessation – Weight gain isn’t inevitable, but it’s certainly common. The good news is that you’re still better off quitting, in terms of heart health, and your doctor may be able to prescribe something to help.
Your financial situation – A sudden job loss or other financial calamity can affect your ability to afford good food, participate in sports or recreation, or readily access mental health services. And if you have to spend hours riding the bus across town to work, or put in overtime at a second job, self-care like exercise, cooking, and even sleep will likely suffer.
Your neighbourhood – People who live in more walkable places tend to gain less weight, especially if they can walk to the grocery store, work, restaurants, etc. Makes sense right?
Your commute – On the other hand, people who spend more time in their cars tend to be more susceptible to weight gain. More time sitting = less time moving.
Job changes – If you switch from an active job to a desk job, or suddenly have to work more hours, you may see weight gain. Similarly, if you take a new job where you have to travel often, eating more restaurant food and sacrificing time for sleep and movement, weight gain may result.
Sleep difficulties – Speaking of which, sleep is notoriously tied to weight. People intentionally deprived of sleep in studies eat hundreds of additional calories the next day. It’s a natural response to stressors like sleep deprivation.
Stress – Speaking of that… distress in other forms can also promote weight gain. (Hello pandemic!) If we need to soothe our souls, food is often the easiest and most accessible way to do that, although it may not meet our deeper needs. Stress, including poor sleep, can also be a physiological trigger of weight gain, regardless of food intake.
Physical activity – While exercise may not be the weight loss driver many people hope for, it can play an important role in slowing or preventing weight gain. And how much we move just in regular living can impact weight. Again, a major pandemic problem. 
Eating habits – Finally, yes, food and eating habits can absolutely play a role, which is why so many people turn to dietitians for help with weight.
While I love to help people learn to eat in a way that better supports health, and we can strategize for how to counter some of these other factors, I wanted to raise awareness that there’s usually much more going on than what’s on your plate.
I’m sure I’ve missed some things in my quick list here, but you get the idea.
So no beating yourself up if you’ve gained weight
A quick skim through this list and it’s no surprise why so many people have gained weight over the past year!
Again, weight gain isn’t necessarily a bad thing. As I often say, if food is helping you cope, at least you’re coping. There are worse ways.
There’s just so much misplaced self-blame with weight that I want to dispel. I often hear people slip into the self-loathing, self-critic mode: “I’m just lazy.” (No you’re not.) “I have no willpower.” (Willpower is overrated.)
If you’re reading this, I bet you’re doing the best you can with the cards you’ve been dealt.
And I’m not just saying that to be nice. Appreciate the critical importance of self-compassion. It’s actually associated with concrete benefits, like reduced stress, improved performance after failure, and lower rates of anxiety and depression. (Stuff that impacts weight!)
So instead of “I’m just lazy,” you might say “I struggle with motivation to cook when I’m at home by myself all the time.” Instead of “I have no willpower,” think “There’s not a lot of pleasure in my life right now, and those cookies give me a bit of a mood boost when I need one.”
The other benefit of framing up root causes like this is that the solutions become clearer. If “I’m just lazy,” that’s that, and I can’t do much about it.
But if I recognize that “There’s not a lot of pleasure in my life right now,” then perhaps I need to build some into my life. Plan a walk with a friend three times a week. Put some good books on hold at the library. Play your favourite music or watch a great movie.
If you have a hard time reframing things in a more self-compassionate way, it might help to do this work with a professional, or a trusted friend.
What to do?
Is it possible to overcome these things? Some of them yes. And some we can get better at living with.
Again, don’t measure success in pounds lost. We don’t have much control over that. But, for example, if you’re sleeping better and your weight “won’t budge,” let’s reframe that. Perhaps you’ve stopped gaining weight, and you have more energy to do other things that can make you feel better, like a walk or trying a new recipe. Maybe your blood sugars are improving, or you’re getting stronger. 
It’s an upward spiral. You may well have good days and bad days. But try, even if it means failing sometimes. Persist, and you might surprise yourself. One day something will click. So start today, take baby steps, and be kind to yourself.
Does this resonate for you? Have I missed anything? Chime in on Facebook.