NHS Choices - Live Well
Most people put on weight because they eat and drink more calories than they burn through everyday movement and body functions.
But in some cases, your weight gain may be due to an underlying health condition. Here are nine medical reasons that can cause weight gain.Underactive thyroid
An underactive thyroid (hypothyroidism) means that your thyroid gland is not producing enough thyroid hormones, which play a central role in regulating your metabolism. Although an underactive thyroid can occur at any age and in either sex, it is most common in older women. “Without enough thyroid hormone, the body’s metabolism slows down, which can lead to weight gain,” says dietitian Catherine Collins. The condition is usually treated with daily hormone-replacement tablets, called levothyroxine.Diabetes treatment
Weight gain is a common side effect for people who take insulin to manage their diabetes. Insulin helps to control your blood sugar level. It’s not uncommon for people with longstanding diabetes to eat a diet that "matches" their insulin dose, which can mean they’re eating more than they need to in order to prevent low blood sugar – also known as hypoglycaemia or "hypo" – from developing.
“Excessive snacking to prevent a hypo contributes to an excessive calorie intake and overall weight gain,” says Collins, who recommends becoming an "expert patient" by attending a diabetes education course such as DESMOND for people with type 2 diabetes or DAFNE for type 1 diabetes, to help make your diabetes fit your lifestyle – not the other way round.Ageing
People begin to lose modest amounts of muscle as they get older, largely because they become less active. Muscles are an efficient calorie burner, so a loss of muscle mass can mean you burn fewer calories. If you’re eating and drinking the same amount as you always have and are less physically active, this can lead to weight gain. “To reduce muscle loss, you should stay active and try to do regular muscle-strengthening exercises,” says Collins.Steroid treatment
Steroids, also known as corticosteroids, are used to treat a variety of conditions, including asthma and arthritis. Long-term use of corticosteroid tablets seems to increase appetite in some people, leading to weight gain. “The higher the dose and the longer you are on steroids, the more weight you are likely to put on,” says Collins. “This is because steroids make you feel hungry, affecting the areas in the brain that control feelings of hunger and satiety.”
She says that being extra careful about what you eat during your steroid course will help you not to eat more than you normally do. It’s not a good idea to reduce or stop your steroid treatment. If you’re worried about weight gain, chat to your GP about help to control your weight.Cushing’s syndrome
Cushing's syndrome is very rare, affecting around one in 50,000 people, and is caused by high levels of the hormone cortisol. It can develop as a side effect of long-term steroid treatment (iatogenic Cushing's syndrome) or as a result of a tumour (endogenous Cushing’s syndrome). Weight gain is a common symptom, particularly on the chest, face and stomach. It occurs because cortisol causes fat to be redistributed to these areas. Depending on the cause, treatment typically involves either reducing or withdrawing the use of steroids, or surgery to remove the tumour.Stress and low mood
People respond differently to stress, anxiety and depressed mood. Some people may lose weight, while others may gain weight. “People can turn to food as a coping mechanism,” says Collins. “It can lead to a vicious circle. Weight gain from depression can make you more depressed, which can lead to further weight gain. If you know you’re an emotional eater, you need to find other forms of distraction, such as exercise or a hobby, calling a friend, going for a walk or having a soothing bath.”Tiredness
Some studies have shown that people who sleep less than seven hours a day may be more likely to be overweight than those who get nine hours of sleep or more. It’s not clear why, but one theory suggests that sleep-deprived people have reduced levels of leptin, the chemical that makes you feel full, and higher levels of ghrelin, the hunger-stimulating hormone. “If you’re always feeling tired, you are more likely to reach for high-calorie snacks to keep your energy levels up throughout the day and do less physical activity, which means you burn fewer calories,” says Collins.
Fluid retention (oedema) causes parts of the body to become swollen, which translates into weight gain. This gain is caused by fluid accumulating in the body. Some types of fluid retention are not uncommon – for example, if you're standing for long periods or are pre-menstrual. The swelling can occur in one particular part of the body, such as the ankles, or it can be more general.
“More severe fluid retention can also cause breathlessness,” says Collins. “If you notice that you have swollen ankles during the day, have to get up to pee overnight, and have to sleep on a few pillows to avoid breathlessness, you should see your GP, as these examples of fluid retention can indicate heart or kidney problems that need assessment.”Polycystic ovary syndrome (PCOS)
PCOS is a common condition that affects how a woman’s ovaries work. Symptoms can include irregular periods, trouble getting pregnant, excess hair and weight gain. The exact cause of PCOS is unknown, but it's thought to be hormone-related, including too much insulin and testosterone. “Women with PCOS typically put on weight around their waist,” says Collins. “The more weight you put on, the more insulin you produce, which causes further weight gain.” Weight loss through dietary changes and exercise, and in some cases medication such as orlistat, will help to break the cycle."
One in 20 children in the UK will experience child sexual abuse. Here are the signs to be aware of and what to do if you suspect a child is being sexually abused.What is child sexual abuse?
Child sexual abuse is illegal in the UK and covers a range of sexual activities, including:
- possessing images of child pornography
- forcing a child to strip or masturbate
- engaging in any kind of sexual activity in front of a child, including watching pornography
- taking, downloading, viewing or distributing sexual images of children
- encouraging a child to perform sexual acts in front of a webcam
- not taking measures to protect a child from witnessing sexual activity or images
- inappropriate sexual touching of a child, whether clothed or unclothed
- penetrative sex
Both boys and girls can be victims of sexual abuse, but girls are six times more likely to be affected.Who commits child sexual abuse?
People who sexually abuse children can be adult, adolescent or a child themselves. Most abusers are male but females sometimes abuse children too. Forty percent of child sexual abuse is carried out by other (usually older) children or young people.
Nine out of 10 children know or are related to their abuser. Eighty percent of child sex abuse happens either in the child’s home or the abuser’s. Boys are more likely to be abused outside the home, for example, at leisure and sports clubs.
“Child sex abusers often present as engaging, charming individuals,” says John Cameron, Head of Child Protection Operations at the National Society for the Prevention for Cruelty to Children (NSPCC).
“If someone wants to sexually abuse a child, they usually have to build up a relationship of trust before they go ahead. People often doubt their own eyes and ears because the abuser appears to be a decent person.”
You may notice that an abuser gives a child special treatment, offering them gifts, treats and outings. They may seek out opportunities to be alone with the child.Which children are at risk of child sexual abuse?
Any child can be sexually abused, but there are some factors that increase the risk. Children are more vulnerable if they have already experienced abuse of some kind. Children who live in families where there is child neglect, for example, are more at risk.
Disabled children are three times more likely to be victims of sexual abuse, especially if they have difficulties with speech or language.
Children can also be at risk when using the internet. Social media, chat rooms and web forums are all used by child sex abusers to groom potential victims.
See how to protect your child from abuse.What are the signs that a child is being abused?
Child sexual abuse can be difficult to identify. Research suggests that one in three children who are sexually abused don’t speak out about it at the time.
Children often don’t talk about the abuse because they think it is their fault or they have been convinced by their abuser that it is normal or a ‘special secret’. Children may also be bribed or threatened by their abuser, or told they won’t be believed.
A child who is being sexually abused may care for their abuser and worry about getting them into trouble.
Here are some of the signs you may notice:
Changes in behaviour – a child may start being aggressive, withdrawn, clingy, have difficulties sleeping or start wetting the bed.
Avoiding the abuser – the child may dislike or seem afraid of a particular person and try to avoid spending time alone with them.
Sexually inappropriate behaviour – children who have been abused may behave in sexually inappropriate ways or use sexually explicit language.
Physical problems – the child may develop health problems, including soreness in the genital and anal areas or sexually transmitted infections, or they may become pregnant.
Problems at school – an abused child may have difficulty concentrating and learning, and their grades may start to drop.
Giving clues – children may also drop hints and clues that the abuse is happening without revealing it outright.What are the effects of child sexual abuse?
Sexual abuse can cause serious physical and emotional harm to children both in the short term and the long term.
In the short term children may suffer health issues, such as sexually transmitted infections, physical injuries and unwanted pregnancies.
In the long term people who have been sexually abused are more likely to suffer with depression, anxiety, eating disorders and post-traumatic stress disorder (PTSD). They are also more likely to self-harm, become involved in criminal behaviour, misuse drugs and alcohol and to commit suicide as young adults.
Children who have been sexually abused are also at risk of sexual exploitation, in which children are sometimes passed around a network of abusers for sexual purposes or are made to do sexual favours for others by their boyfriend.
See more about how to spot child sexual exploitation.Will reporting the abuse make things worse?
Children are less likely to suffer long-term consequences from sexual abuse if they get the right help and support early. The only way this can happen is if they disclose the abuse themselves or if someone else reports it. If these things don't happen the abuse is likely to continue.
“Child sexual abuse is never a one-off,” says John Cameron. “It is often a highly addictive behaviour. Without intervention the likelihood of it stopping decreases over time.”
You may be worried that the child in question will be taken away from their parents and put into care. This could be a particular concern if you are the child’s parent.
“The last thing children’s services want to do is take children away,” says John Cameron. “What they are more likely to do is make sure the perpetrator is distanced from the child. If the father is the perpetrator, for example, he can be asked to leave the home and any further contact supervised.”How do I report child sexual abuse?
It's best not to delay if you suspect a child is being sexually abused. “Don’t wait until you’re certain because you will be waiting forever and a day,” says John Cameron. “We all know that feeling when something isn’t quite right. If you have that sense of disquiet, trust your instincts and check it out with someone.”
You can talk directly to the police or your local children’s social services and this can be anonymous. You can also get advice or report your concerns anonymously to the NSPCC by phoning their free helpline on 0808 800 5000. Or you can report sexual abuse to the NSPCC via email or online.
If you are a health professional and suspect a child you are caring for is experiencing abuse or is at risk of abuse, you can seek advice on what to do from the ‘named nurse’ or ‘named doctor’ in your hospital or care setting.
You’ll find more information and advice about child sexual abuse on the NSPCC.
If you are concerned about your own thoughts or behaviour towards children, you can phone Stop It Now! in confidence on 0808 1000 900 or email email@example.com.
If you are a child and someone is sexually abusing you, you can get help and advice from ChildLine – phone 0800 1111, calls are free and confidential.