How do you know if you have a medical cause for being overweight?

A medical cause for being overweight is present when an underlying condition, such as a thyroid problem or hormonal imbalance, affects body weight in a way that is independent of eating and exercise habits. This is less common than many people think, but it is certainly possible and deserves serious attention. The questions below help to understand when a medical cause is realistic and what the next step could be.

Which medical conditions can cause weight gain?

Various medical conditions can contribute to weight gain, regardless of eating or exercise habits. The most common ones are an underactive thyroid (hypothyroidism), Cushing's syndrome, polycystic ovary syndrome (PCOS) and insulin resistance. Certain medications, such as antidepressants, beta-blockers or corticosteroids, can also have weight gain as a side effect.

In hypothyroidism, the thyroid gland produces too few hormones, causing the metabolism to slow down. This leads not only to weight gain, but also to fatigue, sensitivity to cold and a slow heart rate. The thyroid as a cause of excess weight is regularly investigated, but the effect on weight is in most cases more limited than people expect.

Cushing's syndrome is rarer and is caused by a prolonged elevated cortisol level. Cortisol is a stress hormone that promotes fat storage, particularly around the abdomen. PCOS affects women and is accompanied by hormonal imbalance that can cause insulin resistance and weight gain. Insulin resistance itself, where cells respond less well to insulin, makes it more difficult to burn fat and increases the likelihood of weight gain.

How do you recognise the symptoms of a hormonal cause?

A hormonal cause of weight gain can be recognised by a combination of symptoms that go beyond weight alone. Think of persistent fatigue, irregular periods, dry skin, hair loss, mood swings or bloating, combined with weight gain that cannot be explained by changes in eating or exercise habits.

It is important that no single symptom on its own proves there is a hormonal cause. Fatigue and weight gain are also common consequences of sleep deprivation, stress or an unhealthy diet. The pattern of symptoms and the context are decisive. When multiple complaints occur simultaneously and do not improve despite lifestyle adjustments, it is advisable to have this investigated by a doctor.

In men, low testosterone levels can also contribute to weight gain, reduced muscle mass and fatigue. This is a hormonal cause that is less commonly recognised, but which can certainly be relevant in weight loss that despite effort it does not succeed.

What tests does a doctor perform to determine a medical cause?

A doctor determines a medical cause of excess weight through blood tests, a physical examination and a comprehensive medical history. Blood tests typically focus on thyroid function (TSH and free T4), blood sugar levels, insulin resistance, cortisol and sex hormones such as testosterone or oestrogen.

The medical history is at least as important as the laboratory values. A doctor asks about the pattern of weight gain, medication use, family history, sleep patterns, stress levels and any other symptoms. Based on this complete picture, the doctor determines whether further investigation is necessary, such as an ultrasound of the thyroid or a cortisol measurement via urine or saliva.

It is also possible that a doctor decides not to carry out any further investigation if the symptoms and blood test provide no indication of an underlying condition. That is not a dismissal, but a medical judgement based on the available information.

What if a doctor finds no medical cause, but losing weight still doesn't work?

When a doctor finds no medical cause but losing weight still does not work, it does not mean that nothing is wrong. It means the cause likely lies in a combination of factors such as metabolism, eating behaviour, sleep, stress and environment, each of which is difficult to change on its own but together have a major effect on weight.

For many people, losing weight is not just a matter of willpower. Biological mechanisms, such as the regulation of hunger hormones like ghrelin and leptin, play a major role. When someone has been in a calorie deficit for a long time, the body adapts by slowing down the metabolism and increasing the feeling of hunger. This makes further weight loss increasingly difficult, even without a medical condition.

In this case, medical supervision may still be useful. GLP-1 medication for overweight is an example of a treatment option that is not aimed at treating an underlying condition, but at supporting the feeling of fullness and metabolism. This type of medication is only prescribed after evaluation by a doctor and is not suitable for everyone.

When is medical guidance for being overweight useful?

Medical supervision for overweight is useful when lifestyle adjustments do not yield sufficient results, when the weight poses health risks, or when there is a suspicion of an underlying medical cause. A doctor can assess whether medical support, such as GLP-1 medication, is appropriate as a supplement to lifestyle change.

Medical treatment for overweight is not a replacement for behavioural change, but a support for it. Results vary per person and depend on multiple factors, including consistency, lifestyle and individual response to treatment. Not everyone is eligible for medication-based treatment; a doctor will assess this on a case-by-case basis.

People who are unsure whether medical guidance is relevant to them are best off starting with a consultation with a doctor, either through their GP or via an online intake with a telehealth provider. This ensures that the most appropriate next step is assessed based on their personal situation.

How Wellumo helps with overweight using a medical approach

Wellumo offers online medical guidance for people who want to explore whether a treatment for being overweight is suitable. The programme is designed to be accessible and discreet, without compromising on medical diligence.

• A medical questionnaire forms the basis of the intake process, allowing a BIG-registered doctor to fully assess the situation.
• The doctor decides independently whether a treatment is medically justified; not everyone is eligible.
• Upon approval, a prescription is drawn up and forwarded to the collaborating pharmacy, which independently assesses and processes the delivery.
• Medication is shipped discreetly, with an optional subscription for repeat deliveries.
• Prices are communicated transparently in advance, with no hidden costs.

Would you like to know if a medical treatment for being overweight could be suitable for you? Start the intake at Wellumo and have a doctor assess your situation. Want to know more about how the process works? View How Wellumo works of neem Contact us with questions.