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Family Medicine  (Expert Forum)
 | 
Weight Issue
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.

Weight Issue

by Legend, Aug 06, 2003 12:00AM
My daughter is 19.  Since her periods began when she was 14, her weight has continuously increased.  She was a very active and successful athlete until she broke her leg in the Spring of her senior year in high school.  All during high school she has continuously struggled keeping her weight down.  She has tried numerous diets and has almost become an expert in nutrition in the process.  Finally, because she was unable to maintain her weight, she suffered some depression during her senior year and began to binge.  Her weight continued to increase.  We got her to a therapist and although the binging has stopped, her weight continues to increase.  We had taken her to our family doctor that year, but he was unable to identify an issue.  He did some significant blood work and there was nothing out of line.  This summer she got a blood work up and the only thing out of whack was that her thyroid was a bit sluggish and her cholesterol was elevated.  She’s now taking pills for the thyroid.  Today our family doctor told her that she is suffering obesity.  She is crushed.  She’s done everything everyone has recommended and can’t stop her weight from increasing.  Her food input is moderate.  She does not binge (we feel pretty confident about saying that).  I was wondering if seeing a doctor specializing in metabolism or endocrinology might help identify something.  I’m looking for help beyond the standard of exercise and diet prescription. We believe there’s a cause, but where do we go from here?

by Kevin Pho, MD, Aug 09, 2003 12:00AM
Medical causes of obesity includes hypothyroidism (which has been diagnosed), Cushing's syndrome, polycystic ovary syndrome and growth hormone deficiency.  Each of these disorders can be tested for.  



If all the obvious causes (i.e. sedentary lifestyle, overeating etc.) have been ruled out, then a referral to an endocrinologist can to evaluate for the above causes is certainly reasonable.  



An alternative route would be to observe the weight while on the thyroid medication, and if it continues to increase, then be evaluated by an endocrinologist.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Thanks,

Kevin, M.D.

Member Comments (1)

by kevinmd, Aug 07, 2003 12:00AM
Hello - I will be on vacation until August 9th. I look forward to answering your question when I return.



Thanks,

Kevin, M.D.
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