Medical hypothyroidism, which is a disease that causes low

Medical Causes of Obesity   

According to the National Institute of
Diabetes and Digestive Kidneys Disease, “more than 1 in 3 adults were
considered to have obesity” in 2014 (“Overweight and Obesity”). Obesity is a
disease that causes excessive fat to accumulate around the body. It is often
diagnosed when a person has a body mass index of 30 or more. The excessive fat
can lead to numerous other health problems such as cardiovascular diseases, diabetes,
cancers, and hypertension. Obesity is a problem that needs to be dealt with. The
number people that are affected and diagnosed are increasing at a rapid rate.  There are a lot of factors that come into play
and can cause the rate to increase. Many people believe that obesity primarily
occurs because of the increases in fast food restaurants, or the lack of
physical exercise a person gets. However, studies show that there are several genetic
and medical factors that can contribute to obesity.

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There are some diseases that can increase
the chances that a person will gain weight. Most of these disorders are
endocrine disorders. The endocrine system produces different hormones that help
to provide energy and create balance in the body. However, having a problem
with this system can cause obesity to occur. The most notable of these diseases
is hypothyroidism, which is a disease that causes low levels of the thyroid
hormones, triiodothyronine (T3) and thyroxine (T4), to be
released(“Hypothyroidism”).  These
hormones are usually released from the thyroid gland and deal with the body’s
metabolism. When there is a decrease in the levels of the hormones being
produced, the body’s metabolism is also decreased (“Hypothyroidism”). There are
several causes of hypothyroidism that can contribute to the decrease in
hormones being released. One of them is an autoimmune disease called Hashimitos
thyroiditis which causes the immune system to attack the thyroid gland. Other causes
include thyroid surgery, medications, radiation therapy and pituitary disorders
(“Hypothyroidism”). Signs and symptoms of the disease tend to develop slowly
which causes many people to not know they have the disease for a while. However,
the symptoms can be associated with the decreased in the metabolism which can
cause fatigue, sensitivity to cold, constipation, dry skin, pain in muscles and
joints, thinning of the hair, slowed heart rate, and depression (“Hypothyroidism”).

The decrease in the metabolism can also lead to weight gain because the body is
unable to use the energy of the food that is eaten. This cause most people that
have hypothyroidism to also have obesity. 

Abhyuday Verma et al. authors of
“Hypothyroidism and Obesity”, conducted a study to see the “frequency of
primary hypothyroidism in obese patients and frequency of obesity in primary
hypothyroidism patients” (1135). The authors found that out of their 625 obese
patients, 548 of them were diagnosed with hypothyroidism (Verma et al.). Most
of the patients that had thyroid dysfunction also had problems with their
weight and were obese. Having problems with the thyroid hormones can lead to
problems with the metabolism and can ultimately lead to a person to become

Like hypothyroidism, another disease that
causes extreme weight gain is Cushing syndrome. This is a disease that causes
people to have high levels of glucocorticoids, specifically the hormone cortisol,
in the blood. Cortisol is a hormone that is produced by the adrenal glands of a
person’s body, and it helps with a variety of functions such as regulating
blood pressure, helping the body deal with stress, and reducing inflammation (“Cushing
Syndrome”). This increase in the cortisol can cause glucose to constantly be in
the blood rather than be taken up by the cells in the body. Therefore, this
excess amount of glucose in the blood can lead to weight gain because it gets
stored as fat. The increase of cortisol can be caused by several factors. It
can be caused if a person is taking oral corticosteroids over a long period of
time. This makes the body susceptible to high doses of cortisol which can lead
to Cushing’s diseases.  Stressors, such
as emotional and physiological stress, pain and cold can all also lead to the
excess production of cortisol. In addition, this disease can be made in the
body, usually by tumors on the pituitary gland, adrenal gland, or other organs (“Cushing
Syndrome”). Some of the signs and symptoms of this disease include fatigue,
headaches, high blood pressure, muscle weakness, slow healing cuts, acne,
stretch marks on the abdomen, thin fragile skin, visible body, facial hair in
women, and decreased sexual function in men (“Cushing Syndrome”). The most notable
symptom of this disease is the weight gain that occurs in the person’s face,
back and abdomen. This weight gain is caused by the excess cortisol that is
released in the body that can cause the body to store more fat. Ozay Tirayakioglu et al., authors of the article
“Screening for Cushing’s Syndrome in Obese Patients”, conducted a study to see
how many people had Cushing’s Syndrome when the only symptom they had was
obesity. The researchers found that most of the people that had obesity also
had Cushing’s disease. There were 150 obese patients and out of them 14 people
had Cushing’s disease (Tirayakioglu et al.).  They said that if a patient that has simple
obesity they also needed to be evaluated for Cushing’s as it can indicate if
they have the disease (Tirayakioglu et al.).  Most of the people that have this disease
often display symptoms that can cause of obesity such as having excess fat
stored in the face and the abdomen and fat. The excess cortisol that is
released in the body leads to the increase in weight gain.

Just like these different diseases, there are also
some medications that contribute to obesity.  Medicines such as
antidepressants and antiepileptics can cause weight gain and lead to obesity.

Antidepressants are medications that are used to treat depression. There are
different types of these medications that are categorized based on the type of symptoms
that accompany them. Some of these types include selective serotine reuptake inhibitors,
serotonin and norepinephrine reuptake inhibitors, atypical antidepressants, and
monoamine oxidase inhibiters (“Antidepressants”).  There are some medications that can cause
weight loss; however, many drugs can cause weight gain in people. Alessandro
Serretti and Laura Mandelli, authors of “Antidepressant and Body Weight: A Comprehensive
Review and Meta- analysis” believe that there are some antidepressants can
cause weight gain. They said that some medications usually start off by
inducing weight loss, but then they stimulate weight gain. They also found that
some specific medications such as tricyclic antidepressants amitriptyline, mirtazapine,
and paroxetine are some of the medications that cause weight gain to occur overtime
(Serretti & Mandelli).  Most of the
people that take these medications often take them for long periods of time.

This long-term exposure to the antidepressant medications are what contributes
to the weight gain.

Like antidepressants, another type of
medication that is known to induce weight gain is antiepileptics. Antiepileptics
are medications that are taken to control seizure activity that happens in the
brain. Elinor Ben-Menachem author of
the article “Weight Issues for People with Epilepsy- A Review” showed that
there have been studies done that show that people with epilepsy tended to be
overweight. They were more likely to exercise less and be obese. In fact, a
study done in Germany with 136 patients found that the people with epilepsy had
participated less in physical activities and had a higher BMI (Ben- Menachem). They
believed that the weight gain in epilepsy is related to lifestyle factors and
antiepileptic drugs. Ben- Menachem also compiled a list of the well know
medications and the effects that they have on the weight of the patients. For
example, valpropate is one of the medications that they found that induced
weight gain. The author found that “patients receiving valproate increased
their weight by an average of 2.0 kg” (Ben- Menachem, 43). The patients that
were taking this medication were taking it for one year. Another medication that
they found was Gabapentin and more than 50% of the patients that were taking
this medication increased their body weight by 5% (Ben- Menachem). The patients
that took this medication also took it for one year. These are some of the
medications that are known to cause weight gain and taking them for a long time
can ultimately increase the likelihood that a person will get obesity. Often
when patients are told to take antiepileptics, they must take it for life to
control the seizure activity. The long exposure to the antiepileptics can
contribute to excessive weight gain.  

Likewise, genetics are another aspect
that plays a role is causing obesity. There are different genes in the body
that can contribute to obesity, and one of these hormones is called leptin.

Leptin is a hormone that is produced in the fat cells of the body, and it controls
weight (“Congenital”). This hormone signals the hypothalamus, located in the
brain, to make the person eat less and provides feelings of saiety. The hypothalamus controls hunger and thirst as
well as sleep, moods, and body temperature. It also regulates the release of
many hormones, like Leptin, that have different functions throughout the body. Leptin
is made by a gene called the
LEP gene (“Congenital”) Leptin
attaches to and activates a protein called the leptin receptor which is found
on the surface of many cells in the body. When leptin binds to the receptor it
causes a series of chemical signals that affect hunger and help provides
feelings of satiety (“Congenital”).

However, for some people this binding cannot
occur because they lack the hormone. This can cause Congenital Leptin Deficiency.

Signs and symptoms of this disease include, extreme hunger, weight gain and decrease
in the production of hormones dealing with sexual development (“Congenital”).  Since the leptin is not present to provide
feelings of satiety, many people with this disease often keep eating and tend
to gain a lot of weight.  Martin Wabitsch
et al., author of the article, “Biologically Inactive Leptin and Early- Onset
Extreme Obesity”, found that having this deficiency can cause early obesity.

They found that the mutated LEP gene does not bind to the leptin receptor and
does not reduce the food intake (Wabitsch et al,). Wabitsch et al, described a
patient (a child) in the article who was born to healthy parents and had a
normal birth weight. However, after birth, he started to gain an excessive
amount of weight, and when he was just 2 years old he weighed 33.7 kg and had a
body mass index of 39.6. They performed a test on him to see how much food he could
eat and saw that he was able to eat 680 kcal in one sitting (Wabitsch et al,).

This patient had a leptin defincey. The LEP protein in his body was able to be
secreted; however, it was not able to bind to the leptin receptor. This caused
the patients to be unable to tell when he was full which made him eat a lot. This
is the same problem that happens to all people that experience this deficiency.

The lack of the leptin hormone can cause obesity to occur.

Like congenital leptin deficiency,
another genetic disorder is Prader-Willi syndrome. This is a neurodevelopment
problem that affects, appetite, growth, metabolism and cognitive function and
behavior (“PWS Basic Facts”). It is caused by genetic imprinting (“Clinical
Review”). Usually people inherit two sets of genes, one from the mother and one
from the father. In genetic imprinting only one of these parent gene is
expressed while the other one is not. For this syndrome, the father gene is the
one expressed while the mother gene is not (“Clinical Review”). This disorder
usually affects the genes on chromosomes 15. The genes that are not expressed control
feelings of hunger and satiety. A person who has this disease and is missing
them will not be able to control how much they eat. They will find themselves unable
to be full and will continue to eat and eat. This can contribute to obesity at
such a young age. Some of the children may gain an
excessive amount of weight by the time they are adolescents (“PWS Basic Facts”). Most of the people affected by this
disease, show signs and symptoms of a short stature, small hands and feet, poor
sexual development, cognitive disabilities, feelings of being hungry and a slow
metabolism (“PWS Basic Facts”). They
also tend to have decreases in muscle tone and mass which is what contributes
to their low metabolic rate.  The feeding
pattern of the people with these disorders start around the age of 18 months
which can cause obesity to occur. However, with this disease many people don’t
notice the symptoms in children until the children get a little older. In an
article by Medscape, it describes a child that had a normal birth but was
eventually diagnosed with this disease (“Growth Hormone”).  The parents didn’t realize anything was wrong
with the child until he was four years old when they noticed a developmental
delay. When he was six years old, they noticed his uncontrollable appetite. In
addition, the son weighed 25 kg and was in the 90th percentile at
only six years old (“Growth Hormone”).  The
lack of the genes being expressed causes insatiable feelings of hunger which makes
Prader –Willi syndrome to cause to obesity.

There are medical and genetic factors that need
to be taken into consideration when talking about the cause of obesity.

Different diseases such as Hypothyroidism and Cushing’s Syndrome are disorders
that affect the hormones released in the body and can ultimately cause obesity
to occur. In the same way, some medications are known to contribute to obesity.

Antidepressants and antiepileptics that are taken over a long period were seen
to have a substantial impact on the weight of a person. In addition, genetics
plays a role in causing obesity as well. Genes such as Leptin, cause feelings
of fullness and not having this gene can cause obesity by making the person
unable to know when to stop eating. In the same way, Prader Willi syndrome is
caused by lack of genes that control hunger and saiety of a certain chromosome.

This can lead to a person to have obesity. With all these different causes, the
causes of obesity cannot be blamed on one thing. Often people think that
obesity is a disease that can be easily prevented if people continued to eat
right and exercised often. However sometimes there are some causes that are out
of control for people; it does not have anything to do with peoples’ lifestyle
factors. These causes need to be taken into consideration when dealing with
ways to combat obesity. 


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