Eating too Much, Exercise too Little
Hormonal Weight Gain
Genetic and Familial Weight Gain
Psychological Reasons for Weight Gain
Muscle bulk
Giving up smoking
Chronic Fatigue Syndrome and Myalgic Encephalomyelitis (ME)
Prescription drugs
Alcohol
Old age

So far there is no perfect universal weight loss plan that works for everybody. Really, this is not surprising, as we are not all the same and so it is logical that factors such as genes, gender, metabolism, constitution and state of health and fitness should all influence how we process and store the energy we get from our food.

Having carefully observed why people put on weight and why some can and some cannot lose it, it has been noted a number of important facts.

1. Many people who have successfully followed a diet programme then get bored by the restrictive regime, or go on holiday and forget all about watching what they eat, and the weight all goes back on again. Most diets give you a plan to lose weight but not a plan to maintain it.
2. A quite different problem faces those for whom diets have had very little effect. However little they eat, and however many different regimes they try, nothing seems to work, which makes them very frustrated and often depressed.
3. Some people who have never had a weight problem wake up to the fact one day that, although their diet and energy levels do not seem to have changed, they keep getting heavier.
4. In contrast to this, there are those for whom the opposite is true: their life undergoes a specific change - it may be giving up smoking or undergoing some traumatic event in their lives - and their weight shoots up.

Based on these and other observations and experience over the past twenty years, weight gain can be categorized into four principal causes. To lose weight on a permanent basis, you need to understand the underlying cause for your excess weight. If you have a hormonal problem then half-starving yourself will not be the answer, and if you come from generations of podgy people you may need a different approach from someone who is comfort eating to stave off emotional problems.

Eating too Much, Exercise too Little

By far the most common cause of putting on too much weight is simply eating too much, or the wrong foods, and exercising too little. For most people, balancing what they eat and the amount of exercise they do can determine their weight. If you fall into this category you can lose weight by cutting down on what you eat, or cutting out certain foods, or exercising more. Carbohydrates and especially fats are the main source of energy in our diet: if we do not draw on this energy that our food has provided (due to a sedentary lifestyle), then storing it as fat deposits is the body's only solution.

With exercise, the demand for energy increases and the stores of fat are broken down. If you also increase the amount you eat, though, the balance will remain the same and you will not lose weight, only avoid gaining it.

There are several diets that are effective for this type of weight gain, because any regime that puts restrictions on your food intake will cause you to lose weight. In fact, the weight loss is often due to a simple change in what you eat, rather than the amount. The problem with most diets that treat this kind of weight gain is that they are not complete changes in eating habits and do not provide a workable plan for maintaining your new lower weight once you have achieved it. Cutting down on, say, sugar or fat or alcohol and doing some exercise has a beneficial effect, but once you stop and slip back into your old ways, the weight alt starts piling on again.

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Hormonal Weight Gain

The fat that commonly builds up from dietary excess or lack of exercise is called yellow fat, and it is usually deposited over the entire body But there is another type of fat, white fat. White fat, commonly called cellulite, is accumulated as a result of hormonal changes and is found in concentrations below the navel, on the buttocks, thighs and arms, and across the breast region (in both men and women). Some hormonal imbalances, such as Cushing's syndrome, or long-term use of artificial steroids, cause fat to relocate from elsewhere on the body to the cheeks and jawline - hence the term 'moon face'.

Many of our vital functions are controlled by hormones, the levels of which are carefully balanced by the pituitary-hypothalamic area of our brain. If this gets the wrong stimuli, or is malfunctioning, the hormonal balance can be easily upset, resulting in a whole range of symptoms, from cellulite deposits and fluid retention to an unregulated appetite centre.

Many women who have never had to think about their weight find that they put on weight in their late forties or as they approach the menopause. As this weight gain is primarily hormonal, it can be very difficult to shed.

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Genetic and Familial Weight Gain

Sometimes obesity runs in the family. An entire family can be fat not only because they eat the same way but also because it is in the genes. There is a particular gene (popularly referred to as the obesity gene, or ob-gene) that affects leptin, a protein produced in fat tissue. Leptin regulates how we deposit fat, so its control naturally affects our fat levels.

When scientists discovered the 'obesity gene' many thought that this was an open passport to eat and drink as they liked because they could not do anything about a genetic condition. That is not entirely true. A genetic propensity towards obesity does not, I'm afraid to say, take the responsibility out of your hands and the discovery of the obesity gene does not mean you have to be fatalistic. It is just that you have to do more and not less to control your weight.

Genes also determine our underlying body shape and weight. If both your parents are short and broad you are unlikely to be tall and willowy (even if, with an optimum diet, you may be taller than your parents). Basic body shapes run in families, just like hair and skin colour.

Weight can also be a problem that runs in the family without being strictly genetic in origin. The eating habits we learn as children become deeply ingrained, and can be passed on from one generation to another as familial, rather than truly genetic traits. Some families simply love eating. And if they share a love of food that is rich in fats and sugar, then they share the resultant weight problem too. These may be exacerbated by common habits such as spending long hours slumped in front of the TV or avoiding sport at school.

If you have a genetic disposition towards obesity, it's important not to think: I'm fat because of my genes; there's nothing I can do about it. The aim is not to emulate a very slim model or a world-class athlete, but to be a healthy weight for your height, build, sex and age - and this is certainly achievable.

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Psychological Reasons for Weight Gain

Food can be eaten for many reasons other than as fuel for the body or for pleasure. It can be a great comforter, and eating in search of an emotional uplift or for a 'sugar rush' is something that most of us indulge in from time to time, but for some people it becomes a long-term problem. Many people under stress find they eat more at these times.

Normally, the appetite centre in the hypothalamus stimulates and suppresses appetite as it identifies low and high levels of glucose in the blood. But psychological problems can overrule these messages (which also block the hunger pangs in anorexics).

1. In the case of obsessive compulsive eating, all control of eating habits is lost. The appetite centre fails to stop the entire ritual attached to eating (looking at food, hand movements, chewing, swallowing), so that a sufferer can eat dozens of ice creams, empty out packs of cookies, devour a whole block of cheese within minutes, without any check from the appetite centre. The mind goes into a state where eating brings neither comfort nor satisfaction. In times of stress or anxiety, the desire to eat something is uncontrollable, however full the stomach. This ritualistic eating pattern is the same as other obsessive compulsive behavioural patterns such as constant hand-washing or pulling out hair, where the action itself provides some sort of relief. A huge increase in weight is inevitable. Since the hypothalamus is involved, its other functions are also likely to get out of kilter, resulting in increased fluid retention and hormonal problems, leading to yet more weight gain.
2. Binge-eating is a milder form of obsessive compulsive disorder, and also has psychological causes. As soon as bulimics feel stressed, they try to divert the mind by eating; the taste of food and the process of eating is calming and helps to overcome the stress temporarily. Of course, it does nothing to resolve the actual cause of the stress, and if this persists then bingeing can recur several times a day. Bulimia is a more severe form of this, in which sufferers force themselves to vomit after a bingeing session.

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Other Contributors to Weight Gain

There are a number of other factors than can contribute to weight gain, such as:

1. Muscle bulk: Gram for gram, muscles weigh more than fat, so heavy exercise can cause your weight to increase because of the build-up of muscle bulk. Body builders and sumo wrestlers are huge in size but their weight is in their muscles. In following a vigorous weight loss programme that combines diet and exercise, initial weight loss can be rapid as it is from fluids and reduction of fat, but then it disappointingly slows down as muscles build up. This needs to be taken into account when comparing or recording weights, and is another illustration of how individual we are.
2. Giving up smoking: Putting on weight is a major concern for people who give up or intend to give up smoking. Why are the two connected? Smoking's 'feel-good' factor comes in part because nicotine dilates the blood vessels and allows more blood to flow through. As the appetite centre in the hypothalamus is well supplied with blood, and therefore with glucose, smoking can keep the appetite suppressed. After giving up smoking, the opposite happens and the appetite centre sends out messages of increased appetite and in particular a craving for sweet things. The metallic taste in the mouth after giving up smoking also increases the demand for something sweet. To the many young teenage girls who take up smoking in order to stay slim, nicotine's appetite-dampening properties may seem a great idea, but they are just building up problems for the future.
3. Chronic Fatigue Syndrome and Myalgic Encephalomyelitis (ME): CFS, often flippantly and misleadingly called 'yuppie flu', is frequently labeled as a psychological problem. In my opinion, CFS is a multifactorial condition, to which a viral infection, poor supply of glucose and oxygen to the brain and yeast or fungal overgrowth in the gut, can all contribute. (Epstein Barr virus triggers CFS in up to 30 per cent of cases and sufferers can continue to be affected for years from its debilitating drain on energy even though viral activity is negligible. This is the severest form of CFS, and is called myalgic encephalomyelitis or ME.) CFS often leads to a marked weight gain because it combines a craving for sugar with such low energy levels that exercise becomes impossible.
4. Prescription drugs: HRT drugs and steroids such as cortisone are well known for causing a rise in weight, but other drugs such as antibiotics and antidepressants can also cause weight gain.
5. Alcohol: Alcohol contributes to weight increase in several ways. Just like an alcohol-based cleaner soaks up grease, alcohol helps fat to be absorbed effectively. Alcohol, especially white wine or champagne, before a meal enhances your appetite. It is also highly calorific and quickly absorbed, so more of the food eaten with or after the alcohol is perceived by the body as surplus to its energy requirements and so is stored as fat,
6. Old age: As we age we tend to graduate more towards our natural body type. While some people find they become positively skinny in old age, for many fat seems part and parcel of the ageing process. This does not have to be so. Being overweight 'just because you are old' is often unnecessary and is due to the failure to recognize that our diet needs to adapt to our ageing bodies.

Continuing to eat three full meals a day, even when your mobility is restricted, or having a diet far too concentrated on bread, butter, cheese, salt, sweets and puddings will usually account for the increase in weight. Pre-packaged, ready-to-eat meals may seem like a great convenience, but they also exacerbate indigestion, constipation, bloating and gas. Additional weight puts strain on the joints (think of all those hip and knee replacements) as well as the heart. In countries where ancient traditions are followed, such as Japan, elderly people generally eat less. They know very well that their digestive power is weaker and that eating late or at night is not good, so they develop a habit of eating some breakfast, a normal lunch and only a very light dinner. In India elderly people eat fruit or rice puddings or drink milk for dinner - never a full meal.

Even from these brief descriptions we expect you recognize some familiar scenarios; quite probably you feel you are a mixture of more than one category.

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