After giving birth to her daughter in 2009, Allison Karavos happily lost 30 pounds of baby weight (plus another 10 she'd been trying to lose pre-pregnancy) by eating right, walking with the stroller, and breastfeeding. She was thrilled to say sayonara to the weight -- but about five months postpartum, she regained 15 pounds. She attributed it to slips in her eating and new-mommy exhaustion: "I thought it was because I was tired and craving carbs. I figured it was normal after having a baby."
However, when she began having vision problems, noticed that her voice sounded gravelly, and experienced joint pain and numbness in her hands, she went to her doctor, where she was given a blood test. It turned out that the weight gain and other symptoms were due to severe hypothyroidism. Karavos's thyroid gland, which regulates metabolism, was under-active. "There's an increased chance of a woman developing a hypothyroid condition during or right after pregnancy because of changes in the immune system," explains Pamela Peeke, M.D., author of Body for Life for Women. Untreated, hypothyroidism can lead to obesity, infertility, and heart disease.
After Karavos was put on a thyroid supplement to jump-start her thyroid and metabolism, her energy returned. "I noticed a difference almost right away. I wasn't in as much pain. My vision cleared up. I was sleeping better and within a week I could walk around the mall more easily," she says. Plus, being more active helped her lose weight. Today, she is expecting her second child and working with her doctor to maintain healthy thyroid levels during her pregnancy.
Like Karavos, many women attribute their mysterious weight gain or bloating to being a busy mom. But if you're doing all the right things (exercising regularly, eating right, and getting plenty of sleep) and still can't fit into your clothes, see your doctor to determine if a medical condition could be sabotaging your ability to stay slim. Read on for a rundown of some of the most common culprits.
Polycystic ovarian syndrome (PCOS) is a hormonal imbalance that can cause weight gain -- as well as ovarian cysts, excessive hair growth on the body, acne, and irregular or long periods. Many women are diagnosed when they have difficulty conceiving due to irregular ovulation.
The Treatment Although PCOS can't be cured, there are ways to treat the symptoms, says Nieca Goldberg, M.D., author of Dr. Nieca Goldberg's Complete Guide to Women's Health. This usually includes a diet and exercise regime to encourage weight loss, along with birth-control pills to regulate ovulation and shrink ovarian cysts. You may also be prescribed the diabetes drug Metformin to improve insulin sensitivity, which helps with weight loss, fertility, and cysts.
Sadness, fatigue, or changes in sleep can be signs of depression. So can ballooning weight -- even Kevin Federline told the world how his blues made him belly up to bad food choices. "Depression slows you down. You can sleep too long and be too down to go to the gym," Dr. Peeke says. Because levels of dopamine, a neurotransmitter that signals pleasure, and serotonin, a mood modulator, are lower in depressed people, it's natural to crave food to give you a boost, so you're likely to gain weight.
The Treatment Speak to your doctor about a possible combination of therapy, antidepressants, physical activity, proper nutrition, and building up your support system. Talking things out with a trained specialist may help you to understand the triggers for your problems -- and keep you from turning to food for comfort, says Dr. Peeke. Even inviting a friend to take a walk with you can help lift your spirits and shrink your waistline.
If you're gaining weight or having trouble buttoning your pants, and experiencing pelvic pain around the time of ovulation or during intercourse, schedule a checkup with your doctor. "Unusual bloating or abdominal distention that doesn't go away can be caused by an ovarian cyst, or in very rare cases, cancer," explains Donnica Moore, M.D., editor-in-chief of Women's Health for Life. Some cysts may be a side effect of taking fertility drugs like Clomid. Doctors can usually diagnose a cyst with a pelvic exam, but you may need further testing (an ultrasound, pregnancy test, MRI, CT scan, or laparoscopic removal) to determine what type you have. Ovarian cancer is rare in women under 40, but a suspicious mass would be investigated via biopsy and a blood test.
The Treatment Although a cyst can dissolve on its own, your doctor may prescribe birth-control pills to help shrink it. Those that are large, ruptured, or malignant may require surgery, which can involve removing the ovary or even having a hysterectomy. You may need other treatment if PCOS turns out to be the cause of multiple cysts.
Fibroids are benign growths that develop on or in the walls of the uterus; although their exact cause is unknown, there are several contributing factors, including a hormonal connection. While some cause no symptoms, others lead to bloating, pelvic pain, or heavy and long periods. "Uterine fibroids can grow to be the size of a grapefruit and actually make a woman look pregnant," says Dr. Goldberg. Bloating -- caused by the fibroid pushing the abdomen out -- is more likely than experiencing actual weight gain, which would only happen if a fibroid is very large (like a grapefruit). Your doctor can detect a fibroid in a pelvic exam, and an ultrasound will confirm the diagnosis.
The Treatment Most fibroids do not require care other than over-the-counter pain medication such as ibuprofen, or hormone therapy to treat heavy periods. Larger fibroids that cause severe symptoms or that might interfere with your ability to get pregnant are treated with surgery to remove them. Lasers and fibroid embolization (cutting off the blood supply to the fibroid) are less invasive but may make it more difficult to become pregnant.
If you have problems processing certain foods, like lactose or gluten, eating them can lead to significant bloating and discomfort. Take lactose intolerance, for instance: In this case, the gut can't handle milk or other products that have lactose, because you don't have enough lactase, the enzyme that breaks the protein down. As a result, it goes through your system unprocessed and causes an inflammatory reaction in your intestinal lining. This leads your bowel to become distended, resulting in bloat, Dr. Peeke explains. If you suffer from gluten intolerance -- also called celiac disease -- eating a slice of bread can trigger a similar reaction, including pain, gas, nausea, and even vomiting and diarrhea. Eventually, the decreased absorption of nutrients that occurs with celiac disease can actually lead to weight loss, although it has also been linked to obesity.
The Treatment Whatever problem you suspect, it's important to speak to your doctor before making any changes to your diet. She may instruct you to eliminate all possible foods that could be causing an adverse reaction, while keeping a diary of what you're eating. If, as you add selected foods back into your diet, you experience stomach distress, you've likely "caught" an offender. If gluten intolerance appears to be the issue, your doctor can diagnose it with a blood test and confirm it with a biopsy of the small intestine; lactose intolerance can be diagnosed with a blood or hydrogen breath test. Once a diagnosis has been made, adopting a diet free of your food foe should put a stop to your tummy troubles and make your belly deflate.
Originally published in the July 2011 issue of Parents magazine.
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