Weight Gain

MANUAL OF CLINICAL DIAGNOSIS

Weight gain is a condition characterised by an increase in total body mass, which can result from the accumulation of fat, muscle, fluids, or a combination of these factors. While weight gain can be physiological, such as during pregnancy, it can also be a sign of various pathological conditions. Identifying the underlying cause is crucial for providing appropriate treatment and preventing further complications.

Pathology	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Excess Caloric Intake	Weight gain, increased adipose tissue, abdominal circumference growth	Dietary history, physical examination	Dietary assessment, body mass index (BMI)
Medications	Weight gain, possible specific medication side effects	Medication history, physical examination	Review of medication history, dosage adjustment
Congestive Heart Failure	Weight gain, peripheral oedema, dyspnoea, orthopnoea	Medical history, physical examination	Echocardiogram, chest X-ray, BNP (B-type natriuretic peptide)
Hypothyroidism	Weight gain, fatigue, dry skin, cold intolerance, bradycardia	Medical history, physical examination, hypothyroid symptoms	Thyroid function tests (TSH, free T4)
Premenstrual Fluid Retention	Cyclical weight gain, oedema, mastalgia, premenstrual symptoms	Medical history, menstrual diary	Clinical evaluation, exclusion of other causes
Polycystic Ovary Syndrome (PCOS)	Weight gain, menstrual irregularities, hirsutism, acne	Medical history, physical examination, PCOS symptoms	Pelvic ultrasound, hormonal levels (testosterone, LH, FSH)
Pregnancy	Weight gain, amenorrhoea, morning sickness, breast tenderness	Medical history, physical examination, pregnancy symptoms	Pregnancy test, obstetric ultrasound
Liver Cirrhosis with Ascites	Weight gain, oedema, abdominal distension, jaundice	Medical history of liver disease, physical examination	Liver function tests, abdominal ultrasound, paracentesis
Nephrotic Syndrome	Weight gain, generalised oedema, proteinuria, hypoalbuminemia	Medical history, physical examination, nephrosis symptoms	Urinalysis, albumin levels, renal biopsy
Cushing’s Syndrome	Weight gain, central fat distribution, moon face, hypertension, striae	Medical history, physical examination, hypercortisolism symptoms	Salivary/24-hour cortisol levels, dexamethasone suppression test, CT/MRI of adrenal/pituitary glands
Other Causes	Symptoms vary according to underlying pathology	Medical history, physical examination	Specific tests according to clinical suspicion