It can be difficult to identify source of slow weight gain | News, Sports, Jobs

DEAR DOCTOR. ROACH: My daughter is about 5 feet 4 inches tall and weighs 230 pounds. It has slowly increased over the past few years. She is disabled but has been watching her diet and working with a personal trainer to build strength. She takes several medications, including Abilify and Sertraline. Your doctor did several tests (thyroid, etc) and they all came back normal. Nobody can explain the weight gain. She can lose 5 pounds but then gain 10. Her legs are so big that she has difficulty walking. Your cerebral palsy disability is of no help. Are we missing something? She is 41 years old and I’m afraid it will only get worse as she gets older. – SB

ANSWER: It may be impossible to find the underlying cause of the weight gain. It sounds like your daughter is trying very hard with her diet and exercise. Among their medications, both aripiprazole (Abilify) and sertraline (Zoloft) are less likely to cause weight gain than others in their class, but may still cause weight gain in some people. Many doctors use a drug such as metformin to try to reverse drug-related weight gain when those drugs really cannot be stopped or replaced.

I would definitely recommend you to discuss this with your GP. There are some newer drugs that also help weight loss, such as semaglutide, whose data show greater effectiveness than previous drugs and (still) few side effects.

DEAR DOCTOR. ROACH: My granddaughter refuses to let us see or collect her 4 1/2 month old baby because we may be shedding the virus through vaccination against COVID-19. Could you please shed some light on this? We don’t understand what that means. In the meantime, we miss the baby’s progress, and we miss it terribly. – LM

REPLY: “Discard” after vaccination refers to people who are contagious even though they have no symptoms. Elimination is only possible after vaccination with a live vaccine. Even then, it is very, very rare for a person to develop complications after exposure to a recently vaccinated person.

For example, the MMR (measles, mumps, and rubella) vaccine is a live vaccine, but no case has ever been published of a person becoming ill after exposure to the current version of the vaccine. However, live polio vaccines (not used in North America for decades) had the potential to shed and cause disease as well. It was replaced with a killed vaccine.

The smallpox vaccine can be very dangerous for a person with severe eczema, and recently a case was published about a young family member of a soldier who became quite ill after contact with the soldier within a few days of being vaccinated. The live vaccine against chickenpox (but not the new Shingrix vaccine against shingles) has the possibility of shedding live viruses, but is very low-risk for contacts. Rotavirus vaccination can spread to household contacts if their immune systems are very weak and there have been some reports of diarrhea. Rotavirus and chickenpox vaccine are still recommended to give contact to people who have been severely vaccinated, but caution should be exercised.

Vaccines made from killed viruses, vaccines made from purified proteins from bacteria or viruses, vaccines that use a viral vector (such as the Astra-Zeneca and Janssen / Johnson & Johnson vaccines), and those that use mRNA (such as Pfizer and Moderna COVID-19 Vaccines) cannot excrete live viruses. There is no risk to your granddaughter or child.

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