I found this conversation too general. It did not say much besides the usual formulaic stuff about eating moderately and exercising regularly. Common sense really. What may be useful would be to pick up a theme around which the interview could be structured - say thyroid deficiency and the symptoms and how these would have to be addressed differently from just obesity and weight gain. Or say someone with a lower back problem who is also overweight. Again some sense of what notions of right weight are would be useful - someone is 49 kgs and is complaining about weight gain!! Frankly, I was a little disappointed.
It is an exaggeration to think that weight gain could be due to thyroid problem. To be specific, it is Hypothyroidism, that is, subnormal functioning of the thyroid gland. In my 27 yrs experience, these patients form about 1-2 percent of all obesity patients. There are specific problems like dryness of skin, lethargy, constipation, lack of appetite, facial puffiness, abnormal wt gain, sleepiness, frequent & excess periods, excessive hair fall, forgetfulness & sometimes abnormal behavior. In extreme cases, there is extreme slowness of the heart & the patient may be brought in a comatose condition.
Besides, there is an entity called Subclinical Hypothyroidism that causes a lot of confusion for several months or even years. Patience of the part of the patient & the doctor will solve this issue. One should remember that the weight gain that is due to Hypothyroidism will subside after treatment & NOT those due to other causes like obesity, renal & other endocrine disorders. There is no use of repeating T3, T4 and TSH in all the cases repeatedly as done by some doctors. Periodic estimation of TSH is sufficient in most of the cases. Eltroxin is taken as a single dose on empty stomach.
If we dont consider hypothalamous response while weight reduction and also glycogen leven depletion creates false hunger,also known as hormonal hunger ,we can never reduce the weight.
