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21 March 2012

New research shows that successful treatment for hyperthyroidism may be associated with a significant risk of becoming overweight or obese. These findings were presented at the Society for Endocrinology conference in Harrogate, UK. Medical professionals should be aware of this association and provide patients undergoing treatment for hyperthyroidism with appropriate advice on the risk of becoming overweight. Further research is required to determine if lifestyle management techniques are useful in the prevention of this excessive weight gain. Hyperthyroidism is a common endocrine condition where the thyroid gland becomes overactive and produces too much of the thyroid hormones, thyroxine (T4) and tri-iodothyronine (T3). This condition has a number of different causes including auto-immune disease and toxic thyroid nodules. It affects approximately two in 100 women and two in 1,000 men. If left untreated, it can cause serious health problems including heart failure and stroke. Dr Kristien Boelaert and team from the University of Birmingham, UK studied 1047 patients who had been diagnosed with hyperthyroidism to determine whether their weight changed after treatment and investigate any risk factors for this. They found that 69.4% (727) patients gained more than 5% of their presenting body mass over a median treatment duration of 22 months. 44.2% of patients who presented with a normal BMI became overweight or obese and 44.6% of patients who were overweight at presentation became obese. Patients were more likely to gain weight over the course of treatment if they had more severe hyperthyroidism (p<0.001), they reported weight loss prior to treatment (p<0.001) or their treatment took longer (p=0.001). Men were also at significantly higher risk of gaining weight during treatment (p=0.05). There was no effect of treatment type (antithyroid drugs versus radioactive iodine treatment) on the risk of gaining a minimum of 5% in body weight. This is the largest dataset investigated on the effects of hyperthyroidism treatment on weight. It is important that clinicians and nurses are aware that weight gain is a common side-effect of hyperthyroidism treatment and work with their patients prior to, during and following treatment to advise on potential lifestyle interventions to prevent excessive gain. Lead researcher Dr Kristien Boelaert from the University of Birmingham, said: “Our data confirm anecdotal reports and results from very small studies indicating weight gain after treatment for hyperthyroidism is common. However, our study also shows which patients are at higher risk of putting on weight, namely those with more severe hyperthyroidism, those reporting prior weight loss, men, and those whose treatment takes longer. “It is very important that patients do not put off receiving treatment for hyperthyroidism due to concerns about weight gain, as delaying treatment can have serious consequences. Healthcare professionals working with patients with hyperthyroidism should be aware of these findings and should provide patients with advice on measures to minimise weight gain. We now plan to examine whether a package of lifestyle interventions can be developed which limits excessive weight gain in these patients.”

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