128: Weekend Weight Gain: What Really Happened?

A big weekend can make the scale jump, but that number rarely means you gained pounds of fat overnight. We break down why short term weight fluctuation happens and how to respond without panic or risky “fixes.” 

• Scale weight reflecting water, fat, muscle, and digestive contents 
• Why fast changes cannot be reverse engineered from one weigh in 
• Sodium and fluid retention driving “water weight” 
• Carbohydrates, glycogen storage, and the water that comes with it 
• Hard workouts causing temporary water retention during muscle recovery 
• Food timing, larger meals, and constipation affecting the number 
• Menstrual cycle related fluid shifts and recurring patterns 
• Weigh in consistency: same time, same scale, similar conditions 
• Focusing on trends over time instead of one reading 
• Returning to normal meals and routine instead of “compensating” 
• Avoiding laxatives, deliberate dehydration, excessive water intake, or changing meds to force a lower number 
• When to seek medical attention for swelling, shortness of breath, or chest pain 
• Heart failure weigh in rules being different and following your care team’s thresholds 

You could find us on Instagram. You can send us an email, your checkup pod at gmail.com. 

Transcript

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Welcome To Your Checkup

SPEAKER_00 0:03

Hi, welcome to your checkup. We are the patient education podcast where we bring conversations from the doctor's office to your ears. On this podcast, we try to bring medicine closer to its patients. I'm at Delesky, a family medicine doctor and obesity medicine specialist in the Philadelphia area.

SPEAKER_01 0:20

And I'm Nicola Rufo. I'm a nurse.

SPEAKER_00 0:22

And we are so excited you were able to join us here again today. So what are we going to talk about today, Nick?

Why The Scale Jumps Fast

SPEAKER_01 0:29

Today we're talking about why you might gain weight after a fun weekend.

SPEAKER_00 0:34

Yeah, so it's easy to look at that and think, like when you step on the scale on a Monday morning and maybe you gained like a couple pounds after weighing a certain weight on Friday. Like if you go on a bachelor party with your friends at the Poconos and you come back and you weigh nine pounds heavier than you did when you came back. And it's easy to look at that and think, well, what did I do? Especially if you've been working on your health and you feel like a couple of days undid your progress.

SPEAKER_01 1:00

But that number is not telling you that you gained three pounds of fat because that physically could not happen in two days. Um, so it includes water, muscle, body fat, and what's in your digestive system.

SPEAKER_00 1:14

The poop.

SPEAKER_01 1:15

Gotta gotta come account for the intake and output here. All of those things can change over a weekend, and we need some more information before we decide what the increase means.

SPEAKER_00 1:29

Yeah, and so that means that works in both directions, actually. A quick drop doesn't necessarily mean that you lost that much fat either. Sorry. And that might be a fun thing to think about. You can't work backward from one reading and figure out exactly what happened at dinner to lead to this change.

SPEAKER_01 1:48

The questions I would start with are how quickly did it change? Were the measurements taken under similar conditions? And are there any new symptoms? These details matter more than guessing just which singular meal caused it.

SPEAKER_00 2:02

Yeah, and like this, your body changes so frequently throughout the day that measuring at the same time can be really important. So like me, I try to measure my body weight with we have a compet body composition scale. Thank you, Nikki. And I try to measure it in the morning before like after I wake up, but after I pee to be graphic. Um, anyway, so there's one distinction up

When To Follow Medical Weigh-Ins

SPEAKER_00 2:26

front. If you track your weight for heart failure or another medical condition, you should follow your care team's instructions and kind of throw out whatever we're saying here today.

SPEAKER_01 2:37

Yeah.

SPEAKER_00 2:38

We'll come back to that, but we're gonna look at some more common reasons for a short-term change. So we're gonna start the conversation around salt, carbohydrates,

Salt Carbs And Water Retention

SPEAKER_00 2:49

and some water. Nikki, why don't you dive in there?

SPEAKER_01 2:52

Sodium is the first one. So the saltier the meal, your body will hold on to all that water. The salt sucks the water temporarily. Water does have weight. A lot of the weight fluctuation is probably like what people call quote unquote water weight. So if you've eaten differently over the weekend, fluid retention can be a part of the change. And just like a scale.

SPEAKER_00 3:16

Yeah.

SPEAKER_01 3:16

That's just like a regular scale, not a body composition scale, um, can't separate the water from everything else that it's measuring.

SPEAKER_00 3:23

Yeah, I think that's a really poignant piece. Um, you can even like eat a bag of chips and like you feel like your fingers can swell. And now, like wearing a ring all the time. Like I'm like, oh, I can like I can't get this thing off. Not that I'm ever trying to people, but why does it need to be off? But it like you notice it like doesn't move around as much. And you can kind of tell. I think you know, you you had that experience before I did with the engagement ring, or like women, this no shade to men. I would think on average, women wear more rings than men. Um, you can come at me if if you think otherwise. But uh I you know you were you were always like, Oh my god, I was so I'm so bloated, I'm so swollen.

SPEAKER_01 4:03

Yeah, we had sushi last night. I can't take my ring off.

SPEAKER_00 4:06

My head's on fire and I can't take my rings off and sushi, but it was so good. So the other can be carbohydrate storage, and that's another piece of this. So your body stores some carbohydrate as this molecule called glycogen, and it lives in your liver and muscles along with water. So if you've been eating fewer carbs and then eat more, replenishing those stores can increase your weight without that increase being entirely body fat. Glycogen is this molecule that like is quickly used for energy expenditure. So you're gonna sprint a little bit. And there are certain phases of energy usage. We're not diving into that today, but if you didn't know what glycogen is, that's basically what it is. So exercise can complicate the picture too. After a new or harder workout, muscles can temporarily temporarily, excuse me, retain water as they recover. So glycogen storage can also change, and then the muscles themselves are holding on to more water in their building and recovery process. So doing something helpful for your health can be followed by a higher weight. So that's also another reason that people can have this weight gain in a short period of time.

SPEAKER_01 5:27

And we shouldn't jump jump to the complete opposite explanation where maybe you had a hard workout, you're up three pounds. That's not up three pounds of a new muscle growth. It just doesn't work like that. Um so you can temporarily notice a little bump in bump in the scale, maybe after a hard workout.

SPEAKER_00 5:48

Yeah. Um, so we also can't tell someone it's definitely all water, and it'll be gone by Wednesday. All of these things that we've talked about are possible contributors, certainly not a diagnosis or a timetable.

SPEAKER_01 6:01

And the uncertainty is okay. You really don't have to identify exactly where every pound come from came from to avoid over overreacting to one measurement. Um, I mean, your weight will even fluctuate like throughout the day if you wear yourself in the morning versus the afternoon. But if the change continues or you're feeling unwell, that deserves another look.

SPEAKER_00 6:24

So then we're gonna talk a little bit more about digestion and some timing and other useful comparisons.

Digestion Constipation And Period Weight

SPEAKER_00 6:29

So food and drink also have weight while they're passing through the body. We kind of alluded to that before. A larger meal or a later meal or constipation, thank you very much, can change what's on the scale. So it it's not measuring only what your body has stored in fat.

SPEAKER_01 6:50

And menstrual cycle changes. That's another fun one that can affect fluid retention. Why are you looking at me like that? I don't know. What, because you tell me this every month. Yeah. Most recently, like yesterday. Um, you'll probably notice a recurring pattern. It doesn't mean we explain why every change, but it's another reason not to assume it all comes down to what you eat. And you might just wake up one day and have your period and be five to seven pounds heavier. And in a couple days it'll go back to normal.

SPEAKER_00 7:21

And it's the rudest thing. And so, like, let me go back to are we comparing measurements taken under similar conditions? Like a Friday morning weight and a Saturday night weight after dinner are not a clean comparison. So you're just gonna not like yourself if you do that. So don't do that. We don't do advice here, but like be nice to yourself. Don't eat, don't weigh yourself after you go to the Chinese buffet. I just or eat a giant sandwich.

SPEAKER_01 7:48

Um, so like we've kind of said before, if weighing is part of your plan for whatever you're doing, keep the setup consistent. So always on the same scale, on a firm level surface, um, with similar clothing or just like no clothing to be the most accurate in the nude, um, in the first thing in the morning, pee, weigh yourself after you pee, before you eat or drink anything.

How To Weigh More Consistently

SPEAKER_01 8:18

And that's the most practical way to do it.

SPEAKER_00 8:21

Yeah. And then for people who are like undergoing weight management, it's a pattern over time that usually tells us more than one isolated result. And that doesn't mean that everyone needs daily weigh-ins. I think it's like a way bigger conversation. Um, how often you should check in with that is a very personal decision. And then if you're working with someone like in a healthcare setting on this, like you could talk to them about it as well. But we do know that measuring more frequently than not is potentially not so harmful to people and helps prevent weight regain. That's an evidence-based thing. So let's take the scenario that like someone woke up, they step on the scale, and their weight is up from what they were hoping for and what they expected.

A Calm Monday Morning Plan

SPEAKER_00 9:04

Like, how would you what's the approach or thought process?

SPEAKER_01 9:07

So for someone who, you know, otherwise feels well and you have no other medical instruction to act on a weight change, start with the next normal meal. So breakfast, just eat a normal breakfast, keep your routine the same, um, skipping a meal or like running yourself into the ground at the gym to work out to compensate for the weekend isn't going to do anything.

SPEAKER_00 9:33

Right.

SPEAKER_01 9:34

Like it'll all level out. Just go back to being normal.

SPEAKER_00 9:38

Yeah. Totally. And like then, some people do take this a step further that um we would uh suggest not doing, like trying to force a lower number with laxatives so you poop more or deliberate dehydration, or on the other side, excessive water intake isn't necessarily a safe response to this. And so a rapid change on the scale is not the same thing as an improvement or a negative in your health.

SPEAKER_01 10:07

Um, and similar to like the medication aspect of it, if you're prescribed any sort of fluid or medication plan, just keep doing what you've been doing, unless you've been told otherwise, of course, but don't like increase a water pill dose to try to get that number down.

unknown 10:26

Yeah.

SPEAKER_00 10:27

Unless your doctor tells you. Unless they tell you to do it and they told you what plan, but like otherwise, just do what you're told. And if the increase keeps showing up, then maybe it's reasonable to review the pattern, especially if it's unexplained. And like you can bring that to your whoever's taking care of you in healthcare.

SPEAKER_01 10:42

Maybe you need an obesity certified doctor.

SPEAKER_00 10:46

Maybe not for the Monday morning thing, though. That's what we're trying to debunk here. It can happen, it'll all level out at the end of the day.

Red Flags And Heart Failure Rules

SPEAKER_00 10:53

Okay, so let's go over like when this change needs medical attention next.

SPEAKER_01 10:58

Yeah, so if we're having new swelling or shortness of breath, that really changes the conversation. And you should be getting medical advice sooner rather than later, or assuming that it's just like a normal swelling. Because honestly, like your like limbs shouldn't be swelling after just like a normal weekend of like your legs and ankles and like stuff like that.

SPEAKER_00 11:26

That's abnormal.

SPEAKER_01 11:28

Yeah.

SPEAKER_00 11:28

Yeah. Not normal.

SPEAKER_01 11:30

Not normal. Abnormal. Um, but yeah, if you're having like sudden severe breathing difficulty or chest pain, shortness of breath.

SPEAKER_00 11:40

Don't call your PCP.

SPEAKER_01 11:41

Don't call your PCP because they won't be able to see you for three weeks at the earliest. Just like go to the closest emergency room.

SPEAKER_00 11:48

So for you know, this is a good example to talk about is heart failure here. Um people are often told to weigh themselves daily to detect fluid buildup. And so a guidance commonly flags gains of more than two or three pounds in a day or more than five pounds in a week. And so your own care team should set the threshold of what to take, but like this situation inherently is different for people with different health conditions.

SPEAKER_01 12:14

So if your plan says to call into the doctor, you should still call, even if you think one visit to Tom's dim sum could explain this away.

SPEAKER_00 12:25

Shut up.

SPEAKER_01 12:26

So don't wait for like, you know, the week's average or just for your symptoms to progressively get worse. Just do what you're told, even if there's a possible explanation. And maybe your doctor will tell you that. But some things you don't mess with. Oh, our most loyal listeners calling.

SPEAKER_00 12:43

Oh wow.

SPEAKER_01 12:44

Is it your turn?

SPEAKER_00 12:45

Yeah. And so persistent unexplained weight changes are also worth discussing, even if you feel okay. Because if it's worrying you, then it's worthwhile talking about it. So this episode is meant to help you understand fluctuations, but it can't tell you the cause of the individual change. So the big takeaway is three pounds over the weekend, there's probably a lot of context to it. And it could be anything that we discussed here. It could be some water, it could be stored carbohydrates if you didn't know that glycogen is doing this. It could be digestion, it could be your muscles actually getting a little bit bigger and recovering because you had a great workout. And so we would suggest that you look at the pattern before you draw any conclusions about body fat or anything that you're trying to work on in your health. And if this really is bothering you, just try to get back to your normal routine and see what shapes up. And if you can head back to where things are at your baseline. And if you've talked about this with your own doctor for like important medical reasons, stick to that plan overall.

Godfather Banter And Sign Off

SPEAKER_00 13:46

We're gonna give you, um, we're gonna banterize for just a quick second here so we can have a complete episode ready for you guys. I do have to say that this was the first week that I watched, it's the first time I watched The Godfather.

SPEAKER_01 14:00

Oh yeah. Oh my god.

SPEAKER_00 14:02

And I gotta say, like we watch a lot of TV.

SPEAKER_01 14:04

Closer to your people now.

SPEAKER_00 14:06

I feel so much closer to my Italian people. I I hope that I can be the consigliere.

SPEAKER_01 14:12

Oh my god.

SPEAKER_00 14:12

And there's so much to say.

SPEAKER_01 14:14

I think you are.

SPEAKER_00 14:15

I think I might be the consigliere. He consigliere. Um, I you if you guys are listening to this, I've I've definitely had patients come back and they've like been shocked when they learn a thing about me. They're like, oh my god, I listened to your podcast. You're a Mets fan, with disgust in their face. Or, oh my god, it took me way too long to realize that your intern is your dog. Um, or or now they're gonna be like, and I can't wait until how long it's gonna take when they're like, oh my god, it took you 30 years to watch The Godfather. Amazing movie. I Spielberg did great, and I just I was glued. It took two nights to watch.

SPEAKER_01 14:52

Okay, well it's like over three hours, right?

SPEAKER_00 14:53

Over three hours. I bought it to rent, I rented it, I paid money to rent it, is what I meant to say. And just the whole character arc of Michael Corleone, and it's the done. Like there are so many things that make sense to me now. And like in the morning when I put my hair back and like I'm like doing my hair, if I slick it back just a little bit too vertically, just so it's just back, I feel like vito.

unknown 15:18

Oh my god.

SPEAKER_00 15:18

I feel like vito corleone. Is it Corleone or Corleone? Like the Americanized is Corle like Corleone and then Italian Corleone.

SPEAKER_01 15:28

I don't know.

SPEAKER_00 15:30

We gotta find out. Yeah, we have to start, we have to search far and wide. Um God, great movie. And there's two other ones, too. Now there's Godfather part two.

SPEAKER_01 15:40

I didn't know there was a third one, and three. I only ever saw the the OG.

SPEAKER_00 15:44

Really? You haven't seen the two?

SPEAKER_01 15:45

Mm-hmm.

SPEAKER_00 15:46

We might be watching we might be watching two.

SPEAKER_01 15:48

We might be.

SPEAKER_00 15:48

I cut up as a family and watch The Godfather. You come to me. Like I now I finally saw the teen, the scene. You've come to me on the day of my daughter's wedding. And I might be talking like this the whole week after.

SPEAKER_01 16:00

He's been talking about or talking like this all week.

SPEAKER_00 16:02

I'm fascinated. I I'm fascinated with the the plot, the development, the cinema itself, the filming, the music, the solo trumpet. So many jokes have been made on TV shows about that, and I'm like, oh, finally, I'm like, I'm part of the culture and they're probably like, oh my god, this guy's a noob, he hasn't seen The Godfather. But like I just haven't so good. I did have to look up like names and pictures of people afterwards because they assume that you're like smart and that you follow the names, and they're like, listen to this Italian name who's a part of the five families, and this Italian name, and you saw them for one scene, but they're important because they get whacked later. My gosh. If you haven't seen The Godfather, make sure there are no children around, but you might consider watching the good. All right, we got a big weekend ahead of us. We're actually like heading there imminently. So we are going to sign off here. Um, do you have any thoughts? Any banterized thoughts that you want to share with our loyal listeners?

SPEAKER_01 17:08

I don't think so.

SPEAKER_00 17:10

We did receive some fan mail, it's explicit, and I we can't share it.

SPEAKER_01 17:14

Yeah, it was so good.

SPEAKER_00 17:15

And there's more, maybe we can listen on the way down. But I appreciate that we did receive some fan mail from our our brothers.

SPEAKER_01 17:21

Yeah, our brothers. Listen to it at 6 a.m.

SPEAKER_00 17:24

It will only be for our ears. Um, so thank you for coming back to another

Medical Disclaimer And Final Note

SPEAKER_00 17:30

episode of Your Checkup. Hopefully, you were able to learn something for yourself, a loved one, or a neighbor who's gained three pounds over the weekend. You could find us on Instagram. Uh, you can send us an email, your checkup pod at gmail.com. Um, but most importantly, stay healthy, my friends. Until next time, I'm Ed Deleski. I'm Nicola Rufo. Thank you. Goodbye.

SPEAKER_01 17:50

Bye.

SPEAKER_00 17:54

This information may provide a brief overview of diagnosis, treatment, and medications. It's not exhaustive and is a tool to help you understand potential options about your health. It doesn't cover all details about conditions, treatments, or medications for a specific person. This is not medical advice or an attempt to substitute medical advice. You should contact a healthcare provider for personalized guidance based on your unique circumstances. We explicitly disclaim any liability relating to the information given or its use. This content doesn't endorse any treatments or medications for a specific patient. Always talk to your healthcare provider for a complete information tailored to you. In short, I'm not your doctor. I am not your nurse. And make sure you go get your own checkup with your own personal doctor.