My dear, Thank you for visiting me here at HCM. You want to know what causes weight gain, decreased eye sight and breathlessness. I have reviewed what little information you sent for such a complex array of problems impacting on your weight gain. I will try to identify as many problems with associated solutions as I can. First of all, youi sent me quite a list of medications, so let us start there. Many of your necessary medications encourage the weight gain process and they are all through different mechanisms. One medication lowers you metabolic rate, so how do we get it back up? Another medication affects one of your appetite hormones, ghrelin. Another acts via leptin. Then lets through in the probable vitamin deficiencies from the medications so your body doesn t have the nutrients it needs to process the food energy it is given. You are correct, it sounds like you are menopausal and it is not uncommon for the hormonal changes to act against your weight control efforts. I would like to go through each medication/condition and how to correct any potential deficiencies or possible interactions: Dry mouth: probably related to RA, do not drink calorie laden drinks like artificial saliva, carry a water bottle. Enbrel: Talk to your doctor about the potential side-effect of optic neuritis that results in some patients taking Enbrel (Decreased Eye Sight Query)It might also cause aplastic anemia, when was your last CBC to check your hemoglobin? (Breathlessness query); Methotrexate: Increase intake of fluids to increase urine output (pay attention that you don t become dehydrated, basically)Interestingly, the side effect is weight loss!Food delays absorption, so take on an empty stomach.; Celebrex- may increase cholesterol, better absorbed on empty stomach but may be irritating requiring adding food with administration; Prilosec - may decrease iron and B12. It looks like your meds may induce anemia. The methotrexate is a folic acid inhibitor and that is its mechanism of action. Neurontin: dry mouth, weight gain Ok, so we have some things to work around. It is not all you, so relax and don t blame yourself.I can tell you what I would recommend if you were my patient. Now, green tea is known to increase metabolism which is a problem. If you don t have any clotting issues, I would add uncaffeinated green tea 6 ounces three times a day. Talk to your doctor about some of the vitamin concerns and which type of multivitamin would be safe to take if any (all have folic acid in them); eat small frequent meals with adequate protein and low glycemic index carbohydrates. Swith your oils over to health oils and get rid of trans fat dramatically lower saturated fat and add good fats such as monounsaturated fats, omega-3,etc. Add soluble fiber to help you feel full to counteract the problem with ghrelin. Walk every day. That is about how the health advice I can give without doing a comprehensive assessment to make formal recommendations. I can do that through the specialist portal if you wish. Remember if you want to continue to work this out, send me all medication changes, new labs, sample one day diet, likes/dislikes, diagnosis and any current diet order. Good luck, dear. Kathryn Shattler, MS,RDN