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all right lets talk about one of the most common causes of setpoint elevation that i see in my practice medications so lets first discuss how medications can cause weight gain they dont have any calories how could they cause weight gain if they dont have any calories and a lot of people will think well theyre going to stimulate your appetite by stimulating your appetite theyll cause you to consume more calories theyll decrease your metabolism slow your metabolic rate or they could release hormones to trigger fat storage but in essence the way theyre all going to work and the way i think about them is that they they will cause your set point to go up whether that set point goes up predominantly because of increasing hunger or a slow metabolism or something more downstream like the the way fat is stored is really rel is irrelevant um what were what we have to think about them as they just cause the set point to go up so theres some categories that we should watch out for contr