It’s easy to dismiss a double chin as a sign of someone being fat or careless about their diet. But if you’ve experienced it first hand and know it isn’t your lifestyle that’s to blame, it's time to look elsewhere. It could be a symptom of a more deep-seated health condition, one that you can treat if you know what is causing it.

Spotted an ungainly double chin in the latest photograph of yourself? That centuries-old sign of prosperity (of someone who has plenty to eat and drink!) may be masking something bigger. While your double chin can be chalked up to weight gain or not eating right, there is the chance it could be something else. And if that’s the case, cosmetic surgery or a weight-loss plan may only offer temporary respite before the problem rears its head again. More importantly, you should get on top of whatever underlying disorder is triggering that double chin – whether it is an underactive thyroid, too much cortisol, or even a kidney problem.

Thyroid Trouble

You probably already know your eyebrows may thin at the ends if your thyroid isn’t working fine. You may also know that weight gain is a common indicator of hypothyroidism. But ever considered the possibility that your hanging jowls may be a sign too? If the skin in the region below your jaw bone begins to sag and fill up with fat over time, you develop that classic double chin not too far from your thyroid. Normally, when the lymphatic system gets backed up with bacteria, this would be processed and expelled by your liver after the action of your thyroid sets off the cycle. With an underactive thyroid this doesn’t happen, causing lymph glands to swell. Thyroid enlargement or goiter can cause the neck to swell as well. This condition can result from an autoimmune problem called Hashimoto’s thyroiditis (or chronic lymphocytic thyroiditis) or from a pituitary gland problem; it could also be inherited from birth or be a temporary result of major emotional/physical/social changes (for instance a pregnancy, a death, or an infection).

Cushing’s Syndrome

A characteristic “moon face,” upper body obesity, and increased fat accumulation in the neck region, like a double chin, is a symptom of Cushing’s syndrome. Prolonged exposure to high cortisol in the body causes this syndrome and may result from pituitary adenomas (a benign tumor) or, more commonly, from excess glucocorticosteroid intake. If you have an adenoma, a combination of drugs or surgery to remove the tumor may be needed. If you’re taking corticosteroid medication prednisone to treat your rheumatoid arthritis, lupus, or asthma, the dosage may need to be evaluated.

Sinus Infections

Chronic sinusitis can cause the lymph nodes to swell because of the inflammation, giving you a puffy face and neck in general. Such chronic sinusitis that’s responsible for a swollen neck with the semblance of a double chin may result from allergic rhinitis, asthma, nasal abnormalities, or repeat episodes of acute sinusitis.

Kidney Disorders

Swelling of the face is one of the symptoms of acute nephritic syndrome. This kidney problem results from your body’s immune reaction to illnesses like Hepatitis B or C, lupus nephritis, or even viral diseases like mumps or measles. This causes the inflammation and swelling of the kidney’s glomeruli, the capillary network responsible for blood filtration.

Salivary Gland Inflammation

Your salivary glands too can get infected and can result in a swollen face and jaw area, giving the look of a double chin, with the swelling especially bad in the region below the floor of your mouth.Oral hygiene problems, salivary duct stones, inadequate water levels in the body, chronic illness, and smoking are some of the common causes of this inflammation. Sometimes, a dental infection could also result in such swelling.

Did any of these problems ring a bell? If you suspect your double chin could be a front for any of these conditions, you should seek medical help and get the right treatment from a professional. And if it turns out to be good old-fashioned weight gain that’s causing that double chin, some facial exercises that involve using your jaw more should help. Losing weight overall should also help you lose some of that excess weight you carry on your face and neck.