i have been struggling with weight gains my whole life.  i recetnly dropped 100lbs in about 6-7 months by exercising my butt off, and being very picky.  it wasnt the healthiest way so im trying new attacks to find out what works.   i have a trainer and hse has me eating micro meals every 2.5-4 hours, i usualy try last the 4 hours, it keeps your metabolism cooking.  i work out 4-5 days a week for 1.5-2.5 hours a night.  and i am thinning out and actually gaining muscle mass.  i have over all joint pains, but they are mostly in my knees and one ankle.  i found working on both strength and flexibility have helped me out a lot.  i take glucosamine, vitamins, and calcium daily.  i also drink powerade after a workout and eat a few carbs before with the whole glucose level and adrenaline acting differently in people with cah.  but im noticing im not losing so much weight as over all size.  i seem to building enough muscle to keep up with the rate at which i am bruning fat right now.  i feel great, and im getting more and more driving daily.  im not a fan of fad diets, im a true believer in eat right and exercise is the best way. also for some extra protein, i use 1% - 2% milk with low fat frozen yogurt and a serving of whey protein, and make sort of a milkshake.  jsut some thing working for me.  hope something in there helps.