Have you ever thought there must be more to losing weight than just dieting and exercise? Well, it turns it you are right! Gaining and losing weight can be due to many things, for example: Sleep deprivation, nutritional imbalances, genetics, environmental toxins, gut flora imbalances, food addictions, allergies, and inflammation.1
Frequently ignored is the impact of hormones on weight and metabolism. Hormones determine what your body does with food; therefore, balanced hormones are crucial to controlling weight
In men and women, hormone production declines with age which can trigger a sluggish metabolism and weight gain. Body shape changes (almost always an indicator of hormonal imbalance) with fat appearing around your middle, belly, breast, and arms.2 Hormones affecting weight in both men and women are cortisol, insulin, thyroid, estrogen, progesterone, and testosterone. When any of these are imbalanced, hormonal disorders ensue causing weight gain and or difficulty losing weight.
Stress — real or imagined — throws the body into panic mode and cortisol is released into the bloodstream. Cortisol raises blood sugar and breaks down fat for energy. This response is lifesaving when faced with life threatening situations. When the immediate stress ends, cortisol rises, leading to craving for fatty, salty, sugary foods to replenish the source of energy that was just depleted. Then cortisol falls to normal levels. Prolonged stress leads to continuously high levels of cortisol which causes continual excess calorie intake. Since these calories aren’t needed immediately, they get deposited as abdominal fat.3 Chronically elevated cortisol keeps blood sugar elevated which can lead to insulin resistance.
Sugar (glucose) stimulates the release of insulin which carries glucose into cells to be used as fuel. When cells have received enough glucose, excess gets stored as fat, especially in the belly and buttocks. Insulin resistance is when the body produces insulin but cells are less sensitive to it. As a result, the pancreas will pump out increasingly more insulin, but the insulin is unable to push glucose into cells. This excess circulating insulin causes sugar cravings, increased appetite, and weight gain.
This hormone regulates the metabolism of every cell in the body. When the thyroid gland is not making enough of this hormone, it’s called hypothyroidism. Hypothyroidism causes a slowing of most bodily functions. Sometimes, people have symptoms of low thyroid including fatigue, hair loss, sluggishness, weight gain and or difficulty losing weight. However, their lab tests are normal. 4 This is a source of great stress for individuals who know something is wrong but the cause is not obvious. Thyroid hormone needs to be suspected and tested properly.
Testosterone, Estrogen, and Progesterone
As men and women age, testosterone levels decrease, leading to a loss of muscle and bone, accumulation of belly fat, and decreased metabolism. The effect is more severe in men because their testosterone levels are much greater to begin with. Ovaries produce less estrogen and progesterone in women starting as early as age 35. When estrogen is not in correct balance with other hormones (primarily progesterone), weight gain can occur. Signs of estrogen excess are weight gain around the abdomen, hips, and thigh, water retention and abdominal bloating. Estrone, the main estrogen in menopause, shifts fat from hips to abdomen. Progesterone helps the body utilize and eliminate fat and increases metabolism. Excess progesterone production relative to estrogen leads to an increased appetite and fat storage. 5,6
To prevent weight gain from hormonal imbalance:
1. Limit carbohydrate intake
2. Reduce stress
3. Have hormones levels checked and balanced
4. Take a probiotic
5. Exercise 45 min., 5 days/week
To learn more about medical weight loss and how it might be able to help your patients control the effect of hormones on weight and metabolism, click here.
1. Smith, P., “Why you can't lose weight: why it's so hard to shed pounds and what you can do about it.” Garden City Park, NY: Square One Publishers, 2011
2. Smith, P., “What You Must Know about Women’s Hormones,” Garden City Park, NY: Square One Publishers, 2010
3. Epel, E, et al., “Can stress reshape your body? Consistently grater stress-induced cortisol secretion among women with abdominal fat” Psychosomatic Med 2000; (62):623-632
4. Brownstein, D., “Overcoming Thyroid Disorders.” West Bloomfield, MI: Medical Alternatives Press, 2002
5. Kalkoff, R, et al., “Metabolic Effects of Progesterone “Journal Obstetrics Gynecology, 1982: 142-146
6. Vliet, E., “Women, Weight and Hormones.” New York: M. Evans & Company, 2001
The journey doesn’t really end once you’ve hit your weight loss goal. Once you achieve your desired weight, another goal is automatically set: Keeping the weight off. Some may find this more difficult than losing the weight to begin with, and according to some research there could be some medical reasons behind that.
The Endocrine Society recently released a new statement recommending more research to understand what causes difficulty with long-term weight loss. The statement suggest that it could be more of a biological issue as opposed to a dieter’s unwillingness to continue to do what earned them the weight loss to begin with.
Authors of the statement believe that once the dieter has lost the weight, the combination of decreased energy expended while hunger increased is the perfect recipe for weight regain. “Our therapeutic focus has traditionally been on achieving weight reduction. Most patients can do this; what they have the most trouble with is keeping the weight off,” says Michael W. Schwartz, MD, of the University of Washington in Seattle, and the chair of the task force that authored the statement.
Obesity is an awfully expensive issue in America. According to the Centers for Disease Control Prevention, it costs an estimated $147 million a year to treat obesity. That amount includes treatment for those that lost the weight and regained it. So the question is, what can be done to keep the weight off?
Your best chance at maintaining the weight loss is to going into it with a plan. The beginning part of the process will likely be the most difficult, just like it was when the journey originally started, but with the right focus and the right people behind you it can’t be done.
Although the statement issued by The Endocrine Society emphasized learning the factors for regained weight, that isn’t the only thing they felt deserved further research. Other issues that they felt merit more research were: brain imaging to better understand appetite and feeding behavior, effect of socioeconomic status on obesity risk, the role that diet composition plays in the development of obesity, and more.
Source: The Endocrine Society
Blog written by Marcus Miller/Robard Corporation
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