You’re not alone if you feel like your weight loss journey comes with an extra burden of guilt—from every angle, someone is telling you you’re doing something wrong. You’re eating too much. You’re not eating enough of the right foods. You’re not exercising enough. You must not be motivated enough.
The list goes on.
And while there are a million and one different reasons why someone may struggle with their weight, for many women, the true culprit lies in their hormones.
I’m not saying that weight loss is impossible or that you can't lose weight by eating less and exercising more. But I am saying that for many women, trying to lose weight without addressing the hormonal imbalances at play is like swimming upstream.
So, if you're a woman struggling to lose weight, here's what you need to know about the role of hormones in weight loss.
Unexplained Weight Gain in Women May Be Hormone-Related
If you've been eating a relatively healthy diet and exercising regularly but still find yourself slowly gaining weight, it may be time to consider the role of hormones in weight gain.
Your hormones control virtually every function in your body, from your mood and energy levels to your digestion and reproductive health. So when hormones are out of balance, they can cause a ripple effect throughout your entire body.
Let’s start with hypothyroidism as an example. The thyroid gland is responsible for producing thyroid hormones, which play a major role in regulating your metabolism. An underactive thyroid (hypothyroid) means metabolism may not fire as it should, leading to weight gain, fatigue, and other symptoms.
Insulin resistance is another one I see often. Insulin is the hormone that helps regulate blood sugar levels. When you eat carb-containing foods, your body releases insulin to help your body use the energy you take in, while keeping your blood sugar levels from getting too high.
Insulin resistance means your body isn't responding correctly to insulin. Blood sugar levels rise and stay high while more and more insulin is released to try to bring it back down. The result? Weight issues, increased hunger, and even extra cravings for sugary or carb-heavy foods.
But if you aren’t aware this is all happening beneath the surface, you may assume that you need to restrict calories even more or exercise harder. This approach can do more harm than good for women with hormonal imbalances.
@drjolenebrighten Weight gain isn’t always diet & exercise! #drjolenebrighten #learnontiktok #tiktokpartner #thyroidproblems #thyroid ♬ What If (I Told You I Like You) – Johnny Orlando & Mackenzie Ziegler
Effects of “Eat Less, Move More” on Hormones
The advice we're often given to lose weight—eat less, move more—can worsen hormonal imbalances, making it harder to lose weight. It’s a big, vicious circle.
I can't tell you how many women come to me, barely eating 1000 calories a day (which, by the way, is more likely the caloric requirements for a small child, not a grown woman) and exercising 2-3 hours a day.
They're doing everything by the book, but they're not losing weight. And in many cases, they're actually gaining weight.
When you severely restrict calories or exercise excessively, it can throw off your hormones further. Let’s look at some examples.
As I mentioned earlier, insulin is a hormone that helps regulate blood sugar levels. One of the big things I see with over-restriction is someone will skip meals trying to cut calories and then head into lunch or dinner absolutely starving.
Guess what happens? Blood sugar spikes, causing a significant insulin release and a corresponding sugar crash. Over time, high insulin levels and insulin resistance can promote fat storage and make it more challenging to lose weight.
It's a vicious cycle that becomes increasingly difficult to break out of the more you do it.
As I mentioned earlier, a well-functioning thyroid is needed for healthy metabolism, so a common symptom of low thyroid levels is weight gain. At the same time, severely restricting calories can lead to lower thyroid hormone levels.
An older study found that women who followed a very low-calorie diet significantly lowered T3, the active thyroid hormone. I should point out that participants were only eating 400 calories daily in this study, which is (hopefully) much lower than what you’d typically eat. But it still points to the importance of calories for thyroid health.
Plus, if you significantly drop your calories, you’re more at risk of missing out on essential nutrients for your thyroid like zinc, iodine, selenium, or magnesium.
Cortisol (Stress Hormones)
Cortisol is a stress hormone, and it's released in response to physical or emotional stress. In the right amounts and at the right times, cortisol is beneficial. But when cortisol levels are constantly elevated, it can lead to weight gain, particularly in the abdominal area. It can also lead to other health problems, such as adrenal issues, anxiety, and depression.
Stress hormones like cortisol are a major reason “eat less, move more” is often ineffective for women and can make it harder to lose weight. Women's bodies are especially sensitive to nutrient depletion, and the body considers lack of nutrition a stressor. So what does your body do? It protects you from starvation by holding onto weight. Your body can’t tell whether your caolrie deficit is because you want your jeans to fit better, or because you’re in a famine.
This evolutionary response served us well when food was scarce, but not so much in our modern world, where food is abundant. However, we're still constantly dieting and trying to lose weight, but research shows that even lowering calories to 1200 calories can significantly increase cortisol.
Estrogen is tricky because both high and low levels can be a problem. Estrogen dominance means someone has higher than average estrogen levels, or the ratio of estrogen to progesterone is off. It can happen for various reasons, but chronic stress and adrenal function influence estrogen levels.
Too much estrogen can lead to weight gain, particularly in the hips and thighs. It can also cause a whole host of other problems such as anxiety, mood swings, insomnia, and PMS, and research suggests that weight loss can help lower estrogen levels.
On the other hand, low estrogen (as seen in menopause) can also make it harder to lose weight, especially around the middle.
It’s well-known that calorie restriction adversely impacts sex and reproductive hormones in women’s bodies. Nutrient scarcity ups the stress response, throwing sex hormones out of balance and bumping up cortisol levels.
Low testosterone is another common hormone imbalance I see in women, particularly as they age. Testosterone is often thought of as a “male” hormone, but women have it (and need it) too.
Testosterone helps us build and maintain muscle mass and burn fat, and it's also important for sex drive and libido.
Low testosterone levels can lead to weight gain, fatigue, low sex drive, and difficulty building muscle mass. Caloric restriction and weight loss can deplete testosterone even further.
Losing Weight with Hypothyroid
Okay, so you know hypothyroidism can make it difficult to lose weight, and “eat less and move more” can worsen the problem.
But what can you do if you have hypothyroidism and want to lose weight?
The first step is to check your thyroid hormone levels (see what I recommend for comprehensive thyroid testing here). Taking the correct medication and dose might be what you need to get your metabolism going again..
The next step is to make sure you're eating nutrient-dense foods that support thyroid function. This means eating plenty of healthy fats, protein, vegetables (both non-starchy and appropriate amounts of starchy vegetables too), and low-glycemic fruits, while avoiding processed foods as much as possible. Supplements can also help you get enough of the nourishing nutrients your thyroid needs.
Another often overlooked nutrient in weight loss is fiber. While we are busy worrying about macros like protein, fat, and carbohydrates, perhaps the unsung hero of the weight management is fiber in all of its many forms but specifically soluble fibers and resistant starches. Not only is fiber satiating and may be helpful to control overall caloric intake, but fiber could also impact estrogen levels and help harmonize this important hormone. On top of that, doctors often suggest increasing fiber for patients who are keeping an eye on their blood sugar.
And finally, check on those stress levels because chronic stress can exacerbate hormone imbalances.
Low Thyroid Function Symptoms
Wondering if you might have low thyroid?
Here are some symptoms to look for:
- Weight gain
- Brain fog
- Hair loss
- Dry skin
- Cold intolerance
- Muscle weakness
If you're experiencing any of these symptoms, it's essential to see a doctor and get your thyroid hormone levels checked.
Losing Weight with PCOS
At its foundation, PCOS is an endocrine (hormone-based) condition, so “eat less and move more” is definitely not the answer. Plus, women with PCOS are more likely to experience disordered eating behaviors, so telling someone with PCOS to eat less, which happens all the time, is not helpful and could even be damaging.
Addressing PCOS and weight requires a holistic approach, including lifestyle, diet, supplements, and stress management. Each topic requires an article of its own (and I've written about them extensively), but here are some of the basics:
- Diet. A nutrient-dense, anti-inflammatory diet is vital for PCOS. This means plenty of healthy fats, lean protein with an emphasis on lower saturated fats and more omega-3 fats in animal proteins (read: wild salmon versus fatty bacon), vegetables, and low-glycemic fruits to balance blood sugar.
- Supplements. Extra nutrients can be helpful for PCOS, including inositol (more on this one below), magnesium, and omega-3 fatty acids.
- Stress management. Find something that helps you manage stress. This might include yoga, meditation, journaling, and spending time in nature.
@drjolenebrighten Strength training is one of the best exercises for #PCOS. Yes, it can help you #loseweight because of the metabolic shifts. But when it comes to regulation #ovulation and periods, lowering testosterone, and improving insulin sensitivity, #strengthtraining is at the top of the list of my patient recommendations. In the video I said it increases insulin resistance when I meant to say it improves #insulinresistance. This is because it helps your body become more sensitive to insulin. #pcosweightloss ♬ Cowbell and Conga, the rhythm of Cha-cha – Yoshihiko”Mizalito”Miza
High Androgens in Women Makes Weight Loss Harder but Not Impossible
High androgens, primarily testosterone, significantly contribute to weight challenges associated with PCOS. Increased testosterone can also make it challenging to maintain a healthy weight because of the effect on insulin.
Remember that high levels of insulin and insulin resistance can promote weight gain. High testosterone can make the problem worse by increasing insulin levels and making the body more resistant to its effects. This can lead to even more weight gain.
But again, using the strategies listed above could help balance insulin and testosterone production, which in turn could support a healthy weight.
Balancing Hormones for Weight Loss
Phew. I know I just gave you a ton of info, and sometimes it can feel overwhelming to even start.
But the first step is always to get your hormone levels checked by a doctor. This will give you a starting point and help you understand which hormones might be out of balance.
From there, you can start to make dietary and lifestyle changes to support hormone balance. Here are some examples.
Diet to Balance Hormones
There's no one perfect diet for each of us, but here are some general tips that support hormone balance:
- Eat nutrient-dense foods, including plenty of healthy fats with an emphasis on monounsaturated and polyunsaturated fats, protein, vegetables, and fruit.
- Don't skip meals, and make sure to include protein and fiber at each meal to help stabilize blood sugar.
- Address food sensitivities and digestive issues to support gut health (this often requires professional support).
- Support your natural detoxification systems with at least 25 grams of fiber.
P.S.: Not sure where to start with a hormone-balancing diet? Check out my free Hormone Balancing Starter Kit, which includes a free 7-day meal plan, recipes, and a ton of extra info to get your hormones back into balance.
How Inositol Regulates Hormones
I can't write an article about hormones, weight loss, and PCOS without mentioning inositol. It's one of my favorite go-to supplements, and here's why.
Inositol acts like a helpful messenger for insulin to help move glucose out of the blood and into the cells. When the cells are more responsive, blood sugar levels normalize, and less insulin is needed.
There’s a lot more to be said about the benefits of inositol (including fertility support, menstrual cycle regularity, and more that you can read about here), but one important thing to note is the types of inositol—D-chiro-inositol and Myo-inositol—as well as the ratio, are important for effectiveness.
I created my product Myoinositol Plus to provide the optimal dosage and ratio of Myo-inositol and D-chiro-inositol, so I know my patients are getting an effective, evidence-based product.
Addressing Hormones is Crucial for Weight Loss
The calories in equals calories out equation is oversimplified, especially when hormones are out of balance.
If you’ve been struggling with weight loss and feel like you’ve been restricting more and more or spending hours on the treadmill, it’s time to take another look at what’s happening in the body.
It can take time to turn off the noise that tells us we aren’t doing enough and work with our natural rhythms instead of against them. But nourishing the body to support hormone balance can make all the difference.
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