Nothing is more frustrating than making lifestyle changes to support your health and lose a little weight, only to find that nothing changes despite your efforts. Everywhere you look, a new fad diet or workout regimen seems to bring about dramatic transformations. So why won't it work for you?
It may be related to a hormone imbalance.
In this article:
The dirty little secret of the billion-dollar weight loss industry is that despite what you've heard, eating less and moving more isn't always the key to weight loss success. And a lot of the time, the more you try to restrict or over-exercise, the worse things can get. While it’s true that some people’s weight loss does require a caloric deficit, achieving it is much easier said than done, especially when hormones are out of balance.
If this sounds familiar, it's time to look at the possibility that a hormonal imbalance is contributing to your weight loss resistance. And it is certainly time for the arm chair (or weight bench) medical experts to calm down with their shame and blame tactics because when it comes to women’s metabolic health and body composition—hormones are everything.
Note: We’re going to talk about weight loss in this article because that is some people’s goals. If that’s not your goal, that’s ok. But round here, we aren’t going to shame anybody’s goal or any body. And if you struggle with an eating disorder and feel this might be triggering, please feel free to head to any of our other articles instead.
What are Hormones and How Do They Affect Weight Loss?
Hormones are your body's chemical messengers that help regulate everything from metabolism and appetite to fertility and mood. When hormones are out of balance, they can wreak havoc on your entire system—including your weight.
Hormones are like the gas pedal and the brakes of your metabolism. When they're in balance, your metabolism runs smoothly. But when they're out of balance, your metabolism can grind to a halt. So bringing this back into balance is crucial if you want to feel better in your body.
But make no mistake, the hormone influences metabolism shifts are by design. You, being very sensitive to environmental shifts because the intention was that you’d create life in your body, are not flawed. Your body is made to survive in the wake of serious stress, which means shifting hormones and storing energy (that’s what fat cells are for) to endure.
Effects of Specific Hormones on Weight Gain and Loss
Multiple hormones can affect your weight, but here are the ones that I address most often in my practice (and in many cases, the imbalance includes more than one hormone because they all work together synergistically). And as an important note, as a board-certified naturopathic endocrinologist, what I most commonly see is that weight is a symptom of a greater issue.
Estrogen
Estrogen is produced by the ovaries and is responsible for developing and regulating the female reproductive system. It's also essential for bones, brain, and heart health. But too much (or when it's not in balance with progesterone), called estrogen excess or more commonly estrogen dominance, might make it hard to lose weight.
Estrogen dominance can lead to weight gain, water retention, painful breasts, irregular periods, and other health issues. Estrogen dominance, at least in part, can be related to factors such as high environmental estrogen1 levels, stress, or poor gut health.
Weight loss with estrogen dominance can be challenging because fat tissues2 can actually make more estrogen, so it becomes a vicious cycle. In addition, adipose tissue or fat cells can also lead to increased inflammation, which not only can be a culprit in weight loss resistance, but can also contribute to more estrogen in the body.
The tricky thing about estrogen is that it can contribute to weight gain when it drops, as seen with menopause. So both too much and too little can be a problem because estrogen helps regulate fat tissue in your body.
If you’re experiencing weight gain around the butt, hips and thighs, that may be a clue your estrogen is in need of support.
Healthy lifestyle tips to support estrogen imbalance for weight loss include:
- Increase fiber intake. Fiber3 can bind to a portion of the estrogen in the gut and help eliminate excess from the body. Aim for 25-35 grams of fiber per day. Good sources of fiber include beans, legumes, whole grains, and vegetables. While all fiber is healthy, the viscous soluble kind that you find in chia seeds, oats, and beans might be most beneficial for fat loss. If you’re like me, a meal plan and recipes can definitely be helpful in giving some guidance. You can grab a free hormone balancing meal plan here.
- Reduce alcohol intake. Alcohol may increase estrogen4 levels in the body. Limit alcohol intake to 1-2 drinks per week. The alcohol-hormone conversation is a big one, which is why I’ve got a whole article breaking it down for you here.
- Avoid xenoestrogens. Xenoestrogens5 are chemicals that mimic estrogen in the body. They are found in many household products such as cleaning supplies, cosmetics, and plastics. Avoiding xenoestrogens can be difficult, but it is essential to reduce your exposure as much as possible. You can read about how endocrine disrupting chemicals impact your body and how to avoid them.
- Consider supplements. You may want to try supplements that support healthy estrogen balance like DIM, magnesium, and vitex (or a combination supplement that includes all of these).
Thyroid Hormone
Your thyroid is a small, butterfly-shaped gland in the neck that produces hormones to regulate metabolism, heart rate, and body temperature. Thyroid hormone can affect weight because your thyroid6 regulates how your body uses energy.
A major symptom of an under-active thyroid (hypothyroidism) is weight gain or weight loss resistance because it slows your metabolism. This can make it difficult to lose weight or maintain a healthy weight.
Stress, nutrient deficiencies, certain medications, and diet all play an essential role in your thyroid health. While medication may be needed to correct thyroid dysfunction, lifestyle can't be ignored.
Healthy lifestyle tips to support thyroid hormone balance include:
- Eat a thyroid-supporting diet. Nutrients needed for optimal thyroid health include magnesium, selenium, and healthy fats (I've got a one-day thyroid meal plan here).
- Consider supplementing. Thyroid-supportive nutrients like selenium, iodine (in the right balance), zinc, and vitamin A could be beneficial if you have thyroid issues. I've created a thyroid supplement with these nutrients and more to help you meet all your thyroid nutrient needs.
- Address your gut health. Gut integrity7 is closely linked to Hashimoto's (autoimmune thyroid disease). Support your gut with a nutrient-rich diet, probiotics, and supplements like glutamine and zinc.
- Eat regularly to support blood sugar. There's a close link between hypothyroid and insulin resistance (more on this next) because thyroid hormone8 influences how your body uses glucose (sugar). Eating regularly spaced fiber-rich meals plus snacks balanced with protein and healthy fat can help regulate blood sugar.
Metabolic Syndrome and Insulin Resistance
Metabolic syndrome9 is a condition that includes a group of risk factors that increase the likelihood of developing heart disease, stroke, and diabetes. These risk factors include high blood pressure, high blood sugar, abnormal cholesterol levels, and excess body fat around the waist.
Metabolic syndrome is closely tied to insulin resistance10. Insulin is a hormone that helps your body use glucose (sugar) for energy. When the body becomes resistant to insulin, it can't use glucose effectively. This increases blood sugar levels, and too much glucose in the blood is eventually stored as fat.
But contrary to popular thought, insulin itself doesn’t make you fat. So before you get scared away from eating that next piece of juicy fruit or sweet potato, please know that the glucose causing elevated insulin levels is a product of insulin resistance and not the root cause. Meaning, it’s not the carbohydrate leading to fat storage but the underlying insulin resistance at a cellular level that’s the cause. And the root cause of that is due to many factors—mainly an ongoing diet composed of too many processed foods and not enough real food.
Insulin resistance is usually linked with type 2 diabetes, but you can have insulin resistance for years before developing diabetes without knowing it (and struggling to lose weight the whole time).
Insulin resistance is present in the majority of people with polycystic ovarian syndrome (PCOS). Keep reading for more on this complex condition.
Healthy lifestyle tips to support insulin resistance:
- Exercise. Exercise helps increase insulin sensitivity11. Aim for 30 minutes of moderate activity most days of the week. Which exercise is best? Honestly, if you have to choose one, lift weights. Strength training is one of the most effective ways to get your cells sensitive to insulin and shift metabolism.
- Bump up fiber. Fiber may help slow down sugar absorption into the bloodstream, which could mean your body releases less insulin. Aim for 25-35 grams of fiber per day.
- Choose ferments. Fermented veggies and pickled foods could help moderate spikes in glucose and positively influence the gut microbiome—maybe even to the point that your metabolic function improves.
- Choose healthy fats. Healthy fats may also help with blood sugar balance because they are digested slowly. Good sources of healthy fats include olive oil, avocados, nuts, and seeds. A little saturated fat is okay and even useful but too much could actually contribute to the underlying insulin resistance that makes us intolerant of carbohydrates. Remember, it’s not the carbohydrate responsible – that’s just a symptom. Here’s an article all about fat for hormones.
- Choose healthy carbs. Yes, healthy complex carbohydrates are our best bet to preventing insulin resistance in the first place. “Carb” has become a dirty word in our diet culture but the truth is, there is a huge difference between a jelly bean and a black bean. Whole, real food sources of carbohydrates such as oats, beans, fruits, and vegetables should be the bulk of your plate. Limit simple carbs such as sugar, honey, and white flour.
- Reduce stress. Stress releases cortisol which could increase blood sugar. Try relaxation techniques such as yoga or meditation.
Testosterone
Like other hormones, too little testosterone is a problem too. Since testosterone can influence metabolic rate (how many calories you burn), women with lower than usual testosterone12 levels can have difficulty losing weight (plus experience other not-so-fun symptoms like fatigue, lack of motivation, feelings of sadness, or low libido).
There is a significant relationship between testosterone levels and weight in women, as women need testosterone in the right amount. Specifically, women with high testosterone can struggle with weight loss because testosterone13 could increase insulin resistance in some people. But higher than normal insulin levels could stimulate the body to make more testosterone. This is most commonly seen in PCOS, as we will discuss in a minute.
Testosterone levels can also affect appetite14 linked to higher levels of ghrelin15, a hormone that stimulates appetite.
And if you’ve got too much testosterone to begin with, but are also experiencing elevations in inflammatory proteins, well that can kick up the estrogen levels in the body.
There are a lot more studies on men than women on testosterone (surprise, surprise), but here are a few healthy lifestyle tips for balancing testosterone:
- Focus on blood sugar balance. Since insulin and testosterone are so closely linked, optimizing blood sugar using the tips mentioned earlier—fiber, regularly spaced meals, healthy fat, and reducing processed carbs are all key.
- Drink spearmint tea. If you have higher testosterone or androgens, as seen with PCOS, spearmint tea16 has been shown to effectively lower androgens.
- Try supplementing with Saw Palmetto. Saw Palmetto is an herb that blocks testosterone from converting to a more active form (it also helps with hair loss and hirsutism).
Leptin
Leptin resistance17 is a condition in which the body becomes resistant to the effects of the hormone leptin. Leptin is responsible for suppressing appetite and regulating metabolism. Just like insulin resistance, leptin resistance means the body isn't responding as it should, so you always feel hungry.
One reason is that the person may carry too much fat tissue since leptin is produced by fat cells. Another reason is that the person's cells may not respond appropriately to leptin signals, preventing the hormone from doing its job correctly. Whatever the reason, leptin resistance can make it very difficult for women to lose weight.
Leptin resistance is tricky and takes a multifaceted approach. You can address your hunger and satiety hormones with healthy lifestyle habits like healthy eating and exercise. Still, sleep, stress, and addressing inflammation causes are all important too.
Why is Weight Loss Difficult with PCOS?
Polycystic Ovary Syndrome (PCOS) is an endocrine-based condition caused by an imbalance in hormones like testosterone, insulin, and progesterone. Testosterone and insulin are often elevated in those with PCOS, making weight loss difficult.
Because of inflammation and insulin resistance, PCOS can make it harder to lose weight and contribute to increased weight gain. Studies have shown that women with PCOS have higher levels of inflammation18, possibly due to insulin resistance. Not every woman with PCOS has insulin resistance, but the majority do.
High androgens like testosterone also play a role, as mentioned above. Weight loss with PCOS takes a specialized approach, including diet, exercise, supplements, and more, to address root causes.
But know, weight gain is a symptom of PCOS, not the cause. And you cannot cure PCOS by losing weight, but in many instances, it can help symptoms. Addressing weight issues in people with PCOS is never a calories in/ calories out conversation. It is important to educate on the multiple ways this condition can impact the body and focus on the nutrition, lifestyle, and sometimes medication strategies that can help bring balance.
When to See a Doctor For Weight Management
If you experience rapid weight gain or loss (like 10 lbs or more in a 6 month period of time) it is time to see your provider. Because weight changes are often a symptom, this one could point to a serious issue.
If you've tried losing weight but can't seem to budge the scale and are feeling frustrated, meet with a provider to discuss your unique health needs is important. If you try a popular diet pattern like intermittent fasting and actually gain weight or notice significant symptoms like fatigue or missing periods arise, it’s time to check in with your medical provider.
If you notice your hair falling out, a drop in energy, dry or thinning skin, joint pain, mood changes, or any period issues that accompany changes in weight—please get it checked out.
It may be time to test your hormone levels to identify any root causes for your weight loss resistance.
Hormonal Imbalance and Hormone Level Testing
Ideally, you’ll work with a practitioner who will order a full thyroid panel (see more about what I recommend here), along with sex hormones like estrogen, progesterone, and testosterone (although these can be tricky if you have irregular cycles), and adrenal hormones like cortisol. You find guidance on when to test hormones here.
Based on these results, you can address the cause of the imbalance with additional support like diet, supplements, or lifestyle adjustments, as each situation is unique.
One thing to add – we all live in different bodies, so a healthcare professional can also help you decide if the weight you're carrying is healthy for your body and readjust expectations if needed. Weight is only one marker of health.
Final Thoughts on Hormones and Weight Loss
The hormone and weight loss equation is complex. So many hormones work together in your body to maintain equilibrium, so when one or more of these hormones is out of balance, it can lead to weight gain or make it difficult to lose weight, even when you're eating right and exercising.
If you've been trying to lose weight without success, it may be time to have your hormone levels checked by a professional to see if they could be the culprit. With the right information and support, you can get your hormones back in balance and finally see and feel the results you want.
And lastly, never stand for a provider who makes weight an issue of morality, shames you about your body, or uses it as an excuse to dismiss your concerns. None of that should be tolerated from anyone, let alone a medical provider.
References
- https://pubmed.ncbi.nlm.nih.gov/22172713/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3428377/ ↩︎
- https://pubmed.ncbi.nlm.nih.gov/17640158/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767933/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104637/ ↩︎
- https://pubmed.ncbi.nlm.nih.gov/20015660 ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353203/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286301/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5933580/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4129661/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569266/ ↩︎
- https://pubmed.ncbi.nlm.nih.gov/34050757/ ↩︎
- https://www.frontiersin.org/articles/10.3389/fendo.2019.00090/full ↩︎
- https://pubmed.ncbi.nlm.nih.gov/22281161/ ↩︎
- https://pubmed.ncbi.nlm.nih.gov/18753737/ ↩︎
- https://pubmed.ncbi.nlm.nih.gov/19585478/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354688/ ↩︎
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7962967/ ↩︎
About The Author
