When it comes to hormones and weight loss, it’s a bit like the chicken and the egg dilemma. Did hormonal imbalance cause weight gain? Or did diet and lifestyle choices cause weight gain, which triggered the hormonal imbalance? Often, it’s the latter, says Sarah Rueven, MS, RD. Either way, hormones are a crucial part of the equation when it comes to successful weight loss — they play a role in many bodily functions ranging from appetite regulation to fat storage.
“By having a better understanding of the various hormones in your body, you can make informed decisions about behaviors and patterns that could be contributing to challenges in your weight-loss journey,” notes Dr. Gretchen San Miguel, chief medical officer for Medi-Weightloss.
Luckily, the recommendations for sustainable weight loss and hormonal balance are relatively similar. “If you are looking to lose weight, it’s important to know the same foods that help you maintain a healthy weight also help balance the hormones associated with fat storage, increased appetite and weight gain,” says Rueven.
Here are some of the key hormones that play a role in weight regulation and how you can get them to work with you:
Although it’s thought of as a stress hormone because it’s secreted to help us decide whether to fight or flight, cortisol also promotes insulin secretion. “This makes us store fat on our bodies, particularly around our waists, one of the more dangerous areas for our health,” says Susan Carnell, PhD, professor of psychiatry and behavioral sciences at Johns Hopkins Medicine. “It can also increase our appetite,” she notes, which can lead to overeating and weight gain.
Hormone hack: Managing stress and how you cope with it is key to losing weight, says Carnell. Find what works for you, whether that’s making a cup of tea when you reach your mental boiling point, going for a daily walk, soaking in a hot bath or enjoying some time in nature. If you tend to stress eat, it helps to keep your go-to foods out of the house, Carnell adds.
Ghrelin is produced by the stomach and often referred to as the hunger hormone. It’s highest when your stomach is empty and decreases after you eat. “It does many useful things in the body, like getting the stomach ready to process food,” Carnell explains. “We also know if ghrelin increases, people are spurred to seek out food, and that stress can produce an increase in ghrelin.”
The combination of stress and increased ghrelin can be especially hard later in the day, according to a small recent study by Carnell and other researchers. “The evening may be a biological ‘high-risk period’ for overeating, particularly when paired with the experience of stress and if you’re prone to binge eating,” she says.
“Elevated levels of ghrelin in the bloodstream can lead to weight gain. It is important to note that ghrelin levels may also rise if someone is fasting or on a strict restrictive diet,” adds Matt Dengler, MS, RDN.
Hormone hack: Again, managing stress is key, as is making sleep a priority since deprivation can increase ghrelin levels. Additionally, Dr. Scott Isaacs, medical director of Atlanta Endocrine Associates, recommends eating high-fiber, high-protein foods, which keep you fuller longer.
Insulin’s job is to drive glucose (sugar) into our cells. While cortisol can cause problems with insulin, so can our dietary habits. “When we habitually eat foods high in sugar, our bodies need to constantly produce insulin so the glucose can be utilized by our cells,” San Miguel explains. “At the same time, an elevated insulin level sends the signal to our body that there is excessive sugar, and it needs to start converting it to fat and storing it for later. This excess fatty tissue not only increases your waistline, but also causes cells to lose sensitivity to insulin, thus signaling the body to produce more insulin, causing even more weight gain.”
This leads to a vicious cycle, known as insulin resistance, where the body no longer responds normally to insulin. Insulin resistance affects 1 in 3 Americans, and is a precursor to Type 2 diabetes. Insulin resistance can make it a lot harder to lose weight, since the body doesn’t respond normally to carbohydrates.
Hormone hack: Many people mistakenly think they need to ditch carbs completely to lose weight if they have problems with insulin. What’s most important, though, is to choose the right types of carbohydrates in appropriate portion sizes. Whole-food sources like sweet potatoes, whole grains and brown rice can help balance blood sugar levels since these “unrefined carbs retain their fiber content, and fiber helps to blunt the body’s response to blood sugar,” Rueven explains.
Whether or not you have insulin resistance, it’s a good idea to eat balanced meals to manage blood sugar and insulin response. “Pairing carbohydrates with protein and fat helps blunt the body’s response to blood sugar,” says Rueven.
Lastly, studies show regular exercise can help improve insulin sensitivity, so maintaining a workout routine is smart.
Produced by fat cells, leptin signals to the brain how much fat is in the body, Isaacs explains. When leptin levels are low, you tend to feel hungry; when leptin levels are high, you tend to feel full.
But it’s more complicated than that, Isaacs adds. “As you start to develop obesity, you start to become resistant to leptin,” he explains. “So you may have high levels of leptin, but the brain isn’t registering that.” This can put you at risk for heart problems and diabetes, adds Carnell.
Hormone hack: Some research suggests physical activity can help manage leptin levels. Although any exercise may help, resistance training appears to be more efficient at reducing leptin levels, according to a recent review of studies on overweight and obese middle-aged adults published in PLOS One. As a bonus, being more active can also help you lose weight.
Sleep is also key. “Leptin is made in your sleep. That’s one reason people with sleep deprivation are hungrier,” Isaacs explains. Research has demonstrated both acute and chronic sleep deprivation decrease leptin levels, so make good sleep habits — like putting away phones 30 minutes before bed and keeping the room a cool 65ºF (18ºC) — a priority.
Neuropeptide Y (NPY) is a neurotransmitter released by the hypothalamus. “It stimulates
food intake, decreases energy expenditure and may lead to weight gain,” says Dengler. Usually, when our blood sugar is low because we haven’t eaten in a while, NPY is released, which stimulates our appetite.
But when someone doesn’t eat frequently enough, or is chronically dieting, blood sugar can drop low, which triggers NPY, explains Erin Kenney, MS, RD. “When this happens on a regular basis, NPY also starts to promote fat storage or weight gain.”
Hormone hack: Avoid fasting or going too long between meals if you’re having problems with hunger during weight loss. “Having protein-rich snacks between meals is a great way to balance blood sugar,” Kenney says, so you avoid getting ravenous and making poor food decisions. “Low protein diets may also stimulate NPY production,” Rueven notes, so getting enough protein in general can help optimize NPY levels.
For women, estrogen levels that are either too high or too low can impact weight and body fat. Having too-high levels of estrogen before menopause, also known as estrogen dominance, is associated with weight gain and increased fat storage, research finds. “High levels of estrogen can also cause insulin resistance, leading to weight gain,” notes Dengler. For example, women with polycystic ovary syndrome (PCOS) are more likely to experience imbalances of both estrogen and testosterone, and have insulin resistance.
On the flip side, as women reach menopause, estrogen levels in the body begin to decline and fat storage is shifted from the thighs and hips to the abdomen, says Rueven. “Fat around the abdomen is known as visceral fat and it puts you at risk for insulin resistance, metabolic syndrome and even certain types of cancer.”
Hormone hack: For premenopausal women, load up on fiber-rich foods and cruciferous veggies. “Fiber reduces estrogen absorption in the GI tract and shuttles excess estrogen out of the body via bowel movements,” Rueven explains. “And cruciferous vegetables like broccoli, cauliflower, cabbage and kale contain a substance called indole-3-carbinol, which promotes estrogen balance by helping the body get rid of excess estrogen.”
Post-menopausal women can promote balance by focusing on whole foods in their natural form like fruits, vegetables, whole grains, legumes, nuts and seeds and lean protein, Rueven notes. “Regular exercise can also help with estrogen balance.”
“Low testosterone in men can impact overall weight and has been linked to weight gain,” says Dengler. Low testosterone levels reduce muscle mass and calorie expenditure, so testosterone deficiency, sometimes called “low T,” can lead to weight gain over time and make weight loss harder.
Hormone hack: Men can combat the loss of testosterone with exercise, Dengler says. “Studies show resistance training such as weightlifting is the best type of exercise for maintaining healthy testosterone levels.” But it’s important to note that for lasting impact on testosterone, exercise needs to be a regular habit. Research shows high-intensity interval training is also a good option.
Originally published June 2018, updated with additional information
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