We’ve been taught for years that there’s a clear formula for weight: eat less calories and burn more calories. But we now know that scientifically, this basic formula just isn’t true because it’s missing key pieces of the puzzle like hormone health. The body is a living, breathing, digesting organism. The way it works, holds onto weight, and loses weight is much more complex than a system of measurement created in a lab (i.e. calories). So if you’ve been going off of the diet-and-exercise formula with no success, let me introduce you to one of the most critical factors of weight: hormones.
“A significant amount of research has suggested a tremendous link between hormones and either weight gain or difficulty losing weight,” explained Dr. Mahmud Kara, MD, a longtime doctor at The Cleveland Clinic and founder of KaraMD. Yes, you can eat a clean diet and burn calories on the treadmill or stationary bike regularly and still not see results. Why? Nutrition and exercise are just the tip of the iceberg—there arer a lot of bodily functions underneath the surface that are telling the body to keep on weight, lose weight, or gain weight. “When it comes to hormones and your weight, there is a big connection,” agreed Cory Ruth, RDN, women’s health expert and the CEO of The Women’s Dietitian. “Elevated levels of various types of hormones can dampen weight loss efforts as well as cause the body to hold onto and store more weight.”
The purpose of this article is not to make you believe that weight loss should always be a goal (it shouldn’t) or that you need to obsess over your hormones or else you’ll gain weight (you won’t). Instead, this article is meant to show you that trouble losing weight has absolutely nothing to do with your willpower, laziness, or worth. Also, that weight gain is not your body’s way of sabotaging you; it’s a sign that there’s something bigger out of whack (i.e. hormones) that you can fix to be your healthiest. It’s OK to have weight loss as a goal (as long as it isn’t sacrificing your self-love and comes from a place of health, not self-worth), but it isn’t an end goal. Instead, weight struggles are a check engine light from the body that something else needs some attention. Here’s how to know if that “something” is hormones and what to do about it.
How can hormones affect weight?
If you have imbalanced blood sugar…
When we think of hormones, we typically think of estrogen and testosterone or maybe you think of happy hormones like serotonin, but we often forget that insulin is also a hormone, and it’s a crucial hormone when it comes to weight. According to Alisa Vitti, a women’s hormone expert and the founder and CEO of FLO Living, imbalanced blood sugar can disrupt your insulin levels, which interferes with weight management. How does blood sugar become unbalanced? Most commonly, the cause is diet. “When we eat a higher-carb diet and don’t add in enough protein, fiber, and healthy fat, our blood sugars increase,” Ruth explained. “This causes insulin levels to spike, which signals sugars be converted into fat.”
It’s important to note that carbohydrates are not the enemy (carbs are crucial for energy!)—a diet too low in carbohydrates (especially complex carbohydrates) can cause prolonged periods of blood sugar imbalance too. Instead, it’s about the balance of macronutrients. Make sure you’re getting in complex carbohydrates that are high in fiber like vegetables, lentils, beans, and grains like brown rice or quinoa, in addition to clean protein sources. The combination of protein and fiber will keep blood sugar stable and help with insulin levels.
If you’re chronically stressed…
Bad news for the overworked, overstressed, and overanxious people out there (AKA all of us?): Chronic stress (through hormones) is a major factor of weight. “The stress hormone cortisol blocks progesterone production and lowers progesterone levels,” Vitti explained. “Your body uses progesterone to make cortisol to respond to stress, and the more stress you experience, the more progesterone your body will ‘steal’ to make cortisol. This can make you have more unopposed estrogen and make weight more stubborn.” In other words, elevated cortisol for long periods of time is literally causing a hormonal imbalance that tells the body to keep on or gain weight. “When cortisol is elevated, it can make the body want to hold onto weight and not let it go—especially in the abdomen,” Ruth agreed.
As if the hormonal imbalance isn’t enough, Vitti explained that chronic stress can also deplete the body of the important nutrients it needs to stay healthy (and stay at a healthy weight). “Excess cortisol from stress depletes the body of essential vitamins, minerals, and micronutrients. B vitamins, magnesium, and omega-3 fatty acids are especially susceptible to stress. Stress causes you to lose the micronutrients you need to have a healthy metabolism.”
If you have an estrogen dominance…
Estrogen and progesterone are known as the “female hormones” and the body should release a balanced amount of the two. Estrogen dominance happens when there is increased estrogen levels relative to progesterone levels, and it’s more common than you may think. Vitti said that estrogen dominance can not only worsen PMS or menstrual issues but can also block your ability to shed pounds. “With women, weight is often related to the estrogen/progesterone ratio,” Dr. Kara agreed. “If this is out of balance, it can lead to weight issues as well as other health problems. Abnormal levels of estrogen, which often occurs when taking birth control or with certain conditions like polycystic ovary syndrome (PCOS), can lead to weight gain.”
If you have excess testosterone…
On the flip side, another sex hormone can affect weight too. Testosterone is known as the “male hormone” (because it plays a key role in the development of male reproductive tissues such as testes and prostate), but all genders have a balance of testosterone, estrogen, and progesterone levels. If there’s an excess of testosterone, it can cause weight management issues just like estrogen. “In women, excess testosterone (which is very common in conditions like PCOS) can cause insulin resistance,” Ruth explained. “This leads to weight gain and can slow, or even halt, weight loss efforts.” Bottom line: Hormonal health and balance of the sex hormones is crucial for all functions of the body, including healthy weight.
If you’re over 30 years old…
PSA: Your hormones don’t just change when you’re going through puberty. Your hormones are consistently changing, and women go through significant hormonal changes in their 30s and throughout the few decades after. “Women start to lose muscle mass in their 30s (unless actively trying to maintain through adequate dietary protein and exercise),” explained Dr. Adrienne Youdim, MD, FACP, an internist who specializes in weight loss and owns her own weight management practice in Beverly Hills.
“This process is accelerated in perimenopause (which can precede menopause by up to 10 years) and after menopause as well. The change in resting metabolic rate can result in weight gain. What’s more, the drop in estrogen that occurs during menopause results in a relative increase in testosterone, directing body fat to the mid-section,” she continued. As if the “anti-aging” pressure for women wasn’t bad enough, we’re actively expected to be “young and thin” as we age, while our bodies are literally meant to do otherwise. Cruel gender norms aside, weight gain is a common symptom of changing hormones as we age.
If you have thyroid issues…
Now to get super science-y: The thyroid is one of your endocrine glands that makes hormones, so instead of just a hormonal imbalance or excess, an under or overactive thyroid is dealing with the creation of hormones at the root. The thyroid can—you guessed it—also affect weight. “The thyroid hormones help control the speed of our metabolism, so low levels of thyroid hormones (or an inactive thyroid) can cause weight gain,” Ruth said. “The thyroid regulates the metabolism of every cell in the body, and thyroid issues can result in inexplicable weight gain (especially weight gain around the middle),” agreed Dr. Carrie Lam, MD, FAAMFM, ABAARM, a physician specializing in anti-aging medicine.
If you have gut issues…
So you already know that the health of your gut can affect bowel movements, bloating, and even mood, and it can also affect weight on its own—multiple recent studies have proven a direct correlation between weight gain (or loss) and the gut microbiome. But if you don’t have a totally healthy gut, there’s a good chance your hormones are out of whack, meaning the gut can affect weight in more than one way. “A healthy gut is critically important for any woman who wants to balance hormones and maintain a healthy weight,” Vitti explained. “That’s because the gut flora (specifically a colony of bacteria called the estrobolome) help process and eliminate excess estrogen from the body.” If you’re not making bowel movements consistently or have other signs of poor gut health, odds are, you’re not eliminating estrogen properly and therefore might be dealing with estrogen dominance.
How do you know if you have a hormonal imbalance?
Hormonal imbalances can be difficult to diagnose since symptoms can vary, but if anything feels “off,” whether it’s your sleep, cravings, energy, or sex drive, it might be worth looking into. “Hormones impact everything in the body, including (but not limited to) metabolism, sleep, sex drive, blood sugar, and more,” Dr. Kara explained. Talk to your doctor about thyroid levels, diet, stress, testosterone/progesterone/estrogen balance, and how gut issues might be affecting your hormonal health. The #1 way to know the health of your hormones is to get them tested (more on that below).
For women with a period, your cycle can offer a lot of insight into the health of the sex hormones. Vitti views any and all PMS or cycle issues (breakouts, cramps, bloating, etc.) as a potential hormonal imbalance because while period symptoms are extremely common, they are not normal. Looking at the pattern of weight gain can provide insights too. Vitti suggested that if weight seems to fluctuate with your cycle (meaning it changes through the month), it’s worth looking into balancing your hormones. Dr. Alexis May Kimble, a urogynecologist and medical director of The Kimble Center, agreed that if you’ve noticed weight gain while staying consistent with caloric intake and activity levels, a hormonal imbalance is likely to blame.
Tips to help heal your hormones
Talk to your doctor and get testing
Of course, you can speculate about what’s going on in your body all day long, but you can’t know for sure without answers. Talk to your doctor if you suspect a hormonal imbalance or if you’re wondering about your hormonal health and its role in your weight. “Test, don’t guess!” Ruth suggested. “Always start with testing to know if you have imbalanced hormone levels. You can ask your doctor for a full hormone panel as well as fasting insulin/glucose and A1C to get a good look at the current state of your hormones and blood sugar.”
“If there is an excess or deficiency of certain hormones, checking levels is necessary in order to suppress or replete them to regain balance,” Dr. Kimble agreed.
Try cycle syncing and change your exercise routine
For women with a period, it’s extremely crucial for hormonal health to adapt your lifestyle, diet, and exercise to your cycle, otherwise known as cycle syncing. Let the experts explain: “Your infradian rhythm affects your metabolism, so if you are not supporting it properly, you’ll be disrupting your period, but it will also increase stress levels, disrupt blood sugar, and make weight management extremely difficult,” Vitti explained. In other words, modify caloric intake and workout intensity (as well as other lifestyle factors) based on your cycle phases—you should not be eating, moving, or doing the same things every day.
We talk more about cycle syncing the diet below, but when it comes to movement, you already know that exercise can help with weight management. However, if it’s done incorrectly (AKA high-intensity workouts during the wrong time of the month or forcing yourself to do the same workout every day), it can disrupt your hormones and lead to weight gain. For more information, check out Vitti’s book In The Flo or download the MyFlo App to track and sync your own cycle.
Adapt your diet
When it comes to nutrition, Vitti explained that the body needs more calories during the second half of your cycle (approximately 279 more calories per day in the luteal phase). Not getting enough calories and nutrients during this time especially can cause hormonal imbalances and hormonal-related symptoms (which kind of puts an end to the myth that eating less and burning more calories is always good for weight loss, huh?).
Ruth also said that your diet should be adapted based on which hormones are imbalanced (according to lab results). For example, eat more protein and fiber if you’re dealing with imbalanced insulin levels, drink two to three cups of spearmint tea a day and follow a blood-sugar friendly diet if you have a testosterone dominance, and include plenty of seeds, fish, vegetables, and fruit if you’re dealing with thyroid imbalances.
Prioritize stress relief, first and foremost
After writing for and coaching women for years, my humble opinion is that non-diet-related weight struggles most often have to do with chronic stress. Whether you want to lose weight or not, you need a go-to stress relief plan and should prioritize it before anything else—including work, time with family, going to the gym, or even eating healthy. That means make time for daily meditation, go to therapy frequently, have a nighttime routine that calms you down, get enough sleep, fit in activities that bring you joy, and get rid of habits that don’t. This also means that stress about weight gain is worse than weight gain itself, so while it’s OK to want to lose weight, simultaneously work on self-love and stress relief so they’re not contingent on the pant size your body fits into.
