What are hormones
Hormones are substances that act as messengers and transfer signals to various body parts through the blood. They help in the regulation of physiological activities in the body and assist in maintaining homeostasis.
Obesity is a condition in which a person has excessive body fat and is at risk for developing harmful diseases such as diabetes, hypertension, hyperlipidemia, and coronary artery disease.
What is the relationship between hormones and weight gain
Hormones may have an influence on our appetite. Some hormones increase feelings of hunger while others reduce it, which causes weight gain, loss, or maintenance. The most typical symptom of hormone imbalance is the fluctuation of weight.
Hormonal weight gain: causes, symptoms, and treatment
Causes of hormonal weight gain
Chronic Stress
When we encounter threats, our body releases a stress hormone called cortisol in order to better respond to stress. Cortisol makes a significant contribution to the regulation of carbohydrates, proteins, and fats. It increases blood sugar production by preventing insulin from being secreted and speeds up protein breakdown, which ultimately enhances fat accumulation. Chronic anxiety, acute or chronic illnesses, excessive alcohol consumption, and depression all contribute to hypercortisolism or excessive production of cortisol hormone.1
Hypothyroidism
Thyroid hormones known as T2 and T3 stimulate appetite by increasing metabolism and energy expenditure. Hypothyroidism causes a decrease in energy expenditure, which leads to an increase in energy reserves and adipose tissue, or fat tissue, and results in weight gain.2 Only a minor amount of weight gain is caused by hypothyroidism. Greater weight gain is much more significant in people with severe hypothyroidism.
PCOS
Polycystic ovarian syndrome is characterised by an irregular menstrual cycle caused by hormonal imbalance. Symptoms of PCOS include having an infrequent or absent menstrual cycle, an increased level of the male hormone androgen, the likelihood of infertility, insulin resistance, and weight gain. It might also cause acne, polycystic ovaries, hair loss, and unwanted hair growth in various regions of the body.3 Women who have PCOS are more likely to experience hyperinsulinemia (an increase in the amount of insulin in the body), which might therefore lead to weight gain.
Hypothalamic obesity
This is a rare form of obesity that coexists with a headache and a growth condition. The hypothalamus, a region of the brain, plays an important role in controlling food intake and energy expenditure. Patients who have radiation therapy, hypothalamic tumours, or trauma to the hypothalamus are more likely to be obese. Damage to the hypothalamus slows down the metabolic rate and causes overeating which contribute to obesity.5,6 In addition, after receiving surgical treatment for craniopharyngioma or a non-cancerous tumour, 50% of individuals develop obesity.7
Growth Hormone Deficiency
The most common deficit in endocrine diseases is a lack of growth hormone. Growth hormone is crucial for preserving energy expenditure, fat metabolism, and bone mineral density. A lack of growth hormone results in loss of muscle mass, excessive belly fat deposition, reduction in the body's overall water content, and an increase in weight of 3.6 to 7.5 kg.8
Weight gain due to sex hormones
The male sex hormone androgen is a major contributor to the enlargement of visceral fat.9 Furthermore, weight gain and an increase in androgen promote illnesses such as type 2 diabetes.10 Loss of oestrogen, progesterone, and growth hormone are also linked to weight gain in women. The relationship between testosterone and fat is inverse, meaning that less testosterone likely means more fat.
Leptin
Leptin is a hormone released by fat cells in the body. Leptin works with the brain's hypothalamus to regulate hunger and energy usage. Individuals with larger percentages of total body fat have higher levels of leptin, which leads to leptin resistance. As a result, with increased production of leptin, prolonged high levels of leptin exposure contribute to the development of resistance to leptin and its mechanism of appetite suppression, which causes hunger. When you consume more than your body requires, leptin levels in your body inevitably rise.12
Ghrelin
Ghrelin is also known as the hunger hormone and is secreted by the stomach. The secretion of ghrelin depends on the nutritional state. Ghrelin level increases before meals, and decreases after meals. This hormone sends signals to hypothalamus in the brain that the body is in need of food and energy stores. The level of this hunger hormone increases when a person loses weight, and decreases when patients gain weight. However, in obese patients, it is observed that the amount of secretion of these hormones varies.13
Symptoms of hormonal weight gain14
- Fat accumulation around the face
- Increase in visceral fat or abdominal obesity
- Weakening of the muscles
- Dry, thinning skin
- Increased tendency to bruise
- Acne
- Hair growth on a woman’s face, chest, and back
- Male pattern baldness
- Hypothyroidism
- Thyroid goitre
- Blurry vision
- Fatigue
- Menstrual irregularities
- Chest pain/heartburn
- Gastroesophageal reflux or acid reflux
- Infertility
- Frequent urination
- Irregular heartbeat
- Insomnia or sleep disruption
Possible treatment for hormonal weight gain:
Since hormonal weight gain is caused by fluctuations in hormone levels, controlling hormones is the most effective strategy to prevent hormonal weight gain. If you consistently experience high levels of stress, an excess amount of cortisol or stress hormone might be produced. You can try simple stress-reduction techniques like meditation, yoga, or listening to music. It is highly recommended to speak with your doctor before commencing any hormone therapy.
Patients who have hypothyroidism-related obesity should be monitored for symptoms, and thyroid replacement therapy may be an option for treatment. Following the introduction of synthetic thyroid hormones, the majority of symptoms disappear quickly.14
Weight loss and insulin-sensitising medications, such as metformin, help to relieve the symptoms and restore an irregular menstrual cycle when treating hormonal weight gain caused by PCOS.
High-risk patients of hypothalamic obesity should be identified, seen by a doctor, and given specialised hormone replacement as necessary, coupled with lifestyle changes to prevent weight gain.
Oestrogen replacement has been linked to the reversal of abdominal obesity as well as an increase in lean body mass in postmenopausal women, even though the hormone replacement therapy does not result in weight loss.
The amount of ghrelin and leptin hormones can be maintained by certain dietary modifications, such as avoiding sugar consumption, increasing intake of fluids, getting eight hours of sleep, and having a regular healthy diet.
Summary
Obesity incidence has increased rather quickly and dramatically, and this trend has been mostly linked to a shift in lifestyle that encourages greater calorie intake and less physical activity. Hormonal weight gain can occur for a variety of reasons and a number of lifestyle changes, such as eating a nutritious diet, getting enough sleep, and engaging in enough physical activity, can help to control hormone imbalance and combat obesity.
References
- Block NE, Buse MG. Effects of hypercortisolemia and diabetes on skeletal muscle insulin receptor function in vitro and in vivo. Am J Physiol. 1989 Jan;256(1 Pt 1):E39-48.
- Krotkiewski M. Thyroid hormones in the pathogenesis and treatment of obesity. Eur J Pharmacol. 2002 Apr 12;440(2–3):85–98.
- Goudas VT, Dumesic DA. Polycystic ovary syndrome. Endocrinol Metab Clin North Am. 1997 Dec;26(4):893–912.
- Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab. 2004 Jun;89(6):2745–9.
- Pinkney J, Wilding J, Williams G, MacFarlane I. Hypothalamic obesity in humans: what do we know and what can be done? Obes Rev. 2002 Feb;3(1):27–34.
- Daousi C, Dunn AJ, Foy PM, MacFarlane IA, Pinkney JH. Endocrine and neuroanatomic features associated with weight gain and obesity in adult patients with hypothalamic damage. Am J Med. 2005 Jan;118(1):45–50.
- Srinivasan S, Ogle GD, Garnett SP, Briody JN, Lee JW, Cowell CT. Features of the metabolic syndrome after childhood craniopharyngioma. J Clin Endocrinol Metab. 2004 Jan;89(1):81–6.
- Rosén T, Bosaeus I, Tölli J, Lindstedt G, Bengtsson BA. Increased body fat mass and decreased extracellular fluid volume in adults with growth hormone deficiency. Clin Endocrinol (Oxf). 1993 Jan;38(1):63–71.
- Björntorp P. The regulation of adipose tissue distribution in humans. Int J Obes Relat Metab Disord. 1996 Apr;20(4):291–302.
- Pasquali R, Oriolo C. Obesity and androgens in women. Front Horm Res. 2019;53:120–34.
- Harrington MG, McGeorge AP, Ballantyne JP, Beastall G. A prospective survey for insulinomas in a neurology department. Lancet. 1983 May 14;1(8333):1094–5.
- Ylli D, Sidhu S, Parikh T, Burman KD. Endocrine changes in obesity. In: Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dhatariya K, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000 [cited 2022 Dec 5]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK279053/
- Klok MD, Jakobsdottir S, Drent ML. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obesity Reviews [Internet]. 2007 Jan [cited 2022 Dec 8];8(1):21–34. Available from: https://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2006.00270.x
- Karam JG, McFarlane SI. Secondary causes of obesity. Clinical Practice [Internet]. 2007 [cited 2022 Dec 8];4(5):641. Available from: https://www.openaccessjournals.com/abstract/secondary-causes-of-obesity-10509.html