The Role of Endocrinologists in Managing Weight Gain
One of the least discussed mechanisms that contribute to weight loss is hormonal balance.
Perhaps the most influential hormone when it comes to weight fluctuations is cortisol. This is the stress hormone that’s released in response to the activation of the sympathetic nervous system (i.e., the fight or flight system).
In this article, we will cover the influence of hormones on weight loss and fat storage. After that, we will highlight why you actually need an endocrinologist to manage weight gain.
The influence of hormones on weight gain
Cortisol
Cortisol is a steroid hormone that mediates the metabolism of all macronutrients (e.g., sugars, protein, lipids).
Cortisol is responsible for dampening inflammation, suppressing the immune system, and upregulating specific metabolic pathways. The last function is responsible for weight gain in individuals with high cortisol levels.
You see, cortisol can have these effects on your body:
· The breakdown of protein (muscle loss)
· The production of new glucose molecules (i.e., gluconeogenesis)
· Conversion of glucose to fatty acids
These metabolic pathways can all promote weight gain. More specifically, you will notice fat accumulation in the abdomen, neck, and face.
The relationship between cortisol and eating disorders
Humans are emotional creatures. This means that our behavior is subject to how we feel at that moment.
High cortisol levels may lead some people to stop eating altogether while others will start eating uncontrollably.
This is why people under a lot of stress tend to gain weight without even realizing it.
Moreover, sugar cravings become powerful, and making healthy choices is no longer a priority.
Cortisol and the basal metabolic rate
Your basal metabolic rate (BMR) estimates the number of calories needed by your body during times of complete rest. This means that it does not account for any sort of activity, including walking.
Researchers managed to identify a number of factors that control BMR, including:
· Age
· Gender
· Weight and height
· Body fat
· Lean muscle mass
· Physical activity
· Diet
· Genetics
A 2015 study added one factor to this list – cortisol levels.
The degree of your stress tightly correlates with your BMR. In other words, the higher your cortisol levels are, the slower your BMR.
As a result, you will burn fewer calories just because you’re stressed.
Insulin
Another hormone that controls weight loss is insulin.
Unfortunately, many patients suffer to lose weight despite their efforts due to insulin sensitivity, which prevents glucose from entering the cells.
As a result, the body will interpret this as a state of starvation, stimulating the release of hunger hormones (e.g., ghrelin, leptin).
Chronically elevated levels of insulin lead to the upregulation of an enzyme known as 17α-hydroxylase, which increases the production of androgens (e.g., testosterone), leading to polycystic ovarian syndrome and all the complications that accompany it (e.g., infertility, hirsutism, weight gain, depression).
Therefore, checking your glucose and insulin levels is integral to preventing hormonal imbalance.
Thyroid hormones
The thyroid gland releases T3 and T4, which control a myriad of metabolic functions of the body, including energy expenditure, basal metabolic rate (BMR), body temperature, and more.
If you are having any symptoms that indicate a problem with the thyroid, we will need to check three steps that lead to the final action of these hormones:
· The production of thyroid hormones
· The conversion of T4 to T3 (T3 is the active form)
· The sensitivity of tissues to the action of T3
Leptin
Leptin is an endocrine hormone synthesized by fat cells (adipocytes). It serves to curb hunger sensations and improve energy expenditure in the liver. Its production mainly relies on the number of adipocytes.
However, a phenomenon known as leptin resistance is present among many overweight individuals, rendering the hormone's actions ineffective. Experts believe this phenomenon is a leading cause of obesity in today’s world.
Leptin resistance can make it very challenging to stick to a calorie-restricted diet because of the impaired hunger signaling pathways. This leads to extreme hunger, forcing people to consume more calories. At the same time, it stops the consumption of fatty acids stored within adipocytes.
Moreover, the situation becomes worse after rapid weight loss. You see, shedding a few pounds can complicate the pursuit of your fitness goals. Weight loss promotes the reduction in adipocyte volume and count, which the brain interprets as a state of deprivation. Consequently, it intensifies hunger signals, making diet adherence exceedingly difficult.
Consequences of leptin resistance include:
· Weight fluctuations (e.g., weight gain)
· Difficulties maintaining a calorie-restricted diet
· Becoming trapped in a cycle of Yo-Yo dieting (rapid weight loss followed by subsequent gain)
How endocrinologists can help you with weight gain
Balancing your hormones is essential to maintain a healthy lifestyle and prevent obesity.
Unfortunately, the clinical presentation of hormonal imbalance can be very tricky to identify due to the complexity of hormonal regulatory cascades, which create a domino effect that’s difficult to track. For this reason, detecting the exact hormonal axis that’s been compromised requires specialized skill and experience.
The following signs and symptoms can all be seen when there is something wrong with the adrenal glands, thyroid, insulin-glucose axis, or sex hormones:
· Hot flashes
· Profuse sweating during the night
· Sleepwalking and other sleep disorders (e.g., insomnia, non-refreshing sleep)
· Unexplained fatigue
· Nocturnal polyuria (i.e., excessive urination during the night)
· Psychological distress (e.g., mood swings, irritability, anxiety)
· Sexual incompetence and decreased libido
· Distractibility
· Weight fluctuations
· Irregular menses
· Irregular core temperature (e.g., hyperthermia, hypothermia)
To pinpoint the exact endocrine axis that’s causing your symptoms, you need to get tested using a special, evidence-based protocol that’s sensitive enough to detect the slightest abnormalities in your hormonal regulation.
For instance, thyroid hormones (e.g., T3, T4) are functional in every cell of your body, which makes the tiniest disturbance in their balance extremely consequential for most organ systems.
Takeaway message
Hormonal imbalances are extremely challenging to deal with, especially in the absence of sensitive and reliable testing. Unfortunately, they can have substantial effects on weight loss and fat storage.
We hope that this article managed to highlight the role of hormones in weight loss and how they can either upregulate it or suppress it.
