Hormonal Weight Loss
There are several hormones that affect your ability to lose weight.
- Thyroid hormones
- Estrogen and Testosterone
- Vitamin B-12
- GLP-1
- Leptin
- Ghrelin
- Insulin
- Cortisol
- CCK
So, what can be done about these?
Some can be modified by diet and exercise, some by simply checking the levels and replacing them, and some are modified by weight loss medications and surgery.
Thyroid Hormones:
Among other jobs, the thyroid is responsible for your metabolism. If you have a poorly functioning thyroid, you will gain weight, or a the very least have difficulty losing it.
We will check your thyroid hormone level and make recommendations for replacing low levels.
Estrogen and Testosterone:
Estrogen and Testosterone are sex hormones responsible for regulating the female and male reproductive systems, as well as the immune, skeletal, and vascular systems. Levels of these hormone change during life stages such as pregnancy, nursing, menopause, and aging. Low levels may affect body weight and body fat. Individuals with low estrogen and testosterone levels often experience central obesity, which is an accumulation of weight around the trunk of the body. This can lead to other health problems, such as high blood sugar, high blood pressure, and heart disease.
We will check your hormone levels and recommend replacements as indicated.
Vitamin B-12:
Vitamin B-12 deficiency can lead to fatigue, irritability, and weight gain.
We will check your levels and recommend replacements as indicated to help you boost your energy and weight loss ability.
GLP-1:
GLP-1 (glucagon-like peptide 1) is a hormone produced in your gut when nutrients enter your intestines. It plays a major role in keeping blood sugar level stable and making you feel full. Research suggests that people with obesity may have problems with GLP-1 signaling.
The new medications like Wegovy, Ozempic, and Mounjaro work to modify this hormone.
Leptin:
Leptin is a fullness hormone that works by telling the portion of your brain that regulates appetite that you’re full. However, people with obesity have leptin resistence. This means the message to stop eating doesn’t reach your brain, eventually causing you to overeat. In turn, your body may produce even more leptin until your levels become elevated.
The only known intervention to decrease Leptin resistence is bariatric surgery. Leptin supplements have not been shown to affect weight loss.
Ghrelin:
Ghrelin is essentially the opposite of leptin. It’s the hunger hormone that sends a message to your brain indicating that your stomach is empty and needs food. Its main function is to increase appetite. Normally,ghrelin levels are highest before eating and lowest after a meal. Curiously, research indicates that people with obesity have low ghrelin levels but are more sensitive to its effects. This sensitivity may lead to overeating.
The only known intervention to modulate ghrelin is bariatric surgery, specifically sleeve gastrectomy. That’s thought to be one of the main components contributing to weight loss after surgery: people don’t have the munchies and don’t get that hungry feeling like they used to.
Insulin:
Insulin, the main storage hormone in your body, is produced by your pancreas. In healthy individuals, insulin promotes the storage of glucose — a simple sugar you get from food — in the muscle, liver, and fat cells for later use. Your body secretes insulin in small amounts throughout the day and in larger amounts after meals. This hormone then transfers glucose from food into your cells for either energy or storage, depending on your body’s current needs. Insulin resistence is a fairly common condition that causes your cells to stop responding to insulin. This condition results in high blood sugar because the insulin cannot move glucose into your cells. Your pancreas then produces even more insulin in an attempt to boost glucose absorption. Insulin resistance has been linked to obesity, which in turn can play a role in other conditions, such as type 2 diabetes and heart disease.
To improve insulin sensitivity, you should exercise regularly, focus on low-glycemic carbs, and get more sleep. Bariatric surgery also has a dominant effect on insulin resistence, helping restire the body’s natural balance and insulin sensitivity.
Cortisol:
Cortisol is known as the stress hormone and is produced by your adrenal glands. During times of stress, this hormone triggers an increase in heart rate and energy levels. The release of cortisol — alongside the hormone adrenaline — is commonly called the “fight or flight” response. While it’s important for your to body release cortisol in dangerous situations, chronic high levels may lead to many health issues, including heart disease, diabetes, low energy levels, high blood pressure, sleep disturbances, and weight gain. Certain lifestyle factors like poor sleep habits, chronic stress, and a high intake of high glycemic foods contribute to high cortisol levels. Not only does obesity raise cortisol levels, but high levels may also cause weight gain, creating a negative feedback loop.
To improve cortisol levels, get better sleep, incorporate stress-reducing routines like mindfulness, and exercise regularly.
CCK:
Like GLP-1, CCK is a fullness hormone produced by cells in your gut after a meal. It’s important for energy production, protein synthesis, dugestion, and other bodily functions. It also increases the release of the fullness hormone leptin. People with obesity may have a reduced sensitivity to CCK’s effects, which may lead to chronic overeating. In turn, this may further reduce CCK sensitivity, creating a negative feedback loop.
To improve CCK sensitivity, you should exercise regularly, focus on low-glycemic carbs, and eat more protein.
Ainsley Freshour, MD, FACS, DABS
Robotic, Minimally Invasive, and Bariatric Surgeon
Board Certified General Surgeon and Surgical Intensivist
