Being overweight and hormones: the warning signs you shouldn’t ignore
Gaining weight does not always depend on how much you eat or how much you exercise. Body weight is also governed by a system of hormonal signals, biological rhythms and nervous system mechanisms which, if disrupted, can lead to weight gain that is difficult to explain by diet alone. In such cases, an endocrinological assessment can help identify the real cause of the weight gain.
We spoke about this with Dr Carmela Asteria, an endocrinologist and head of the Endocrine-Metabolic Nutrition Centre (NutrEndo_Me) and scientific director of INCO (National Institute for the Treatment of Obesity) at the IRCCS Galeazzi-Sant’Ambrogio Hospital, which also collaborates with the Palazzo della Salute Wellness Clinic.
The role of hormones in weight control
Hormones are substances produced by the endocrine glands that regulate numerous bodily functions, including metabolism, feelings of hunger and satiety, body fat distribution and muscle mass.
When their balance is disrupted, even a healthy diet and regular physical activity may not produce the expected results.
Which hormones have the greatest impact
Among the main hormones involved in weight regulation are the thyroid hormones, which determine the basal metabolic rate. “If the thyroid is underactive, as in hypothyroidism, the metabolism slows down, which may lead to weight gain, tiredness and water retention,” explains Dr Asteria.
Cortisol, the stress hormone, can promote the accumulation of abdominal fat and the loss of muscle mass if it remains elevated for a long time.
Leptin and ghrelin regulate satiety and hunger respectively: if the signals they send to the brain are disrupted, appetite may increase without any real energy requirement.
Finally, the decline in oestrogen and testosterone associated with the menopause or andropause alters the distribution of body fat and reduces muscle mass.
The most common causes of hormone-related weight gain
One of the most common conditions is hypothyroidism, in which the thyroid gland does not produce enough hormones, thereby slowing down the metabolism.
Polycystic ovary syndrome is also very common, affecting many women of childbearing age and characterised by hormonal imbalances, irregular periods and infertility. “It can contribute to weight gain, but, in turn, being overweight can exacerbate it, creating a vicious circle,” emphasises Dr Asteria.
Type 2 diabetes and insulin resistance also promote the accumulation of visceral fat. Less common, but still possible, is Cushing’s syndrome, linked to excess cortisol caused by adrenal problems or prolonged use of corticosteroids, which causes weight gain to be concentrated on the face, abdomen and trunk.
When should you see an endocrinologist?
Being slightly overweight is not necessarily linked to hormonal imbalances, but certain signs warrant attention:
● persistent tiredness;
● bloating;
● difficulty losing weight despite a healthy lifestyle;
● irregular periods;
● sleep disturbances;
● reduced muscle strength.
However, the specialist emphasises: “Even those who have already been diagnosed with diabetes, hypothyroidism or polycystic ovary syndrome should have their hormone levels checked regularly”.
