Weight loss is not as easy as cutting calories and increasing exercise. Certainly, increasing your activity level and prioritizing a healthy diet is important. After all, my passion is FOOD AS MEDICINE! But time and time again I see women struggle with weight loss, despite working out at the gym daily and eating clean. That is because hormone imbalance MUST be addressed to achieve sustainable, long-term results. Everything about human metabolism, including weight, is regulated by hormones.

Here are 4 hormones that contribute to weight gain/weight loss resistance:

1.Insulin. Insulin causes obesity. Insulin is secreted when we eat, notably when we eat carbs and sugar. Insulin promotes fat storage. It also inhibits leptin, our satiety hormone. So as we eat carbs and sugar, we store them as fat and never feel full…thus weight gain!

Lab test: Fasting serum insulin. Goal is below 10.

To reduce insulin:

• Intermittent Fasting
• Avoid snacking! Aim to eat 2-3 solid meals per day. Grazing is not healthy. It’s ok to skip breakfast some days in order to get that prolonged overnight fast (ie. intermittent fasting- see above).
• Reduce carbohydrates in the form of flour, bread, pasta, corn, tortillas, potatoes, sugar, cookies, pastries, white rice, bagels.
• Aim to eat at least 6 cups vegetables daily. Vegetables are high in fiber, which reduces the insulin-stimulating effects of carbohydrates. Best vegetables are low glycemic vegetables- greens (kale, spinach, collards, chard, arugula), string beans, zucchini, celery, cucumbers, broccoli, cauliflower, cabbage, bok choy,mushrooms, Brussel sprouts, asparagus, peppers.
• Minimize fruit. Best fruit is berries.
• Limit alcohol to 4 drinks per week.
• Eat protein and fat at every meal to stabilize blood sugar and thus reduce surges of insulin.

2.Cortisol. Cortisol is our stress- hormone. Under acute situations (ie. running from the saber tooth tiger), we produce a lot of cortisol to prepare our bodies for action. Cortisol causes a release in glucose (sugar), which is necessary for our muscles to flee the predator. With physical exertion (running from the predator), we can burn off that glucose.

But with long-term stress, such as marital stress, job stress, or financial stress, blood sugar remains elevated because these modern-day stressors do not result in physical activity. Therefore, we get a constant release of insulin, leading to insulin resistance. This we know results in fat storage.

Excessive production of cortisol leads to weight gain especially in the midsection. It also leads to insomnia. See here for why insomnia is causing you to gain weight.

Lab test: Cortisol is best assessed via the saliva. We offer a salivary Adrenal Stress Index test at Lakeside which accurately measures cortisol along with other stress hormones.

To reduce cortisol:

• Meditation
• Eliminate coffee. Or if you must, limit to 1 cup/day.
• Yoga
• Adaptogenic herbs, such as rhodiola and ashwagandha
• Seriphos (phosphorylated serine)- an amino acid that effectively reduces cortisol

3.Estrogen. Ever notice men can lose weight much easier?! That’s because women have estrogen, and in a state of estrogen dominance it is very difficult to lose weight. Estrogen dominance leads to weight gain notably in the hips and midsection. The goal is to balance estrogen with progesterone. Progesterone is the counter hormone to estrogen. An overall decline in progesterone allows estrogen to go unopposed. There must be a balance when it comes to these two hormones.

Lab test: Estrogen and progesterone are best assessed via the saliva. Saliva testing looks at the “unbound hormone levels” also known as “free fraction hormone levels” which are the hormone levels that are available to be used by the body’s tissues. In other words, it tests the most active hormones as compared to serum testing which tests “bound” or inactive hormones.

To address estrogen dominance:

• Eat organic, especially when it comes to meat. Conventionally raised meat is a common source of exogenous estrogen (ie. estrogen you got from the environment). If you are going to eat meat, always choose organic. Conventional meat contains steroid hormones, PCBs and dioxins. PCBs and dioxins are synthetic chemicals that act as xenoestrogens (or fake estrogens).
• Decrease exposure to xenoestrogens by wearing and using safe products free of hormone disruptors such as parabens and pthalates.
• Green tea. Aim for 2-3 cups/day. I love matcha green tea.
• Eat 2 cups of cruciferous vegetables (broccoli, cauliflower, cabbage, bok choy, kale, brussel sprouts) daily. If estrogen levels are elevated on testing, DIM may be indicated. DIM is a cruciferous vegetable extract.
• Avoid the pill. Here is why you should rethink the pill.
• Boost progesterone if indicated with bio0idetical progesterone cream or the herb, vitex (chaste tree berry).
• Liver support. Your liver clears and metabolizes hormones. In conditions where the cause is excess estrogen, incorporating liver supportive herbs such as milk thistle, burdock and artichoke results in achieving more balance.

4.Thyroid. One of the most common symptoms associated with hypothyroidism is weight gain or weight loss resistance. Other symptoms include hair loss, cold intolerance, dry skin, brittle hair, and fatigue.

Lab tests: TSH, Free T3, Free T4, and thyroid antibodies (TPO Abs and TG Abs). All too common women are told their thyroid is perfectly fine because their TSH is normal. TSH is an indirect marker of thyroid function. TSH may be normal but the other markers, Free T3 and Free T4, are abnormal. Free T3 is your active thyroid hormone (ie. keeps your metabolism up!). A low free T3 will result in weight gain.

To address hypothyroidism (low functioning thyroid):

• Gluten-free diet is a must! But don’t get suckered into all the gluten-free products out there on the market. Just because bread is gluten-free does NOT mean it is healthy. Bread is bread. And it will still spike an insulin response. Your best bet is to eliminate all breads and pastas.
• Brazil nuts-5/day.
• Armour or Nature-throid if indicated. Unlike Levothyroxine or Synthroid, these are prescription hormones that include T3 in addition to T4. Levothyroxine and Synthroid just contain T4 (inactive thyroid hormone).
• Address vitamin deficiencies that may be contributing to low thyroid- B12, Zinc, Selenium, Iron, Iodine, Tyrosine.
• Stress management! Meditation, exercise, massage. Self-care is a must!

Achieving a healthy weight is complicated but absolutely possible. You can do this! Our goal is to identify and address the underlying causes of your weight gain.

Editor’s Note: The information in this article is intended for your educational use only. Always seek the advice of your physician or other qualified health practitioners with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.