Factors That Contribute To Weight Gain, and Make Weight Loss Difficult

Are you in your late 30s or 40s and noticing a change in your metabolism? Has it become harder to maintain your weight, despite eating healthy foods? Or perhaps you’ve noticed the strategies you used in the past to lose weight are no longer working? I hear this time and time again in my practice. 

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This scenario is common as we enter the perimenopause years. Our hormones begin to change, and that affects metabolism and weight. I promise you that it isn’t a problem with willpower, you just need new strategies for weight loss. Those strategies include exploring what is going on with your hormones. 

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This article will dive into some of the common root causes of weight gain and help us to explain weight-loss resistance, especially in women. Keep reading to learn more about:

• The role of insulin resistance in weight gain and obesity
• The connection to metabolic syndrome 
• Other hormone balance issues that contribute

Stay tuned for Part 2 of this series, where we’ll talk more about inflammation and gut health in the context of weight loss. 

Let’s dive in! 

Insulin Resistance and Obesity

The first hormone I’ll discuss is insulin. Insulin is made in the pancreas and released in response to rising blood sugar (glucose), primarily after meals. Insulin has many jobs, but the main job is to help the sugar in the blood move inside the cells where it’s turned into energy. 

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Insulin resistance occurs when blood sugar levels are elevated over time, often from a high saturated fat diet, particularly a diet high in animal proteins, as well as a diet high in refined carbohydrates. But stress, and other factors like genetics and toxin exposure can increase insulin resistance too. Insulin production spikes to address the high sugar, but it’s often misunderstood that carbohydrates are the root cause of the problem.  The poor beautiful carbohydrate has had to take the blame for blood sugar rising even though elevated blood sugars are merely the symptom of insulin resistance.  When the cells become resistant to insulin signals over time, glucose tolerance decreases and our blood sugar levels begin to stay elevated. Insulin resistance symptoms and signs include:

• High blood sugar and high insulin (per blood tests)
• Poor metabolism and weight gain
• Inflammation
• Fatigue, especially after meals
• Metabolic syndrome, pre-diabetes, type 2 diabetes
• PCOS

In perimenopause, the system shifts a little toward insulin resistance or can exacerbate insulin resistance that was there previously, contributing to changes in body composition. 

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You might want to know how to lose weight with insulin resistance - addressing insulin resistance with a blood-sugar balancing diet such as the plant forward eating pattern I often recommend, adjusting exercise to include more strength training, and including insulin resistance supplements for weight loss is where to start. 

Metabolic Syndrome and Obesity

Insulin resistance leads to metabolic syndrome, which is a collection of symptoms that include:

• Elevated fasting blood glucose (over 100 mg/dL)

• Elevated triglycerides (over 150 mg/dL)

• Abdominal obesity (waist circumference over 35 inches for women)

• Low HDL (“good”) cholesterol (under 40mg/dL for women)

• Elevated blood pressure (130/85 mm Hg or higher)

If three or more of these criteria are met, metabolic syndrome is diagnosed. Conventional medicine often leads to medication to address lipids or blood pressure but doesn’t always address the underlying hormone imbalance with insulin. That’s where functional medicine shines. Instead of restricting your carbohydrates unnecessarily, functional medicine can empower you to fully understand what’s causing the decreased insulin sensitivity at the cellular level and personalize a diet and lifestyle plan to to improve sensitivity, decrease circulating levels of insulin and therefore blood sugar which eventually leads to improved fat loss, especially around the belly.

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If you have weight gain plus changes in these metabolic markers, the first step is addressing insulin resistance, which in many cases is entirely reversible with diet and lifestyle change. 

‍Hormone Balance Issues and Obesity

Balancing hormones for weight loss is the important place to begin. In addition to insulin, we will want to consider other hormones as root cause players in hormonal weight gain in order to pinpoint precisely what is going on. 

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For example, weight gain could relate to:

• Elevated cortisol, a primary stress hormone that signals the body to hold on to weight. Addressing this might require stress reduction and management strategies, and HPA-axis support. 

• Low testosterone, which may make it hard to build and maintain lean body mass compared to body fat. I discuss strategies for low testosterone here. 

• Hypothyroidism, or low thyroid hormone, slows down metabolism and is linked to weight gain or weight loss resistance. Here is some more information about Hashimoto’s, which is the common autoimmune form of hypothyroidism. 

There can certainly be other patterns, which is why it is so helpful to work with a functional medicine hormone expert for a full workup and guidance. When we treat the root cause with diet, lifestyle, and supplements to balance hormones, you may unlock positive changes in body composition without putting yourself through extreme measures. 

Learn more about my functional medicine approach to weight loss here, along with diet and lifestyle strategies here. Stay tuned for more on weight, gut health, and inflammation in Part 2 of this series. 

‍References:

1. Lebovitz H. E. (2001). Insulin resistance: definition and consequences. Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association, 109 Suppl 2, S135–S148. 
2. Samson, S. L., & Garber, A. J. (2014). Metabolic syndrome. Endocrinology and metabolism clinics of North America, 43(1), 1–23. 
3. Hewagalamulage, S. D., Lee, T. K., Clarke, I. J., & Henry, B. A. (2016). Stress, cortisol, and obesity: a role for cortisol responsiveness in identifying individuals prone to obesity. Domestic animal endocrinology, 56 Suppl, S112–S120. 
4. Sanyal, D., & Raychaudhuri, M. (2016). Hypothyroidism and obesity: An intriguing link. Indian journal of endocrinology and metabolism, 20(4), 554–557. 

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