Hormonal Update Volume 2 Number 8

Tipping the Scales - The Importance of Hormones in Weight Management 

Statistics show that nearly 100 million Americans, close to 55% of the adult U.S. population, are overweight. Forty million are considered obese and that number is increasing rapidly. Second only to tobacco related complications, health risks associated with excess weight are a leading cause of preventable death. Excessive weight can increase the risk of heart disease, type 2 diabetes, high blood pressure, gall bladder disease, sleep apnea, and breast cancer.

Women tend to have a higher incidence of obesity than men, with nearly half of all women in America overweight. One reason that women are more likely to be overweight than men may be that they are more prone to fluctuating hormone levels. For example, calorie and nutrient intake and energy expenditure are all affected by hormonal fluctuations. 

When hormone levels are balanced, your body functions well. When they are out of balance, or in decline, physical symptoms and discomforts can be the result. Weight gain can be one of those symptoms. In this Hormonal Update we take a look at how hormones play a role in helping the body maintain optimum weight. 

Metabolism - Your Energy Provider

Your metabolism supplies your body with the energy it needs. There are two phases of metabolism - converting food nutrients into substances the body can use, and then reconverting those substances into compounds that fuel cells with energy.

The efficiency of your metabolism, measured in calories, depends on your basal metabolic rate (BMR), which is based on the number of calories you burn when your body is at rest, how much you exercise, and your body’s lean muscle mass to fat ratio. The more lean mass you have in your body, the more calories you are likely to burn. Your thyroid hormones stimulate the consumption of oxygen by your cells, and help to regulate the metabolism of all the cells and tissues in your body. The hormone insulin, in conjunction with other hormone messengers, helps control blood sugar levels, regulate appetite and control calorie intake.

Your body has between 30 and 40 billion fat cells. The calories you don’t need, or use, for immediate energy are generally stored as fat. Interestingly, when you eat refined carbohydrates, candies, cookies and pastries, and flood your system with sugar very quickly, your brain sends a message to your pancreas to increase your insulin level. Because this onslaught of sugar is so readily available for use as energy, other messages are also sent throughout the body as well. One is “stop burning fat for fuel,” and another is “start storing all this excess sugar somewhere.” So the excess sugar gets stored as fat.

Unfortunately, there seems to be no limit to the amount of fat a body can store. Further complicating the situation, when the supply of energy gets low, the body craves more sugar. This can lead to a continual cycle of sugar high and lows, and insulin resistance, which can lead to obesity. One out of every four people in the U.S has some form of insulin resistance. 

Sex Steroid Hormones are Also Important

In an interrelated and very synchronistic way, sex steroid hormones also play a role in controlling and regulating your metabolism and blood sugar, your energy output, digestion, and the way your body stores or burns fat. Estrogen, for example, has a beneficial effect to your digestive system, enhances your sense of taste and smell, and increases your serotonin and endorphin production. Serotonin and norepinephrine are the neurotransmitters that help regulate appetite and mood.

Progesterone helps to regulate fluid and mineral balance in your body, blood sugar, and thyroid function. Many women who experience PMS or dramatic mood swings during perimenopause and menopause often have low or wildly fluctuating levels of progesterone. This can lead to food cravings, erratic eating and weight gain.

Testosterone is an androgen, or male hormone, produced in the testes in men, the ovaries in women, and the adrenal glands in both sexes. Women have lower androgen levels than men. However, new research is showing that androgens perform many very important functions in women. Testosterone can help build muscle and promote muscle tone, and may help increase your energy level. Muscles use more energy than fat. In fact, during rest, men tend to burn 10 to 20% more calories than women, simply because they have more muscle.

DHEA, another androgen, has been shown to increase energy levels, and help with both weight and stress management. DHEA has also been shown to decrease fat tissue, excess insulin, and food intake. By the time you reach the age of sixty or seventy, your DHEA level can be as little as 20% of what it was when you were younger.

Stress Hormones and Weight Gain

Most people have never heard of the hormone cortisol and yet new research is showing us that it may be a very important player in weight management and control. Cortisol, which is also produced by your adrenal glands, is commonly known as your “stress” hormone. It increases your energy and metabolism. One of cortisol’s roles is to help the body convert protein into necessary blood glucose. When there is extra glucose it is used to produce fat. New research is linking over production of cortisol with obesity and increased body fat storage. In addition, an imbalance between DHEA and cortisol can result in adrenal exhaustion. Adrenal exhaustion can lead to hypothyroidism, a lower metabolic rate, and weight gain.

Even though cortisol does help your body cope with stress, if you are under chronic stress your brain can “forget” to shut off cortisol production. When that happens excess cortisol can increase blood sugar production and stimulate fat deposits. This means you could gain weight, experience a severe loss of energy, and be at increased risk for heart disease. A recent study revealed that women who secrete higher levels of cortisol while under stress snack on high fat foods more often than women whose cortisol levels do not rise as high when subjected to the same stressors. 

Balanced Hormones and HRT

The aging process can bring with it a decline in your hormone levels, and changes in your physiology. Perimenopause and menopause have long been considered high-risk times for weight gain in women. It is not unusual for a woman to gain between two and five pounds during these hormonal transitions, with some women gaining even more. There is also a hormonally related redistribution of fat that occurs during perimenopause and menopause - a shift from peripheral to abdominal weight gain, which gives many menopausal women a more ‘apple shaped’ torso.

An apple may be good for you, but an apple figure with excess weight in the middle isn’t. The risk for heart disease rises eightfold for women with diabetes and this shape. The risk for heart disease goes up two and a half times for men with diabetes and the apple figure. Studies show that obesity and abdominal fat gain are related to low levels of sex hormone binding globulin (SHBG). Estrogen replacement increases the body’s production of SHBG.

Along with its many proven health benefits, hormone replacement therapy (HRT) can also help you with weight management. The most common reason women forgo hormone replacement therapy during perimenopause and menopause is a fear of weight gain. Numerous studies demonstrate that HRT does not increase weight. In fact, research shows that women on HRT gain less weight during menopause than women who are not taking replacement hormones.

By helping your body maintain balanced hormone levels, hormone replacement may prevent weight gain, encourage weight loss, and support your body’s insulin response, energy levels, and lipid profile. Topical, or transdermal, androgen supplementation has been shown to reduce abdominal fat, and overall body weight in postmenopausal women. And, HRT is not just for women. Men who were given oral DHEA daily for four weeks showed a 31% decrease in body fat and lowered cholesterol and LDL (low density lipoprotein) cholesterol levels. In animal studies, optimal DHEA levels increase lean body mass and energy production, and decrease fat. It may be premature to say unequivocally that androgen supplementation can help a person lose weight and build lean body mass, but initial studies suggest that might be true. 

Restoring hormone levels to a well-balanced physiologic level that is individually suited to you can help your body function the way it did when you were younger. A salivary assessment of hormone levels and monitoring of your HRT program can serve as an effective tool for managing midlife weight gain.