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What hormone imbalance makes you gain weight?

Hormone imbalances can lead to frustrating and unexplained weight gain. Several key hormones play a role in appetite, metabolism, and fat storage – if these hormones are out of balance, you may find it very difficult to lose weight.

What are hormones and how do they affect weight?

Hormones are chemical messengers produced by glands and released into the bloodstream. They travel throughout the body coordinating complex processes like growth, metabolism, reproduction, and appetite. Hormones work together in complex networks – if one hormone is out of balance, it can throw the whole system off.

Some of the key hormones that influence body weight and composition include:

  • Estrogen – the main female sex hormone
  • Progesterone – another female sex hormone
  • Testosterone – the main male sex hormone
  • Cortisol – the “stress hormone”
  • Insulin – regulates blood sugar levels
  • Leptin – influences feelings of fullness and hunger
  • Ghrelin – stimulates appetite
  • Thyroid hormones – control metabolic rate

When these hormones are balanced properly, they regulate appetite and support healthy metabolism. But when any of them are over- or underproduced, it can lead to weight gain or difficulty losing weight.

Estrogen dominance

Estrogen dominance is a condition where a woman has excessive levels of estrogen relative to progesterone. It is linked to:

  • Weight gain, especially around the hips and thighs
  • Bloating and water retention
  • Fibrocystic breasts
  • Heavy, irregular, or painful periods
  • Mood swings and irritability
  • Fatigue
  • Foggy thinking and memory lapses

Estrogen dominance can occur as a result of:

  • Exposure to xenoestrogens – substances that mimic estrogen, found in plastics, pesticides, growth hormones, and some cosmetics
  • Obesity – fat cells produce estrogen
  • Stress – leads to high cortisol which blocks progesterone
  • Pregnancy and breastfeeding
  • Perimenopause and menopause – progesterone levels drop
  • Use of estrogen-containing birth control pills

To treat estrogen dominance, work with your doctor to balance hormonal levels. Strategies may include:

  • Avoid xenoestrogens
  • Reduce stress and cortisol levels
  • Increase fiber to support estrogen excretion
  • Take supplements such as B vitamins, magnesium, and DIM
  • Prescription progesterone therapy

Low progesterone

Progesterone is essential for balancing the effects of estrogen in women. Low progesterone is linked to:

  • Weight gain, especially around the hips and thighs
  • Bloating and water retention
  • Heavy periods
  • Irregular cycles
  • Difficulty sleeping
  • Anxiety
  • Fuzzy thinking
  • Low libido

Progesterone levels may drop due to:

  • Anovulatory cycles – cycles where no egg is released
  • Perimenopause and menopause
  • Birth control pills – contain estrogen and progestin, not bioidentical progesterone
  • Excess estrogen
  • Chronic stress
  • PCOS – lack of ovulation leads to low progesterone
  • Pituitary or thyroid disorders

Treatment focuses on rebalancing hormones by:

  • Reducing estrogen if in excess
  • Bioidentical progesterone therapy
  • Adrenal support supplements
  • Stress management
  • Regulating blood sugar

Low testosterone in men

While testosterone is often associated with muscle mass and strength, it also influences metabolism and fat distribution. Low testosterone in men can lead to:

  • Weight gain, especially around the belly
  • Fatigue and low energy
  • Low strength and endurance
  • Muscle loss
  • Low libido
  • Erectile dysfunction
  • Depression
  • Irritability
  • Poor concentration

Testosterone levels decline naturally as men age. Other causes include:

  • Obesity
  • Type 2 diabetes
  • Metabolic syndrome
  • Pituitary disorders
  • Inflammatory conditions
  • Stress
  • Lack of sleep
  • Alcohol abuse
  • Opioid painkillers

Treatment involves lifestyle changes, weight loss if overweight, and possibly testosterone replacement therapy under a doctor’s supervision.

High cortisol

Cortisol is released in response to stress. Short-term, it mobilizes energy stores and has anti-inflammatory effects. But chronically high cortisol leads to:

  • Weight gain, especially around the face and neck
  • High blood sugar
  • High blood pressure
  • Muscle weakness
  • Fatigue
  • Insomnia
  • Anxiety
  • Depression

High cortisol can be caused by:

  • Chronic stress
  • Poor diet – especially sugar consumption
  • Lack of physical activity
  • Adrenal tumors
  • Cushing’s syndrome – rare disorder
  • Corticosteroid medications

Treatment involves stress management, diet changes to balance blood sugar, exercise, and reducing stimulation at night for better sleep.

Insulin resistance

Insulin is secreted by the pancreas to control blood sugar levels. Insulin resistance is when cells stop responding properly to insulin. This results in chronically high insulin levels, and the body redirects sugar into fat storage. Symptoms include:

  • Weight gain, especially around the belly
  • Fatigue after eating
  • Brain fog
  • Darkening skin patches
  • High blood sugar

Insulin resistance is linked to a diet high in refined carbs and sugar. Risk factors include:

  • Obesity, especially belly fat
  • Sedentary lifestyle
  • Family history
  • PCOS
  • High blood pressure
  • Elevated triglycerides

Treatment focuses on lifestyle changes – weight loss, exercise, stress reduction, and a low-glycemic diet.

Leptin resistance

Leptin is a hormone produced by fat cells that suppresses appetite. With leptin resistance, the brain stops responding to leptin’s signals. This leads to:

  • Increased appetite and overeating
  • Difficulty feeling full
  • Slowed metabolism
  • Fatigue
  • Sugar and carb cravings

Leptin resistance appears to be caused by obesity – extra fat cells overproduce leptin, leading to inflammation and resistance. Losing body fat can help restore leptin sensitivity.


Hypothyroidism is when the thyroid gland underproduces thyroid hormones T3 and T4. Symptoms include:

  • Weight gain or difficulty losing weight
  • Fatigue
  • Depression
  • Brain fog and memory problems
  • Hair loss
  • Muscle aches and weakness
  • Constipation
  • Cold intolerance

Hypothyroidism has several potential causes:

  • Hashimoto’s disease – autoimmune disorder
  • Thyroid surgery
  • Radiation treatment
  • Congenital hypothyroidism
  • Pituitary gland disorders
  • Pregnancy
  • Iodine deficiency
  • Inflammatory conditions

Treatment involves thyroid hormone replacement medication.

Polycystic ovarian syndrome (PCOS)

PCOS involves a hormonal imbalance of high testosterone and insulin, and irregular ovulation. Symptoms include:

  • Weight gain and obesity
  • Excess facial and body hair
  • Ovarian cysts
  • Irregular or absent periods
  • Acne
  • Hair loss
  • Darkening skin patches

PCOS has a strong genetic component, but lifestyle factors like obesity also play a role. Treatment centers on:

  • Weight loss through diet and exercise
  • Insulin-sensitizing drugs like metformin
  • Birth control pills to regulate cycles
  • Anti-androgen medications

Growth hormone deficiency

Growth hormone is produced by the pituitary gland and promotes growth in childhood. Later in life it helps regulate body composition. Deficiency leads to:

  • Weight gain, especially increased body fat
  • Muscle weakness
  • Fatigue
  • Mood changes
  • High cholesterol
  • Decreased bone density

It is usually caused by a pituitary tumor or injury. Treatment involves growth hormone injections to restore normal levels.

High prolactin

Prolactin is the hormone that enables breast milk production. Excessively high levels cause:

  • Weight gain
  • Headaches
  • Irregular periods and infertility
  • Galactorrhea – discharge from the breasts
  • Loss of libido

High prolactin may be caused by:

  • Pituitary tumors
  • Hypothyroidism
  • Chronic kidney disease
  • PCOS
  • Certain medications

Treatment involves addressing the underlying cause, and possibly medication to lower prolactin levels.


As you can see, several different hormone imbalances can contribute to frustrating weight gain and difficulty losing weight. The good news is that most hormone issues can be improved through lifestyle interventions like stress management, proper sleep, nutrition, and exercise. Working with your doctor can help identify hormone imbalances and tailor treatment to get your hormones back in sync.