Updated: Nov 20, 2020
A new year is upon us, and many people are dedicated to achieving their New Year’s resolution to lose their belly fat. But love handles aren't just unattractive; they can be a key indicator of a hormonal imbalance. Abdominal obesity is a health hazard and is more dangerous than carrying weight on the hips or thighs. Extra belly fat may be associated with one or more of the following hormonal imbalances:
Elevated testosterone and/or DHEA in women
Decreased testosterone in men
Estrogen dominance (progesterone insufficiency) in men and women
Adrenal dysfunction in both sexes
A successful program to get rid of this stubborn fat must address not only proper nutrition, exercise, and sleep, but also hormone imbalances.
Elevated androgens (testosterone and DHEA) in women are most often an early indicator of evolving or established insulin resistance. As the body begins to struggle with glucose metabolism, androgens become elevated and contribute to male pattern obesity - the “apple” shape, or belly fat, which many women struggle with as they age. Younger women with PCOS may also struggle with increased androgens and abdominal obesity. This abdominal obesity is especially dangerous as the adipose cells in this region are more insulin resistant, increasing the risk for developing heart disease and diabetes.
Male testosterone levels tend to taper off with aging, obesity and stress, but today men are experiencing testosterone decline much earlier in life. Low testosterone is associated with insulin resistance and with an increased risk of diabetes and metabolic syndrome. Research indicates that men with low testosterone are more likely to develop a rotund abdomen and other body fat. The good news? Researchers also found that testosterone replacement (when the patient is deficient) may prompt abdominal fat loss.
In males and females, abdominal fat cells increase the aromatization of testosterone into estrogen. As estrogen levels rise, so does the tendency to accumulate more abdominal fat, creating a vicious cycle of blood sugar dysregulation and hormone imbalance.
An additional hormonal factor in weight gain is cortisol; imbalanced levels (both high and low) can be contributory. Researchers at Yale University found that slender women who had high cortisol also had more abdominal fat. More results published in the Journal of Psychosomatic Medicine established a link between high cortisol and increased storage of abdominal fat. Low cortisol levels contribute to fatigue and cravings; however, stress likely impacts more than just cravings. The Journal Psychoneuroendocrinology reports that the combination of chronic stress and a high sugar/high fat diet is a more potent driver of visceral adiposity than diet alone. These findings support the hypothesis that cortisol secretion might represent a mechanism for the observed association between stress and abdominal fat distribution.
Weight loss is incredibly challenging for most people. While exercise, diet, and other lifestyle changes are essential components to any weight loss plan, imbalanced hormones may hinder your patients’ success. Testing for and addressing hormone imbalance provides the missing piece for many weight loss journeys.
Aschbacher K, et al. Chronic stress increases vulnerability to diet-related abdominal fat, oxidative stress, and metabolic risk. Psychoneuroendocrinology. Vol 46, Aug 2014: 14-22.
Bjorntorp P, et al. Obesity and cortisol. Nutrition. 2000 Oct;16(10):924-36.
Epel ES. et al.Stress and body shape: stress-induced cortisol secretion is consistently greater among women with central fat. Psychosom Med. 2000 Sept-Oct;62(5):623-32.
Grossmann M. Testosterone and glucose metabolism in men: current concepts and controversies. J Endocrinol. 2014 Jan 27; 220(3):R37-55.
Kelly DM, et al. Testosterone and obesity. Obes Rev. 2015 Jul; 16(7):581-606.
Moyer AE, et al. Stress-induced cortisol response and fat distribution in women. Obes Res. 1994 May; 2(3):255-62.
Yale News. Stress May Cause Excess Abdominal Fat in Otherwise Slender Women, Study Conducted at Yale Shows. Sept 22, 2000.