When a patient comes to you to inquire about unwanted weight gain, you likely have a detailed conversation about their lifestyle choices, including nutrition, stress management, sleep patterns and exercise routines.
But, have you considered their extra pounds may be due to a hormone imbalance? Since it’s not top-of-mind for most patients, a chat about how hormones affect our metabolism and weight should be considered.
When we manipulate, adjust or change the way we eat, how much we sleep we get, how we manage psychological stress and other lifestyle factors — it also influences how and when the body secretes hormones. In turn, these affect our appetite control, hunger response, satiety cues and weight control, according to an article in the Journal of Nutrition and Metabolism.
Patients already know the old adage to eat less and move more to reduce weight. Now, let’s help them go a layer deeper and understand how these approaches affect their hormone levels and functioning.
When the macronutrient density of a meal is low, the postprandial endocrine response activates, the hunger-triggering hormone ghrelin is released, and you feel less nourished and satiated than after enjoying a balanced, nutrient-dense meal. This can lead to overeating to simply try to feel full.
To suppress the release of ghrelin, a balance of fats, proteins and carbohydrates should be consumed. But, what if your patient has a hormone imbalance stemming from an endocrine system dysfunction? What if their body is producing too much grehlin, or at the wrong times?
A similar misfiring can happen when exercising. For a healthy, regulated individual, grehlin decreases during moderate to intense exercise sessions. But if something is inhibiting this process, or the body is producing too much grehlin, the benefits of regular exercise will likely be offset by hunger cues and extra caloric intake. This may lead to hormone-triggered unwanted weight gain.
Is your patient experiencing sleep disturbances? Again, this affects the circadian rhythm and the natural release of hormones. Leptin, the hormone that suppresses our appetite while we sleep and chooses how the body stores fats, get confused when sleep isn’t happening at the same time each evening, or is speckled with random wakefulness. Those who sleep for short spurts generally have low leptin levels, which may trigger hunger, and encourage midnight snacking.
Reassure patients that hormone levels can be tested. These results help guide a treatment plan, which may include hormone replacement therapy.
When our hormones are not regulated, the body can’t work optimally. Metabolism is impacted. Growth rates may shift. Sexual and reproduction functions change. This dysregulation (whether from poor lifestyle choices or inherent biological issues) can lead to medical conditions that nurture unwanted weight gain, according to Orlando Health.
If your patient is overweight and experiencing any of these conditions, they may be experiencing over or under-production of weight-related hormones.
This list is not exhaustive, but rather some of the most common conditions you may encounter with your weight loss-seeking patients. Testing hormone levels, and offering a treatment plan to regulate them, can not only assist the patient in their weight loss journey and management of food cravings, but also help better manage these medical conditions.
When it comes to looking closer at your patient’s possible weight gain cause, consider testing the following key hormones.
Cortisol: Secreted from the adrenal glands, cortisol is called the “stress hormone”. When cortisol levels spike due to too much negative stress in our lives it may trigger our appetite to rev up and lead to overeating.
Glucagon-like Peptide-1 (GLP-1): This hormone is produced in the gut while eating and tells your brain when your body is satiated. Low production can make it hard for patients to realize they are full. A diet of leafy green vegetables, proteins, probiotics and anti-inflammatory foods can help regulate this hormone.
Ghrelin: This hormone triggers our hunger cue. If our body releases it too often, or in higher-than-normal qualities, it can lead to overeating and weight gain.
Growth hormone: The pituitary gland in the brain produces growth hormone. It helps to manage our metabolism. Low levels of this hormone are common in obese people, according to BetterHealth.
Insulin: This hormone is produced by the pancreas and helps to stimulate glucose uptake from the blood to produce energy. When blood sugar levels are poorly regulated, patients may develop insulin resistance, metabolic syndrome or type 2 diabetes.
Leptin: This hormone lets our body know we are full. If the body is underproducing this hormone, it can lead to extra snacking or meals, which packs on the pounds. Leptin also affects our metabolism and body fat storage.
Neuropeptide Y (NPY): This is a hunger-stimulating hormone produced by the brain and nervous system. Patients enjoying a carb-heavy diet may have high levels of NPY. Educating them on dietary shifts to more protein and soluble fibers can help reduce their weight gain.
Peptide YY (PYY): This appetite-control hormone originates in the digestive system. High levels will prevent overeating and weight gain. If levels of PYY are low, recommend an increase in protein and fiber in the diet.
Sex hormones (estrogen and testosterone): These are linked to many illnesses ranging from sleep apnea, acne, blood clots and heart attacks to liver disease, stroke, breast cancer, low testosterone, menstrual cycle issues, unbalanced estrogen levels and gallbladder disease, according to OB/GYN Associates of Alabama.
Thyroid-stimulating hormones (TSH): This category of hormones can reveal issues with thyroid function including hypothyroidism or hyperthyroidism, autoimmune disorders and more related to weight regulation.
Once you determine your patient’s current hormone levels, use the test results to offer hormone replacement therapy, appetite management supplements, or a referral to a trusted healthcare provider who can assist with lifestyle shifts, such as a dietician, psychologist, sleep technologist, personal trainer, nutritionist or wellness coach.
Hormonal weight gain can be reversible if the patient is open to managing the underlying causes and illnesses that are triggering the unwanted pounds, according to Endocrinology Consultants, P.C. Adult & Pediatric Wellness Center. As an added incentive, the patient reduces their risk of acquiring new health conditions in the years ahead and enjoys the benefits of a balanced diet, healthy body weight, quality sleep, energizing movement and better health day-to-day.
Are you ready to move forward with testing? You can offer patients a simple blood test to get the insight you need to determine if their weight gain is hormonal.
Consider the following options:
Weight Loss Basic: CBC with Diff, Comprehensive Metabolic Panel, Lipid Panel and Thyroid Panel
Weight Loss Plus Panel: CBC with Diff, Comprehensive Metabolic Panel, Lipid Panel, Thyroid Panel and Insulin
Advanced Hormone Testing: There are 11 options with tests specific for males and females.
Sedimentation Rate (ESR): To monitor inflammatory disease severity
CRP, Inflammation: An indicator of inflammatory status
Ferritin: To evaluate iron metabolism, microcytic anemia and iron storage diseases
Fibrinogen: To detect increased or decreased fibrinogen concentration of acquired or congenital origin
If you have any questions regarding testing options, test kits or our process, please reach out. Access Medical Labs would like to become your premier health partner so you can provide results-driven weight management treatment options at your practice.