Can a Hormonal Imbalance Cause Weight Gain?

Jenna Hilton
March 8, 2023

The endocrine glands release chemical substances called hormones into the bloodstream to deliver messages to cells, spurring them into action. Hormones help regulate various bodily functions, from sleep to glucose metabolism, and even slight imbalances in the system can affect our physical and mental health.  

This article explains how an imbalance in hormonal activity can contribute to weight gain and what to do to reverse the condition.

Hormonal weight gain caused by hormonal imbalance

What Is Hormonal Weight Gain?

Hormonal weight gain is an increase in bodily weight due to a hormonal imbalance.

A hormonal imbalance occurs when chronic or significant changes in the amount of one or more hormones prevent them from sending adequate signals to cells.

When such an imbalance occurs with hormones that regulate sleep, appetite, metabolism, and other bodily functions that affect weight, it becomes difficult to shed pounds with the usual lifestyle strategies – diet and exercise.

Signs of Hormonal Weight Gain?

The following signs can help you distinguish between weight gain from overeating and weight gain due to a hormonal imbalance.

  • Sudden weight gain despite no change in caloric intake or physical activity levels.
  • Difficulty losing weight with diet and exercise.
  • Fat accumulation around the abdomen.
  • Weight gain accompanied by other symptoms, such as fatigue, insomnia, low libido, hormonal acne, and thinning hair.

Note: Learn more about how gut health is affected by hormones.

What Causes Hormonal Weight Gain?

The primary triggers of a hormonal imbalance are natural life phases (e.g., puberty and pregnancy), a sedentary lifestyle, chronic stress, lack of sleep, and medical conditions (e.g., tumors, autoimmune disorders).

The following hormonal issues often lead to weight gain.

1. Insulin Resistance

The pancreas produces insulin to regulate blood sugar levels. Chronically high insulin levels lead to insulin resistance – the cell’s inability to respond to insulin, take glucose from the blood, and convert it into energy. This condition leads to higher blood sugar levels, increased insulin production (hyperinsulinemia), and accumulation of fat in the liver and adipose tissue.

Insulin interacts with other hormones in the body, several of which can affect insulin sensitivity, including cortisol, adrenaline (epinephrine), growth hormone, and estrogen.

Note: Learn how are insulin resistance and weight loss related.

2. High Cortisol

Adrenal glands produce cortisol in response to stress. Its main role is to quickly increase the amount of energy available to the body.

To do this, cortisol increases blood sugar levels by stimulating the production of glucose from non-carbohydrate sources. This means that blood sugar levels rise even without food intake. To further maintain high blood sugar levels, cortisol inhibits insulin secretion in the pancreas and reduces insulin sensitivity.

Chronically elevated cortisol levels increase appetite, promote fat storage, and interfere with sleep, indirectly leading to weight gain over time.

Note: Find out how to lower cortisol production naturally.

3. Estrogen Imbalance

Balanced estrogen levels support the healthy accumulation of fat to facilitate reproductive functions during a woman's child-bearing years. However, excess or low estrogen can lead to weight gain.

Women usually experience a decline in estrogen during perimenopause and menopause. Lower estrogen levels contribute to slower metabolism, reduced insulin sensitivity, and increased cravings for sweet and fatty foods.

On the other hand, excess estrogen enhances the activity of enzymes responsible for fat storage, leading to fat accumulation, increased appetite and cravings, inflammation, and reduced metabolic rate. High estrogen levels also disrupt other hormones in the body, such as insulin and thyroid hormones, in a vicious cycle of slow metabolism and weight gain.

Note: One of the areas that can be affected by hormonal weight gain are the knees. Learn about all possible causes of knee fat and how to get rid of it.

4. Declining Testosterone

Testosterone is the primary sex hormone in men, though women also produce it in small amounts. Testosterone promotes the growth of muscle tissue, leading to an increase in lean body mass and a reduction of body fat. It also increases the metabolic rate and improves insulin sensitivity.

As testosterone production in men declines with age, metabolism slows down and energy levels decrease. This leads to increasing fat accumulation, particularly in the abdominal region.

Note: Learn how testosterone therapy can stimulate weight loss.

5. Thyroid Hormone Deficiency

Thyroid hormones, triiodothyronine (T3) and thyroxine (T4), regulate the metabolism and digestive issues. When their levels are low, the metabolic rate slows down and energy levels decrease, resulting in reduced physical activity and fewer calories burned at rest.

Slower metabolism due to thyroid hormone deficiency also leads to a decrease in glucose uptake by the cells, causing increased blood glucose levels, insulin resistance, and consequent weight gain.

Low thyroid hormones also cause the liver to produce less of the protein that carries LDL (bad cholesterol) out of the bloodstream, resulting in high cholesterol and more fat accumulation in the body.

Finally, thyroid hormone deficiency can cause fluid retention and swelling, further contributing to weight gain.

6. Leptin Resistance

Leptin is primarily produced in adipocytes (fatty cells). Its role is to regulate the balance between food intake and energy use, ensuring we don’t eat more than we need by sending signals to the brain when the body has enough energy stores.

However, chronically elevated leptin levels inhibit the body’s response to these effects of leptin. Leptin resistance results in increased appetite, overeating, and lower energy expenditure because the brain doesn’t receive adequate satiety signals.

7. Polycystic Ovarian Syndrome (PCOS)

Polycystic ovarian syndrome is a hormonal disorder occurring in women of reproductive age. Patients with this condition often experience weight gain due to an imbalance in several hormones.

PCOS increases the production of androgens (male sex hormones), causing increased accumulation of abdominal fat and reduced muscle mass. The condition is also closely linked to insulin resistance and inflammation, which can bring about changes in the gut microbiome, leading to higher calorie absorption and reduced energy expenditure.

8. Growth Hormone Deficiency

Growth hormone (GH) regulates growth, metabolism, and body composition. Lowered production of the growth hormone causes a variety of symptoms, including weight gain.

GH stimulates the breakdown of stored fat and promotes the growth of lean muscle mass. Low levels impair the body’s ability to burn fat for energy and lead to a reduction in muscle mass and strength. This affects people’s ability to remain active, increasing body weight.

Growth hormone deficiency can also increase blood glucose levels and impair insulin sensitivity, resulting in increased appetite and fat storage.

9. Endometriosis

Endometriosis is a medical condition that stimulates the growth of endometrial tissue outside of the uterus. The tissue then often spreads to other pelvic organs and often envelops around the fallopian tubes and ovaries, leading to severe pain, especially during menstrual periods.

The most common symptoms of endometriosis include pain in the pelvic area, bloating and weight gain. The cause of the weight gain is due to high levels of estrogen and low levels of progesterone that accompany the disease. It is unknown whether the hormonal imbalance is a symptom or the cause of endometriosis. 

How Is Hormonal Weight Gain Diagnosed?

An endocrinologist or primary care physician will talk to a patient about their symptoms, examine their medical history, and perform the necessary tests. The tests may include blood and urine testing, ultrasound, X-ray scans, and pelvic exams.

After hormonal weight gain is established, doctors recommend adequate treatments.

Note: Fat gain caused by hormones often accumulates in the lower abdomen. Find out how to get rid of hormonal belly fat.

How to Treat Hormonal Weight Gain?

All hormone treatments require adopting healthier lifestyle habits, including:

  • Balanced nutrition
  • Regular exercise
  • At least seven hours of sleep at night
  • Reduced or no alcohol and nicotine
  • Avoiding stress

Besides these, medical professionals may recommend one of the following treatments:

1. Medication

Medical providers often recommend medications that suppress appetite, improve metabolism, regulate insulin levels, and stabilize blood sugar. Commonly used medications for hormonal weight loss include metformin, phentermine, topiramate, low-dose naltrexone, and semaglutide.

Note: Learn more about other effective products for weight loss.

2. Hormone Replacement Therapy

Hormone replacement therapy (HRP) is a medical treatment that helps relieve the symptoms of menopause in women and low testosterone levels in men.

Women usually receive estrogen, progesterone, or a combination of the two hormones in the form of tablets, skin patches, gels, creams, vaginal creams, or rings.

Men receive testosterone in the form of gels, patches, injections, or pellets.

Vibrant Vitality Clinic provides both female hormone replacement therapy and testosterone therapy for men. The HRT consultation costs $249 and includes a 45-minute evaluation, physical examination, blood draw, one 30-minute follow-up appointment, and a discussion of the medication options.

3. Medical Weight Loss Program

Medical weight loss is a medically supervised program for overweight and obese patients. The medical team creates a personalized approach for each patient according to their unique biological characteristics, medical condition, and hormonal activity. The program typically includes a customized nutrition plan, supplements, physical activity, counseling, and medication.

Vibrant Vitality Clinic offers several medical weight loss plans customized for each patient.

Note: Read our article on what a medically supervised weight loss program looks like.

4. Surgery

If a hormonal imbalance is caused by a thyroid gland disorder or a tumor, medical professionals may suggest surgery as a treatment option.

Note: Since slow metabolism can be a symptom of hormonal weight gain, combining the methods above with ways to improve metabolism can be beneficial. Learn how to increase metabolism for weight loss.

What Are the Risks of Untreated Hormonal Weight Gain?

If left untreated, hormonal weight gain may lead to severe and life-threatening medical issues, including:

  • Diabetes type 2
  • High cholesterol
  • High blood pressure
  • Cardiovascular diseases
  • Stroke
  • Sleep apnea
  • Cancer


Hormones naturally fluctuate every day, but long-term and significant changes in their levels may lead to weight gain and severe medical issues. Learn to recognize the symptoms of hormonal weight gain and seek medical help to restore your health.

Jenna Hilton
Jenna Hilton has been a practicing PA since 2009, specializing in Family, Internal Medicine and Medical Aesthetics. She attended Arizona State University where she received her Bachelor's Degree and graduated magna cum laude. She received her Master of Science degree in Physician Assistant Studies from A.T. Still University.

Jenna has been injecting neurotoxin and dermal filler since 2013. She received certification as a Master Injector in 2017 through Empire Medical in Los Angeles, California. She is currently working on a Fellowship Program in Anti-Aging and Regenerative Medicine through the American Academy of Anti-Aging Medicine. Her special interests include use of PLLA, Ablative/Non ablative skin resurfacing, PDO threads, hormone therapy and nutritional therapies to improve cellular regeneration and medically supervised weight loss.

Jenna Hilton believes in a multi-factorial approach, considering internal factors that accelerate aging and disease development. She always enjoys teaching. She co-founded Vibrant EDU courses at Vibrant Skin Bar and regularly performs one-on-one training with fellow injectors. She teaches Aesthetic and Advanced Injectable Courses at National Laser Institute. She has been named Preceptor of the Year and is an Adjunct Faculty Member at Midwestern University. She was born in Iowa, and lives with her husband and three children in Phoenix, AZ.

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