Where You Gain Fat Tells you A Lot About Your Hormones
Most people are concerned with being overweight but they pay little attention to WHERE the fat on their body is accumulating.
This is a huge mistake.
Because the location of the fat on your body can give you valuable information about what type of hormone imbalances that you have.
It works like this:
Certain hormones direct and dictate where your body is going to store fat.
Under normal circumstances, you may expect to have a generalized distribution of body fat all over your body as you gain weight.
But that's not what happens to most people.
Instead, they notice that the fat that they gain is unevenly distributed and often is in one area more than another.
Think of a woman who is gaining weight more in her butt and thighs as opposed to her abdomen (1).
Other women may gain weight primarily in their chest and so on.
This same concept applies to men as well but today we will be focusing more on women because they tend to be more affected.
Why does this information matter?
Because it gives you valuable information on your hormone levels.
Certain hormone imbalances tend to result in weight and fat gain in certain tissues.
So you can look at your body and reverse engineer what type of hormone imbalances that you are struggling with.
This is a very valuable tool to you because it can help direct the type of treatments that you undergo and/or the type of hormones that you may want to consider taking.
Many doctors, especially the so-called "hormone" experts such as endocrinologists, don't take hormone imbalances seriously and may not even be able to help interpret your hormone levels.
Using this body fat hormone guide you can get a much better idea of what type of hormone imbalances you are struggling with which can ultimately help you lose weight and normalize your body.
You will find this information particularly helpful if you are someone who is trying to lose weight with calorie restriction but still find that you have some stubborn areas that don't seem to get better.
Body Fat Hormone Guide:
A couple of things before we jump in...
#1. You need to realize that this is a generalized guide.
This information tends to be fairly accurate but it's not a complete substitute for getting your labs checked.
In addition, you should be aware that there can be a lot of overlap between hormone problems.
For instance, both cortisol and insulin can lead to belly fat and abdominal fat.
In order to completely get rid of your belly fat, you may need to address BOTH conditions.
#2. Most weight gain is driven by your hormones and NOT the calories that you consume.
Many people assume that the predominant cause of weight gain is related to calorie consumption.
Calories are important but more important is the source of those calories and how the food that you put into your mouth impacts your hormone levels.
Eating highly processed foods high in sugar is likely to result in insulin resistance which will lead to weight gain and that weight gain will likely be directed to the abdomen (2) because that's where people with insulin resistance tend to store their fat.
It's not the calories so much as it is the TYPE of calories that you are consuming.
Having said that, calories are still important and they shouldn't be completely ignored.
#3. It's still helpful to get your hormone levels TESTED.
This guide works best when it is combined with your serum hormone levels (or hormones tested via another route).
For purposes of this article and your body fat, here are the hormones that you will want to get your doctor to order for you:
- Free and total testosterone
- Serum estradiol
- Serum progesterone
- 8 AM serum cortisol
- Fasting serum insulin
- Fasting serum leptin
- TSH, Free T3, and Free T4
They aren't required, but they will be very helpful if you have them to look at as you go through this guide!
#4. Genetics still play a role and are still important.
At the end of the day, there may be aspects of your genetics that dictate where your body stores fat.
Or, more likely, your fat storage will be a product of a combination of both your genetics and hormone imbalances.
There may be some areas of stubborn fat that simply don't respond to hormone management because they are due to your genetics (3).
With all of this in mind, let's jump in:
Fat on the Upper Arms and/or Lower Legs
Do you find that your body fat tends to accumulate in your upper arms and or lower legs?
I'm talking about the bicep/tricep area of your arms and the calf area of your lower legs.
Fat in the lower legs (calves) and the upper arms (triceps/biceps) tends to be heavily influenced by your sex hormones, namely progesterone, estradiol/estrogen, and testosterone.
Fat in this area tends to be very stubborn and difficult to treat.
To make matters worse it can't be targeted, either.
For most people who have fat in these areas, fat loss here tends to occur last.
If you are someone who is 50 pounds overweight and you lose that weight, the extra fat that you have in your calves and upper arms will probably be the last area that you see weight loss occur.
You will see fat loss occur in your chest, abdomen, back, and upper legs before you see fat loss in this area.
I have had success in treating fat in this area using a hormone called hCG which stands for human chorionic gonadotropin.
hCG is a hormone that can be used to help regulate sex hormones including estrogen and progesterone imbalances and may help somewhat "target" fat in this area.
Using hCG is completely different from the hCG diet, by the way. I'm talking about using this hormone by itself as a weight loss therapy, usually combined with a whole foods diet and other treatments/medications/hormones.
Fat in this area probably has a strong genetic component which is why many people resort to liposuction to eliminate the fat after attempting healthy diet and exercise.
This may be an option for that stubborn genetic fat but it shouldn't be used unless you have FIRST tried to balance your sex hormones.
Abdominal or Belly fat
Fat in the abdomen and or/belly area is fairly straightforward and common.
Fat in this area is almost always related to either one or both of these hormone imbalances:
Insulin resistance or cortisol dysfunction (or an adrenal problem).
Concentrated belly fat is actually a good thing because it's fairly easy to treat this problem, especially when compared to some other areas that we will be talking about here.
If you are someone who is 20-25 pounds overweight and 80-90% of that fat is targeted in the belly area then there is a big chance that you have one or both of the hormone problems I mentioned above.
Insulin resistance and cortisol problems tend to come in a pair.
Insulin resistance comes from eating foods that are naturally high in refined and processed sugars including things like bread, pasta, pastries, sugary sweets, and so on.
Because the average American consumes way too much of these types of foods, insulin resistance is found in up to 50% of the population (4).
So if you are reading this then there's a good chance you have at least a minor issue with insulin resistance.
Cortisol issues, on the other hand, tend to come from stress.
If you are like most people then you are probably under a low amount of constant stress.
A little bit of stress is good and can rev up your body. But too much stress can lead to cortisol issues which can exacerbate insulin resistance and lead to weight gain in the belly all by itself.
But often these two hormone imbalances are seen together because stress leads to insulin resistance and things that are stressful tend to cause poor eating habits.
Things like not sleeping enough or relying on coffee as energy can reduce willpower and lead to snacking on unhealthy foods which are high in sugar.
The good news is that treating cortisol and insulin resistance is typically not that difficult.
Insulin resistance, on the other hand, can be treated with diet (low carb, ketogenic, carnivore, etc.), supplements (such as berberine, alpha lipoic acid, glucomannan, fish oil, etc.), medications (such as Victoza, metformin, Saxenda, and acarbose).
There really aren't very good prescription medications that will treat a high cortisol level but you can use supplements such as phosphatidylserine to help in that area.
Fat in the Trunk and Neck Area
Fat in the trunk and neck area is almost exclusively caused by problems with cortisol.
If you aren't familiar with the terminology of truncal obesity (5), it refers to fat that is localized in your chest, abdomen/belly, and back area, pretty much anywhere on your trunk that isn't your arms and legs.
And by the neck, I am really referring to weight gain in the back of the neck area. This is sometimes referred to as a buffalo hump if it gets big enough.
Fat in either of these areas is usually caused by cortisol issues.
But in this case, the cortisol issue causing this type of obesity is a bigger issue compared to the cortisol that causes abdominal fat.
The type of cortisol issue that causes abdominal fat is minor and may not even cause problems in your serum cortisol level.
This type of cortisol problem is usually referred to as adrenal fatigue because there are issues in how cortisol is being used by the body but that problem is typically not manifested as big changes in your serum lab level.
Those people who have truncal obesity and fat in the neck area typically have a sufficiently big enough problem with cortisol that their serum cortisol level is marked or flagged as high when it is tested.
This sort of fat accumulation may be a precursor to medical conditions such as Cushing Disease (6) and may indicate that you have a bigger or more serious problem that needs to be evaluated.
Because of this, fat in this area is not quite as common as some of the other areas we will be discussing.
Decreased Muscle Mass or Inability to Build Muscle Mass
I know we've spent time talking about body fat but it's almost important to consider your muscle mass.
Body fat and muscle mass really go hand in hand with one another because both of these tissues compete with each other for your calories.
Think of it like this:
If your fat is winning then your calories will be going into your fat cells which makes them bigger. At the same time, they may be taking calories away from your muscles which may cause them to shrink slightly.
If your muscles are winning then your calories will be burned up by your muscle tissues as a source of energy and more fat will be burned up instead of stored so your fat cells will shrink in this process.
As someone listening to this, you pretty much always want your muscles to win in this war for calories because it means you will be losing weight!
For this reason, we actually care about your muscle mass.
There are a lot of women who struggle with the ability to BUILD muscle mass even while regularly going to the gym, lifting weights, or exercising.
These women often suffer from decreased muscle mass or the inability to build muscle mass and this very problem is usually an indication that you have an issue with testosterone.
Low testosterone levels, in both men and women, cause this very issue.
Many women suffer from low testosterone so this hormone should never be neglected!
If you recall, I mentioned in the beginning that low testosterone may lead to fat on the upper arms and or lower legs.
Fat accumulation in that area tends to be due to a combination of problems in all 3 of the hormones listed there, namely estrogen, progesterone, and testosterone.
Issues with building muscle mass tend to be an isolated hormone imbalance where your estrogen and progesterone may be fine but your testosterone is lower than it should be.
So keep that in mind as you evaluate your hormones.
You can treat low testosterone with the use of bio-identical testosterone replacement.
And yes, women can safely use testosterone as well!
TRT (testosterone replacement therapy) in women is fairly easy but the doses used in women are typically much smaller than those doses used in men.
TRT works quickly to elevate your testosterone level so many people see results in 1-2 months.
Whole Body Fat (generalized fat evenly distributed across your entire body)
By whole body fat what I mean is that you have a relatively even distribution among all areas of your body when you gain weight.
This means your fat is distributed somewhat evenly in your chest, abdomen, butt, back, legs, arms, etc.
With this sort of weight gain you really just see an outward expansion of your entire body as you gain weight everywhere.
This type of fat gain is fairly common and tends to be caused by 2 major players:
#1. Thyroid problems.
And #2. Leptin resistance or leptin issues.
Because your thyroid controls and regulates your metabolism (well, about 60% of it) if you have thyroid problems then you will see a generalized decrease in your metabolism.
This reduction in metabolism will typically lead to weight gain all over.
Thyroid problems typically do NOT cause weight gain in specific areas for this reason.
The other hormone listed here, leptin, is very important as it relates to weight gain.
In my experience, leptin is probably one of the most important hormones for managing your weight and may be a driver of weight gain in most people.
Think of it this way:
If you are overweight and unable to lose weight then you have a leptin problem.
Leptin resistance, the flavor of hormone imbalance that this hormone comes in, reduces your body's ability to burn fat and tends to cause generalized weight gain over your entire body, much like thyroid problems.
What can be confusing, though, is that it's fairly uncommon for someone to JUST have leptin problems.
In other words, if you are overweight for any reason or from any hormone imbalance, this weight gain will be associated with leptin resistance plus whatever hormone imbalance you are struggling with.
To make things even more confusing, thyroid problems can lead to estrogen/progesterone/insulin issues and it can even make leptin resistance worse.
Here's a fairly typical scenario:
Imagine that you start out with a thyroid problem (low thyroid) that leads to a generalized weight gain of 10 to 15 pounds.
This weight gain will be fairly generalized over your entire body and evenly distributed.
But, after about 6-12 months, your thyroid then causes estrogen and progesterone imbalances that lead to weight gain in your upper arms and lower legs.
Even though you first started with a thyroid problem, your hormone problem evolved over time and which led to changes in your body fat distribution.
This sort of thing is very common, by the way.
For these reasons, if you find that your situation is confusing, it would probably be a good idea to get ALL of your hormones tested so you can tease out the major players contributing to your weight gain.
Fat in the Thighs/Butt/Gluteal/Breast Region
If you are struggling with weight and fat gain in the thighs, butt, and breast region then your problem is almost always caused by an increase in estrogen.
Estrogen is probably one of the most important hormones found in women.
It is responsible for softening a woman's skin (10), for providing subcutaneous fat in the face which gives the face a round attractive appearance, it's responsible for the development of the butt and breast area, and much more.
But these things only happen if estrogen is balanced.
Things can go wrong in a hurry when you have too much estrogen.
Because estrogen stimulates fat tissue and can cause certain fat cells to grow, too much estrogen causes certain estrogen sensitive tissues to grow more rapidly than others that don't have as many estrogen receptors.
In women, excess estrogen usually results in the growth of the breasts (think of what happens during your menstrual cycle or during pregnancy), in the butt region, and in the thighs.
Excess estrogen, known as estrogen dominance, can lead to rapid growth of these areas and result in body fat physiques such as the pear shape.
Estrogen dominance refers to a syndrome in which your body is being overstimulated by too much estrogen.
And this syndrome is quite common.
Foods, hormones, medications, and chemicals all can have an estrogenic effect and may tip the balance in favor of too much estrogen in your body.
Compounds that do this are referred to as estrogenic or xenoestrogens (11) and they should be avoided if you are a woman.
You can also get excess estrogen in a roundabout way, through low levels of progesterone.
Estrogen and progesterone are meant to balance one another so if you are too little progesterone, with even normal amounts of estrogen, this creates a relative estrogen dominance syndrome which can lead to the body fat accumulation noted above.
Managing estrogen dominance is possible and can be done by finding the source of excess estrogen in your body.
For some that may mean losing weight and eliminating foods that have estrogenic activity.
For others that may mean using bio-identical progesterone to balance their estrogen levels.
Rapid Weight fluctuations Up and Down over a Short Period of Time
Lastly, we need to talk about weight fluctuations.
Weight fluctuations are important because they impact your weight but they typically do NOT impact your fat mass!
Pretty much everything we've discussed today impacts your weight but I haven't really focused on fat mass specifically.
Most hormones DO impact your fat mass which impacts your weight.
But there are some people who experience weight fluctuations that are unrelated to their fat mass and are instead related to something else, usually water weight from hormone imbalances.
As an example, there are many people who will reach out to me and tell me that their weight goes up and down by 5 pounds or more within a few days or even in one single day.
This type of rapid weight gain is almost ALWAYS related to fluid shifts in the body.
Fluid shifts because your body is holding on to more water and that water is staying as bloating or because you are holding onto more water because of something like constipation.
It's almost impossible for a shift in 5 pounds in a single day to be related to an increase in fat mass.
What can cause this sort of rapid shift?
A few different things can but when it comes to hormones there is one that is often responsible for such rapid weight gain and that's progesterone.
One of the effects of progesterone is to act as a diuretic which helps your body eliminate extra fluid.
Changes in your progesterone level can, therefore, impact fluid levels in your body.
Progesterone is one reason why you can fluctuate several pounds during your menstrual cycle!
It's not an actual gain of fat mass but instead retention of fluid and water.
How to Get Target Fat On your Body
For the most part, it isn't really possible to target areas of fat on your body.
The idea of going more crunches to "burn" belly fat is definitely not going to work.
Having said that, it may be possible to indirectly target these areas by focusing on your hormones.
Typically, when done correctly, balancing your hormones leads to fat loss in the entire body with a more targeted effect on certain areas depending on whatever hormone imbalance you are targeting.
Always remember that your hormones are incredibly powerful and they serve an important purpose in your body.
These hormones help to regulate your metabolism, your muscle mass, where your body stores fat, how your body processes sugar and nutrients, they send signals to your brain to automatically adjust caloric burn, and much more.
This all assumes that your hormones are working as intended!
When you put extra stress on your body, when you consume foods that are processed and heavily manipulated for flavor and calories, when you fail to do essentials things such as ensure you are getting enough sleep, you will see a breakdown in how your hormones are intended to work.
When this happens, you will start to see extra weight gain in the areas that we've discussed here.
The best way to address these issues is with a knowledgeable doctor that can help guide you back to a balanced and normal state.
Using bio-identical hormones such as progesterone, testosterone, and thyroid hormone can help.
Some people may also find a benefit in adding prescription medications as well.
No matter what, though, you need to make sure you are taking care to control inputs such as sleep, stress, healthy eating, and exercise.
Now I want to hear from you:
Are you struggling with an abnormal pattern of weight gain?
What do you think your weight gain is telling you about your body or your hormones?
Have you had your hormones tested?
Are you taking any bio-identical hormones already?
Share your questions or comments below!
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