Dieting and Exercising but Not Losing Weight? It May Be Due to Hormones

" Obesity " is not just about body shape but is also linked to chronic illnesses such as diabetes, high blood pressure, high cholesterol, and heart disease. Many people try seriously to lose weight by controlling their diet, exercising, or using various aids, but they find that " their weight does not decrease " or " it goes back up after losing ". One often overlooked cause is hormonal obesity, a biological factor that makes losing weight harder than usual because it requires in-depth evaluation by specialists.

What is hormonal obesity?

Hormonal obesity is a condition where an imbalance of hormones in the body affects metabolism, hunger, satiety, and fat storage, causing weight gain or difficulty controlling weight despite efforts to change behavior.

Hormones act as the body's "system controllers." If this system is out of sync, the results are not only weight gain but also symptoms like fatigue, insomnia, mood swings, or irregular menstrual cycles.

Which hormones are related to obesity?

1. Insulin (Insulin)
Insulin regulates blood sugar levels. Insulin resistance triggers fat accumulation, especially around the abdomen.

2. Thyroid Hormone
Hypothyroidism lowers metabolism, making weight gain easier, causing fatigue, dry skin, and sensitivity to cold.

3. Cortisol
Chronic high stress hormone levels cause abdominal fat buildup and increase appetite.

4. Female sex hormones (Estrogen / Progesterone)
In women with estrogen deficiency or menopause, hormonal changes lead to increased fat, especially abdominal fat.

5. Leptin
Leptin controls satiety. If the body is resistant to or lacks leptin, frequent hunger occurs, making food intake harder to control.

Warning signs that may indicate "hormonal obesity"

If several symptoms occur together, medical evaluation is advised. It should not be simply attributed to aging or slow metabolism alone.

• Rapid weight gain without increased food intake
• Localized fat accumulation, especially abdominal fat
• A round, flushed face, stretch marks mainly on the abdomen, upper arms, and thighs, often with a purplish color
• Chronic fatigue and easy tiredness
• Irregular menstrual cycles or difficulty conceiving
• Failure to lose weight despite strict dietary control

Diagnosing hormonal obesity

Assessment involves more than weighing or calculating body mass index (BMI); it includes

• reviewing eating habits, sleep, exercise, and stress history
• a detailed physical examination
• blood tests evaluating hormone levels, blood sugar, lipids, and related endocrine diseases

Treatment approaches for hormonal obesity

Treatment depends on the true underlying cause, including

• medically indicated hormone balance adjustments
• personalized nutrition planning
• exercise planning and monitoring body composition—weight, fat, and muscle
• adjusting sleep habits and stress management
• medication when indicated
• considering gastrointestinal procedures such as endoscopygastric suturing or balloon insertionfor eligible patients
• bariatric surgery if behavior changes and other methods fail

Why are modern workers at risk of hormone-related obesity?

Current lifestyle behaviors—such as staying up late, prolonged screen time, accumulated stress, irregular meals, frequent coffee or sugary drinks—affect cortisol, insulin, and melatonin hormones, disrupting metabolism unknowingly. Therefore, weight management must consider the whole body's system, not just calorie counts.

If weight loss efforts fail, it may not be due to a lack of trying.

Hormonal obesity is a medical factor requiring proper evaluation. If you have tried diet control, exercise, or other methods without success, don't blame yourself. In-depth evaluation with a specialist medical team can reveal the true cause and help plan safe, appropriate, and sustainable treatment.

Correct weight loss is not only about better appearance but also about disease prevention and improving long-term quality of life. If you suspect hormonal obesity, consult a specialist for personalized advice.

Information by : Dr. ChompoonuchSakjirapapong, Internal Medicine Specialistspecializing indiabetes, endocrinology, and metabolism(W.50212), Diabetes, Thyroid, and Endocrine Center, Phyathai 2 Hospital