As Black women, controlling our weight may not always be as simple as watching what we eat and exercising more. And it can be even more challenging when we are told that we are obese. That means our body mass index (BMI) is 30 or higher. But sometimes, underlying factors like hormones could contribute to our conditions. Here’s what we should know.
There is some debate within our community about whether BMI is an appropriate assessment tool, especially for Black patients. One reason is it does not factor in individual body type or whether or not there is extra fat or muscle. It also doesn’t consider other important factors such as age, race, or gender. But the controversy surrounding BMI aside, obesity is a chronic condition many of us are living with.
Sometimes, even when we try dieting and exercising, this condition does not go away quickly. To better understand this concept, consider two siblings who grew up in the same environment. One eats sweets and junk food but can’t seem to gain weight, and the other is physically active and plays sports but can’t seem to lose weight. By societal standards, this shouldn’t be the case. But while environmental and genetic factors contribute to obesity, they don’t explain the entire story.
What Do Hormones Have to Do With It?
The fight is only sometimes against food. Hormones can strongly impact our ability to lose weight and maintain weight loss. Our brain regulates hunger by encouraging us to eat to store energy (which is why we feel hungry) and to feel full (so our bodies can burn energy). There are also some specific hormones related to other health conditions that can contribute to weight gain.
Dr. Holly Lofton, Clinical Associate Professor of Surgery and Medicine at the NYU Grossman School of Medicine, breaks down these specific hormones and how they may contribute to weight gain.
Thyroid Hormone
Hypothyroidism is an underlying condition that contributes to weight gain. This does not mean that someone with hypothyroidism can’t lose weight, but getting your thyroid levels treated with medication can treat the problem and no longer contribute to obesity. For any period you are not treated and thyroid levels are not regulated, you may be prone to weight gain.
Insulin
Insulin is a naturally occurring hormone produced by our bodies, and it can also be introduced to our bodies when taken as a medication. When our body produces too much insulin, insulin resistance can occur. Insulin resistance happens before prediabetes is recognized. The presence of excess insulin in the body can result in weight gain.
Cortisol
A small organ above the kidneys produces cortisol called the adrenal gland. It sounds similar to cortisone, which is a steroid. When someone has extra cortisol or takes steroids (cortisone or prednisone) for a medical condition, the size of the fat cells may increase and cause weight gain.
Estrogens
Estrogens are female hormones. Levels can fluctuate throughout different phases of life.
During menopause, estrogen levels can decrease and cause weight gain due to increased fat storage.
Some hormonal birth control methods can also lead to weight gain due to a change in the levels of female hormones in the body.
“Correcting the underlying issue may or may not result in weight loss,” Dr. Lofton says, “but it can be a good starting point and can help determine if medications may be needed, as they often are, to make fat cells smaller.”
Dr. Lofton recommends speaking with your provider or a hormone specialist about additional testing and further workup to rule out these conditions.
Make a Plan
Because obesity is a chronic condition, it should be treated as such. We wouldn’t tell someone with cancer or high blood pressure to wait it out before they seek treatment. Obesity is no different. If you think hormones may be a contributing factor for you, take these practical steps:
1. Collaborate with your healthcare team to develop a plan to manage obesity as a health condition.
2. Inquire whether blood tests to check your thyroid, insulin, cortisol, and estrogen levels may be appropriate.
3. Talk to your provider about all the weight management options available.
Supported by an educational grant from Novo Nordisk Inc.
