Hormonal Imbalance, Muscle Loss Among Top Factors that Sabotage Weight Loss

The conventional method for weight loss uses a clear formula: eat less and burn more. But now we know that this oversimplified formula just isn't effective to lose weight for many people, as it's missing key pieces of the puzzle, including hormone health, gut function, and metabolic changes.

The human body is a dynamic and adaptive system. Weight loss efforts are much more complex than a list of measurements applied in a lab (that is, calories in vs. calories out). So if you’ve been going off of the diet-and-exercise formula with little to no success in actually losing weight, today we're going to discuss why, and how you can break through your weight loss plateau to get where you really want to be.

Learn more about functional medicine at CentreSpringMD: Weight management

Doing everything right, but not losing weight?

You're getting a workout in, watching what you eat, and hitting your daily step goals, but the needle isn't moving in terms of how you're feeling, how your clothes fit, or even the number on the scale.

If you've put all these healthy behaviors into place on your weight loss journey—great! It's a big piece of the puzzle, but it doesn't complete the strategy for your body's optimal path to weight loss.

Your environment, gut function, sleep habits, muscle mass, and so much more impact your body's metabolic rate and how you burn fat. Become aware of these lesser-known factors that hinder weight loss progress, or even stop it altogether, and then consider working with your doctor to develop a plan to overcome them.

Here's what a team of functional medicine doctors have to say about what's stopping you from losing weight.

1. Your gut health is interfering with weight loss

The balance of your gut bacteria is very strongly linked with obesity and metabolic disturbances. Patients often have undetected dysbiosis in their microbiome, SIBO, and unexplained weight gain. These same patients often complain of bloating and other digestive symptoms that don't seem to get better no matter what changes they've made to their diet or exercise routine.

Candida, or yeast overgrowth, can also cause weight gain by driving cravings, inflammation, and problems responding to insulin. This creates the perfect storm for weight gain, especially around the middle. Overall, even the cravings for carbohydrates or sugars alone can sabotage all efforts to lose weight and cause a real imbalance in the diet.

Every week, research discovers more about just how important your microbiome (the collection of bacteria in your gut) is for overall health. Now, we know that some prebiotics and probiotics may help prevent weight gain, and that people who are overweight or obese tend to have less diversity in their microbiome than those at a healthier weight (1). 

Related: How to Heal Leaky Gut in 3 Steps

2. You have estrogen dominance

For women, estrogen dominance happens when there is increased estrogen levels relative to progesterone levels, and it’s more common than you may think. For men, excess estrogen levels can occur as a result of xenoestrogens in the environment, a sedentary lifestyle, stress, poor sleep, and other factors.

Estrogen dominance, or excess estrogen in the body interferes with the function of your main metabolic hormone produced in your thyroid, making weight loss increasingly difficult (2).

Thyroid hormone controls calorie burning, for both men and women. It regulates overall energy, body temperature, and metabolic rate (calorie burning). Optimizing thyroid function is similar to turning up the furnace or tuning an engine—your body's metabolic system simply functions better.

Too much estrogen is antagonistic to thyroid hormone, which makes it much harder to shed unwanted pounds and more likely you'll gain weight. If you're consistent with healthy foods and exercise but still feeling fatigued and have trouble losing weight, speak with a provider about getting your thyroid levels tested.

Learn about becoming a new patient

3. You’re experiencing muscle loss

Muscle mass decreases 3 to 8 percent every decade after age 30, and accelerates with age for both men and women, according to research (3). This poses a big problem, as muscle burns more calories at rest than fat does, and at a significant margin.

Loss of lean muscle mass results in resting metabolic rate (RMR) reduction of 2 to 4 percent per decade (4). As much as 75% of your energy expenditure comes directly from your body’s RMR, so this means you’ll gradually require fewer and fewer calories to power your metabolism if you’re losing muscle (5).

As a result, someone who doesn’t participate in regular strength-training activities to build or maintain muscle can expect to gain between 5 and 10 pounds of body weight with each decade of life, purely because there’s now less lean muscle and more body fat (4).

Post-menopausal women are also more likely to gain body fat and need fewer calories. This is also due in part to natural changes in fat tissue that prompt the body to gain weight, according to an article published recently in Nature Medicine (6). 

Beware the low-calorie diet if you want to maintain lean muscle

Muscle loss also happens during times of calorie restriction (i.e. going on a diet). In fact, as much as 20-30% of weight loss through dieting is from muscle tissue (7).

This is a key reason why the majority of those who successfully lose weight initially manage to gain it all back once coming out of a calorie deficit.

Explore options for weight loss with the help of functional medicine.

How to build muscle while losing weight

According to research, there are 3 main components to keep in mind to lose fat and not muscle: Increase protein intake, don’t drop your calories too low, and strength train.

  • For men don’t drop calories lower than 1,500 – 1,800; and women no lower than 1,200 – 1,500 calories. 
  • Optimize protein intake at about 1.7 and up to 2.4 grams per kg of body weight (8).
  • Aim for a 40-minute workout (20 minutes of aerobic activity interspersed with 20 minutes of resistance exercise), 2-3 days per week.

Read: 8 Ways to Control Hunger Hormones with Functional Medicine

4. Your cortisol levels are too high

Elevated cortisol levels are associated with increased fat around the belly, which is often the one area most people wish to target when trying to lose weight. The biggest factor that ramps up cortisol production is nothing other than our good friend, chronic stress.

Researchers have also identified a stress-related protein known as betatrophin that makes it difficult to break down body fat and lose weight (9). 

Other reasons why stress makes it harder to lose weight:

  • Stress drives cravings for salty, sweet, and high-fat foods because they stimulate the brain to release pleasure chemicals that reduce tension. This soothing effect becomes highly addictive because it feels like it alleviates the stress (it does – but only in the very short term.
  • When someone is stressed they generally sleep less. Poor sleep and fatigue cause the hunger hormone, ghrelin, to rise even if you’re not legitimately hungry.
  • Stress makes it harder to control impulses and stick to a routine. Stress diminishes executive function in your brain’s prefrontal cortex, which is the part of your brain necessary for planning, controlling emotional reactions, and will power (10). With dysfunction in your PFC you might feel erratic, and be more likely to stray from your routine, leading to unhealthy decisions just to get by.

Conditions we treat: Adrenal Fatigue

Prioritize stress relief to decrease cortisol

Non-diet-related weight struggles most often have to do with lifestyle factors and chronic stress. Unresolved stress causes a plethora of downstream effects on hormones, gut function, sleep, and other foundational aspects necessary to get to a healthy weight.

Whether your goal is weight loss or not, a stress relief plan should be a priority as much as going to the gym, or even eating healthy. That means make time for daily mindfulness practices, have a nighttime routine that prepares you for adequate sleep, go to therapy, fit in activities you enjoy, and avoid habits that don’t. This also means learning to manage any stress associated with food and your relationship with your body. So while it’s perfectly fine to want to lose weight, simultaneously work on self-acceptance and stress relief so they’re not dependent on pant size or a number on the scale. 

For help designing the right nutrition plan for your individual needs, get started with Nutrition Counseling at CentreSpringMD

Functional medicine for weight loss

Losing weight is hard enough, but when you’re working against your body it can feel impossible. If you’ve been struggling to slim down, it may be time to look at some of the lesser-known barriers to weight loss like gut health, hormone imbalances, or muscle loss. Working with a qualified functional medicine doctor can help you figure out which factors are impacting your metabolic rate and create a plan to address them. Don’t go through this alone – reach out for help from a professional who understands the complex interplay of factors that affect weight loss.


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333005/ 
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3113168/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2804956/
  4. https://aahf.info/the-muscle-loss-and-weight-gain-connection   
  5. https://pubmed.ncbi.nlm.nih.gov/2691813 
  6. https://www.nature.com/articles/s41591-019-0565-5
  7. https://pubmed.ncbi.nlm.nih.gov/28507015/ 
  8. https://pubmed.ncbi.nlm.nih.gov/26817506/ 
  9. https://pubmed.ncbi.nlm.nih.gov/26569053/
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907136/


hormones, weight loss

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