There are always some people who are trying very hard to control their weight, but they still can’t lose it. Obesity is a disease in itself, but it can also be a symptom of some diseases. When obesity remains out of control or is accompanied by other abnormalities, you should consider seeing your doctor to see if there are other causes.
The truth behind obesity
By regulating the secretion and action of hormones, endocrine system affect many physiological processes including metabolism, appetite, fat distribution and storage. Under normal circumstances, the body maintains a balance of hormones, but if certain hormones are produced too much or too little, disrupt this balance, will cause endocrine disorders, and then related symptoms. Below, we introduce several common changes caused by abnormal hormone obesity.
Insulin resistance
When the occurrence of insulin resistance, the body to stabilize blood sugar, will be compensated to secrete a lot of insulin. Excessive insulin can promote fat synthesis, inhibit fat decomposition, leading to fat accumulation in the body, weight growth.
Hypothyroidism
The effects of Thyroid hormone on metabolic rates are significant. When hypothyroidism occurs, the body appears to be“Slowed down” and energy expenditure is reduced. Even if the daily energy intake remains the same, the excess energy will be stored as fat due to reduced consumption, and over time can lead to obesity.
Hypercortisol
Cortisol can affect body weight through a variety of mechanisms. Long-term high cortisol levels promote gluconeogenesis in the liver, leading to elevated blood sugar. Cortisol also inhibits glucose uptake and utilization by peripheral tissues, especially muscle tissue. This metabolic disorder makes it easier for the body to store excess blood sugar as fat, which is preferentially stored in the abdomen, creating central obesity.
In addition, cortisol can act on the brain’s appetite regulation center, stimulate appetite, make people eat high-calorie, high-fat and high-sugar foods. Cortisol can act directly on adipocytes, promoting their proliferation and differentiation, increasing the number and volume of adipocytes, and inhibiting lipolysis, further leading to fat accumulation. High cortisol levels inhibit protein synthesis and promote protein breakdown, while a loss of muscle mass leads to a drop in metabolic rate. The body uses less energy at rest, and heat tends to accumulate in the body, cause weight gain.
Growth hormone disorder
Insufficient or excessive growth hormone can also affect carbohydrate, fat and protein metabolism. Insufficient or defective growth hormone can inhibit fat breakdown, cause insulin resistance, resulting in fat accumulation. Ghrelin deficiency may increase ghrelin levels, stimulate appetite, increase food intake, and lead to weight gain.
Hormone ‘messes’ with appetite
The hormones that affect appetite include leptin and ghrelin. Leptin, as a“Satiety signal soldier” secreted by adipocytes, normally acts on the hypothalamus, accurately transmitting the feeling of satiety, making people eat less. However, when there is an endocrine disruption, leptin resistance, the brain can not properly receive the signal of satiety, even if the body has sufficient energy reserves, it will continue to produce hunger, driving people to eat, lead to calorie intake far exceeding consumption.
Ghrelin is mainly secreted by endocrine cells in the gastric fundus mucosa. It is usually increased on an empty stomach and decreased after eating. However, when the rhythm of ghrelin secretion is abnormal, even in the non-fasting state, ghrelin levels will increase, making people feel hungry frequently, increasing the amount and frequency of eating. Over time, a lot of excess calories will be converted into fat, and ultimately lead to obesity.
Changes in sex hormones
Sex hormones mainly include estrogen and androgen. Estrogen has a shaping effect on the distribution of fat in women. During puberty, a woman’s estrogen levels rise, leading to a healthy build-up of fat on her hips, thighs and breasts, creating a typical pear-shaped body. By menopause, ovarian function decline, estrogen secretion sharply reduced, fat distribution will change significantly, from the original position to the abdominal accumulation, the formation of apple-shaped body.
In men, androgen helps maintain muscle mass and metabolic rate. When endocrine disruption occurs, androgen levels drop, and muscle protein production is limited, leading to a gradual loss of muscle mass and metabolic rate. At the same time, androgen on the regulation of fat metabolism weakened, reduced lipolysis, abdominal and other parts of the more prone to fat accumulation, and ultimately lead to obesity, especially central obesity.
Thus, endocrine disorders lead to obesity, which involves complex hormonal abnormalities. If the endocrine disorder is serious, should be timely medical treatment, under the guidance of doctors for drug treatment or other professional intervention.
Find the reason, one by one
If you’re still struggling to lose weight after eating right and exercising, see your endocrinologist for an overall evaluation to make weight loss easier.
01
Assess the history of past obesity, including overweight or obesity in childhood and adolescence, and risk factors for weight change (e.g. , significant life changes, changes in work, changes in lifestyle, etc.) , have you ever tried to lose weight? Have you ever had a history of diseases that may cause weight gain (e.g. thyroid disease, pituitary disease, adrenal disease, etc.) , history of medications (e.g. glucocorticoid, antipsychotics, etc.) that may contribute to weight gain, and history and treatment of obesity-related illnesses.
02
Lifestyle measures such as eating habits (taste preferences, overeating, etc.) , exercise habits, sleep patterns, nature and intensity of work, smoking and drinking history.
03
Psychological assessment of overweight or obese patients to determine whether there are potential psychological problems, including anxiety, eating disorders.
04
Physical examination included height, weight, waist circumference, hip circumference, body mass index (BMI) , waist-to-hip ratio, and presence or absence of full-moon face, buffalo back, purplish skin, and black acanthosis.
05
Obesity-related diseases were assessed by blood glucose, Glycated hemoglobin, insulin levels, lipids, uric acid, liver function, and renal function.
06
Assess endocrine gland dysfunction, including thyroid function, cortisol rhythm, and sex hormone levels.
07
Body fat content and visceral fat content were measured. For example, fat content can be measured by bioelectrical impedance, skinfold thickness, and fat distribution in visceral and peripheral tissues can be measured by ultrasound of visceral fat, abdominal CT, and magnetic resonance Imagin MRI.
08
Imaging Studies. If there is a thyroid dysfunction, the patient needs a thyroid ultrasound examination. Female friends in the need to improve the pelvic ultrasound examination to determine whether there is polycystic ovarian syndrome. If there is hypercortisol, patients may need to improve the adrenal gland or pituitary CT, MRI, etc. .
09
In addition, the doctor will be on the cardiopulmonary exercise function, exercise capacity assessment.
After the cause of obesity is identified, it is possible to develop a weight-loss plan under the guidance of a doctor.