I’m A Harvard-Trained MD: Here’s What You Need To Know About Hormones & Weight

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October 8, 2021 — 9:04 AM

Prepare for a wild understatement: Hormones are often misunderstood. They’re so complex, in fact, that it can be difficult to pinpoint which one is out of whack (for what it’s worth, hormones work together in a symphony, so it’s unlikely you have an imbalance with just one). 

What’s even more misunderstood is the connection between hormones and weight. As Harvard-trained integrative medicine doctor Sara Gottfried, M.D., author of Women, Food, And Hormones, tells us on this episode of the mindbodygreen podcast, a heap of hormones have the potential to keep you (specifically women) from burning fat, so it’s important to understand what’s going on under the hood. 

Below, Gottfried provides some baseline knowledge. Here’s what she wants you to know about hormones and weight. 

Let’s not forget, the infamous stress hormone cortisol can stimulate the ​​blood sugar roller coaster, which tells your body that you need to eat—and right now. This, in turn, can turn insulin secretion on overdrive, which makes you store fat. Estrogen and progesterone play a role, too, since estrogen dominance (where your body is either producing too much estrogen or you’re not getting rid of it properly) can contribute to weight loss resistance, and a drop in progesterone can lead to increased appetite for some. 

You see, there’s a very delicate balance between hormones and weight. “That first principle is just to really drive home the point that metabolism includes your hormones,” says Gottfried. 

A ketogenic diet has its benefits—one of them being weight management—but Gottfried says the restrictive eating plan has the potential to affect your hormones. “I went on keto with my husband,” she recounts. “He dropped 20 pounds in a short amount of time, and I gained weight. I had some initial success, but then it just seemed to reverse the deeper I got into ketosis. I realized that keto is definitely affecting your hormones and not always in a positive way—at least not classic keto.” 

Specifically, the diet seems to affect the leptin hormone: Women, generally, have more leptin sensitivity than men, so they can be more sensitive to when leptin levels decline too low, which can influence anxiety, low-quality sleep, and uncontrollable hunger over time. 

“It’s not that women can’t experience the benefits [of keto],” says Gottfried. “It’s just that we need some workarounds.” To ensure leptin levels don’t get depleted, she recommends introducing more carbs into the diet than “classic keto” might allow. “Even though I was told that was not the way to do keto, I found that many patients are able to get into ketosis focusing on net carbs,” she says. (Read all about carb cycling on keto here.)

Gottfried mentions that some hormones really need detoxification in order to work optimally, like insulin, estrogen, and your hunger hormones, leptin and ghrelin. To support your body’s natural detoxification process, she recommends eating your greens—and lots of ‘em. 

“Eating dark leafy greens is a great way to inactivate some of those excess estrogens,” she says. Plus, “getting cruciferous vegetables can help you with liver detoxification, and getting allium vegetables (things like garlic, leeks, and onion) helps you with making glutathione, which is part of this process of mopping up the toxins.” 

Research backs her up: Cruciferous vegetables contain indole-3-carbinol (I3C), a compound that helps break estrogen down, which helps with detoxification. These vegetables, including the alliums, also support liver detoxification by increasing glutathione production, an antioxidant that’s also important for reducing oxidative stress.