What is hormonal belly? Can hormones make you gain weight?

Dr Rakesh Sahay, Senior Consultant Endocrinologist, Aster Prime Hospital, Hyderabad

What is hormonal belly?

With an increasing weight gain there is excessive fat deposition in the abdomen leading to what is commonly called as the ‘hormone belly’ in common vernacular. This is referred to as hormone belly (hormonal stomach) for the reasons that most people with this kind of weight gain, this is caused due to a hormonal abnormality leading to secretion of a lot of adipokines (hormones secreted from adipose tissue or fat cells) which in turn adversely influence the metabolism in the body leading to Diabetes, Lipid disturbances and also the development of heart diseases.

Hormonal Disorders

The various hormonal disorders that can lead to the development of hormone belly are Hypothyroidism, Cushing’s syndrome, and Acromegaly.

  1. Hypothyroidism is a condition of decreased levels of thyroid hormones. The thyroid hormones are T4 and T3, while TSH secreted from the pituitary regulates the thyroid hormone levels. Individuals with hypothyroidism are identified by an elevated level of TSH with normal or low levels of T3 and T4. Unrecognized and untreated hypothyroidism can lead to increasing weight gain particularly around the belly and many a time other classical features of hypothyroidism such as coarse skin and dull appearance.

  2. Cushing’s syndrome is caused by an excessive secretion of cortisol which is a hormone secreted in response to any form of stress and has the effect of increasing fat deposition around the belly with loss of fat from the arms.  It also leads to excessive weight gain and thinning of the skin with stretch marks being visible on the abdomen. The diagnosis of this requires a complex set of hormonal assessments measuring the levels of cortisol and ACTH at different times and in response to various medications.

  3. Acromegaly on the other hand is a disorder with excess of growth hormone secretion from the pituitary gland and has a typical enlargement of the hands and feet and also of the head with increasing size of footwear, gloves and hat. It is also characterized by weight gain and abdominal deposition of fat.

    However, Cushing’s syndrome and Acromegaly are rare disorders, the more common ones being Hypothyroidism can be easily excluded by measuring the TSH levels and this also can be done anytime of the day without any special preparation. Use of estrogens in women can also lead to weight gain and abdominal fat distribution.

  4. The vast majority of people however, do not have hormonal disturbances causing this fat deposition but it is due to an unfavorable alteration in the lifestyle leading to greater ingestion of energy dense foods with reduced energy expenditure through any physical activity.

  5. The hormonal disturbances in this scenario result from belly fat deposition. This belly fat is metabolically very active compared to fat deposited in other locations and it leads to production of various adipokines or hormones of the fat – such as leptin, adiponectin, resistin and a variety of other cytokines like TNF alpha and other interleukins.

  6. These hormones interfere with the action of insulin causing insulin resistance. The insulin resistance in turn predisposes the person to develop diabetes, leads to alteration in levels of cholesterol and favors the development of atherosclerosis or narrowing of blood vessels supplying the heart and brain leading to strokes or heart attacks.

To summarize, individuals with excessive belly fat or hormone belly should be screened to exclude any hormonal disorder causing this and once this is done the focus should be on changing their lifestyle to prevent the hormonal and metabolic consequences of this.