A Root Cause Medicine Approach
|
February 2, 2023

9 Hormone Imbalances That Can Hinder Weight Loss

Medically Reviewed by
Updated On
September 17, 2024

It can be very disheartening and frustrating when you make choices and diet changes to balance your weight, yet your clothes still fit uncomfortably, and your weight doesn't seem to respond. There are so many trends and approaches to weight loss that are promoted. But so often, these only work for a short time.

Often stubborn weight imbalances are rooted in hormonal issues, not willpower. How your body carries weight and responds to food and movement is significantly influenced by a symphony of hormones that work together to regulate many processes in the body.

Several hormones influence weight. These hormones work together to regulate metabolism, hunger, and fullness. Fortunately, many lifestyle changes and approaches can often help bring your hormones and weight back into balance.

Here you can learn about some of these, including leptin, cortisol, insulin, estrogen, ghrelin, neuropeptide Y, Glucagon-Like Peptide-1, peptide YY, and cholecystokinin and how you can keep them balanced to maintain a healthy weight. Β 

Note: Every body is different, and weight goals are very individual. This is not to shame or judge any body type. If you struggle with an eating disorder and feel this might be triggering, please work with your providers to discuss what is best for your needs, goals, and body.

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Hormones That Affect Weight Loss

Weight balance involves much more than calories taken in and calories burned off. There is much more involved in the human body than basic thermodynamics.

Hormones are chemical messengers that help to coordinate different functions by carrying signals throughout the body via the blood to organs, muscles, and other tissues. The levels of hormones need to be maintained within a certain range to allow the body's processes to function in a balanced way. In many cases, even tiny changes can have significant effects throughout the body.

Metabolic hormones significantly influence body weight, metabolism, hunger, and energy. The body is designed for survival and has mechanisms designed to help it maintain balance. This delicate balance can be thrown out of whack by factors like environmental exposures, chronic stress, a lack of sleep, poor gut health and microbiome balance, and more. When hormones are out of balance, they can wreak havoc on your body, including your weight.

Stubborn weight imbalances are commonly rooted in hormonal issues, not a lack of willpower. Restriction and intense exercise can make it harder to find balance due to how they impact hormones. Sometimes, when the body doesn't receive adequate nutrition, it can trigger a metabolic and hormonal response that leads to holding onto weight and even storing extra body fat as an adaptation and preservation.

Leptin

Leptin is a hormone primarily produced by fat cells to help keep food intake and weight balanced over the long term. Leptin is referred to as the satiety hormone because it influences feelings of fullness and satisfaction from eating. When leptin binds to its receptors in the brain, it sends signals to inhibit food intake and increase energy expenditure.

When leptin drops, the body receives the signal that more fuel is needed and that it must eat and save more energy. Therefore, low leptin causes your metabolism to slow down as the body tries to hold onto fat.

When high levels of leptin chronically stimulate the brain, it can stop responding normally to the feedback loop. When leptin resistance occurs, you don't get the sensation of feeling full or satiated and are driven to eat more even though your body has enough fat stores and energy. This lack of satiety and decreased metabolism that occurs in leptin resistance further contributes to obesity and causes additional weight gain in the form of fat storage.

Leptin Imbalance Symptoms

Leptin imbalances and resistance results in a diminished ability of leptin to signal satiety or fullness, suppress appetite and increase the body's energy usage. This leads to the symptoms of leptin resistance, including:

  • increased appetite or constantly feeling hungry
  • increased food intake despite having adequate energy stores or excess amounts of body fat
  • weight gain with calories taken in and stored as fat instead of burning them as energy
  • weight-loss resistance and difficulty keeping weight off

How to Test for Leptin Imbalance?

The Metabolomic Profile measures several markers of fat stores, including leptin and adiponectin, as well as metabolic markers of glucose balance and insulin function to help assess the risk of leptin resistance and metabolic syndrome.

How to Treat Leptin Imbalance

Leptin Resistance Diet

Inflammation and overnutrition play key roles in the development of leptin resistance. A balanced, nutrient-dense, anti-inflammatory diet can reduce elevated leptin and inflammation. This type of diet is beneficial for the following reasons:

  • It provides a metabolically-appropriate amount of calories.
  • It's rich in fiber.
  • It's free of gluten that can leak into the bloodstream and inhibit leptin binding to its receptors in the brain, contributing to leptin resistance.
  • It focuses on vegetables, legumes, and other high-quality proteins like wild fish and grass-fed meats.
  • It includes omega-3-rich foods such as salmon or sardines, flax seeds, and walnuts while reducing omega-6 intake from factory-raised meats and dairy products.
  • It limits inflammatory foods like fried and processed foods, refined sugars, factory-raised meats, and sugary drinks.

Time-restricted eating and fasting

Time-restricted eating, calorie restriction, or fasting may improve leptin sensitivity for some individuals. Eating late in the day, especially after 8 pm, has been associated with higher leptin resistance levels, increased hunger, and more weight gain. Some studies suggest that fasting may help reduce inflammation and reset leptin receptors, encouraging weight loss. The length and frequency of this type of approach must be individualized by a knowledgeable provider.

Move regularly

Incorporate regular, consistent exercise to improve the body's ability to regulate appetite, reduce abdominal obesity, and regulate leptin levels to optimize metabolic health.

Get enough sleep and practice good sleep hygiene

A lack of adequate sleep, poor sleep habits, and altered circadian rhythms can dysregulate leptin and contribute to leptin resistance. For most people, going to bed at a consistent time before 10 pm and getting at least 7-9 hours of good-quality sleep helps balance leptin and weight.

Cortisol

With stressors like imbalanced blood sugar, infections, or emotional stress, the adrenal glands secrete the steroid hormone cortisol. Under stress, cortisol helps to mobilize energy and increases heart rate to contribute to the "fight or flight" response. This hormone acts on the liver, muscle, adipose tissue, and pancreas to increase the availability of blood glucose to the brain. Β 

Chronic physical and emotional stressors contribute to chronically elevated levels of cortisol. Cortisol increases appetite and signals the body to influence metabolism to store fat. Over time, elevated cortisol may lead to many health issues, including metabolic imbalances like type 2 diabetes, heart disease, sleep disturbances, and weight gain.

Overtraining is a stressor on the body. Intense cardio exercise elevates cortisol levels, impairs insulin sensitivity, and contributes to fat accumulation as the body goes into a heightened stress mode. If the body is in a constant calorie deficit because your exercise level is too high and your food intake too low, it gets the message that it must slow down all functioning to conserve energy.

Cortisol Imbalance Symptoms

The following symptoms may indicate a cortisol imbalance:

  • weight gain or difficulty losing weight
  • increased appetite
  • sleep difficulties
  • heart disease
  • high blood pressure
  • anxiety
  • depression
  • fatigue
  • gastrointestinal upset like constipation, bloating, or diarrhea
  • headache
  • irritability
  • problems with memory and concentration
  • low libido
  • irregular menstruation and ovulation
  • slow recovery from exercise

How to Test for Cortisol Imbalance?

Cortisol levels and adrenal function

Cortisol should be measured throughout the day to ensure it's rising and falling appropriately with an Adrenal Function Profile or CAR Profile, which uses a six-point saliva collection to analyze cortisol patterns.

How to Treat Cortisol Imbalance

Manage stress

Unmanaged chronic stress is associated with metabolic dysfunction and leptin resistance, particularly through the impacts on inflammation and blood lipids. Finding a practice that is meaningful for you to manage stress is critical to a balanced metabolism in the long term.

Get optimal sleep

As with leptin and many other hormones, cortisol secretion follows a natural 24-hour cycle, peaking in the morning and declining during the day. To maintain this circadian pattern, it is important to go to bed at a consistent time before 10 pm and get at least 7-9 hours of good-quality sleep.

Pay attention to light

Avoiding blue light from screens a few hours before bedtime and exposing yourself to natural sunlight first thing in the morning helps to keep cortisol levels balanced in their natural cycle.

Exercise, but don't overdo it

Regular enjoyable exercise can improve sleep quality, reduce stress, and help to lower cortisol and weight over time. Mindful forms of movement like yoga and tai chi can be especially useful in managing stress and balancing cortisol levels.

Consider adaptogens

Herbs like ashwagandha, Asian ginseng, and astragalus are adaptogens that are calming and help the body adapt to stress. When used appropriately, they can help modulate and rebalance cortisol.

Insulin

Insulin is a hormone produced by the pancreas that helps maintain balanced blood sugar. Your body secretes insulin, especially after meals, to direct the transfer of glucose from food into your liver, muscles, and fat cells for either energy or storage, depending on your body's needs at that time.

When working well, insulin helps the body maintain energy balance by not allowing blood glucose to spike too high or for too long. But sometimes, the cells can stop responding normally to insulin, leading the pancreas to work harder to release enough insulin to stabilize blood sugar levels. Over time, the pancreas' ability to release insulin decreases as insulin resistance develops.

When there is excess insulin and sugar in the blood, it signals your body to store that excess sugar. Once the liver and muscles are full, excess energy is stored as fat, contributing to weight gain over time. Insulin issues can also contribute to metabolic imbalances such as metabolic syndrome, type 2 diabetes, and non-alcoholic fatty liver disease (NAFLD).

Insulin Imbalance Symptoms

The following symptoms may indicate an insulin imbalance:

  • shakiness or lightheadedness
  • cravings for sweets or carbohydrates
  • headaches
  • irritability if meals are delayed
  • mood swings
  • brain fog
  • fatigue or energy fluctuations
  • unstable blood sugar levels
  • increased thirst
  • increased urination, especially at night
  • blurry vision or vision changes

How to Test for Insulin Resistance?

Blood Sugar and Metabolism Markers

Several tests can evaluate blood sugar balance and insulin function.

Together, these can identify insulin resistance when sugars remain in the blood, causing inflammation and damage to blood vessels, which leads to metabolic syndrome, heart disease, type 2 diabetes, and NAFLD.

The Metabolomic Profile can help assess the risk of metabolic syndrome by evaluating many of these metabolic markers of glucose balance and insulin function as well as several markers of adiposity like leptin and adiponectin.

How to Treat Insulin Resistance

Eat a low-glycemic whole-foods diet

Diets rich in fiber, vegetables, legumes, and other high-quality proteins like wild fish and grass-fed meats like the Mediterranean Diet are associated with more balanced weight and fat distribution, less insulin resistance, and improved markers of inflammation and fat and sugar metabolism. This approach focuses on high-fiber and complex carbohydrates and avoids processed and added sugars to keep blood sugars balanced.

Eat healthy fats

In particular, polyunsaturated omega-3 fatty acids in foods like salmon and walnuts positively impact insulin balance, blood pressure, and triglycerides for overall metabolic health.

Move regularly

Studies show a strong association between physical inactivity and obesity with metabolic dysfunction like insulin resistance. Incorporate regular, consistent moderate exercise to improve the body's ability to handle sugars and reduce abdominal obesity.

Balance the microbiome

The microbiome influences weight balance by impacting your hormones and blood sugar. A diverse plant-focused diet rich in dietary fiber supports balanced gut bacteria that promote a healthy gut lining and proper digestion, weight, and metabolic balance. Prebiotic foods like garlic, bananas, and asparagus feed beneficial gut bacteria. Probiotics in naturally fermented foods like sauerkraut and miso promote microbial diversity to help regulate insulin levels, weight, triglycerides, and inflammation.

Supplement strategically

The herbs Cinnamomum cassia (Chinese cinnamon) and Gymnema sylvestre may regulate appetite by influencing insulin, glucose, and leptin levels.

Manage stress and get enough sleep

Unmanaged chronic stress and inadequate or disrupted sleep are associated with insulin imbalances and metabolic syndrome. Finding a meaningful practice for managing stress and maintaining a regular sleep routine with consistently adequate sleep is vital for a balanced metabolism in the long term.

Estrogen

Estrogen is a crucial hormone for bones, mood, female characteristics, and sexual and reproductive function. In addition to being made in the ovaries, adrenals, placenta, and fat tissue, estrogen metabolism is regulated by gut bacteria and impacted by environmental exposures.

When estrogen gets imbalanced because there is too much of the wrong form or when it's not in balance with progesterone (so-called estrogen excess or estrogen dominance), it can make it hard to lose weight. Imbalances in estrogen, both too high and too low, can contribute to weight gain or difficulty losing weight.

Weight loss with estrogen dominance can be challenging because fat tissues can make more estrogen. Increased fat cells also lead to increased inflammation, which contributes to weight loss resistance and can lead to even more estrogen in the body.

Estrogen imbalances can occur due to exposure to environmental toxins (endocrine-disrupting chemicals), chronic stress, or poor gut health. Liver health and genetics can also impact estrogen levels.

The estrobolome is a collection of gut bacteria that helps metabolize and modulate the body's circulating estrogen. Imbalances in gut bacteria lead to imbalances between the forms of estrogen that may promote estrogen-related symptoms.

Estrogen Imbalance Symptoms

The following symptoms may indicate an estrogen imbalance:

  • weight gain, especially around the butt, hips, and thighs
  • difficulty losing weight
  • bloating and digestive upset
  • acne
  • low libido
  • irregular periods
  • tender, swollen, or fibrocystic breasts
  • headaches
  • hot flashes
  • endometriosis
  • fibroids
  • mood swings
  • polycystic ovarian syndrome (PCOS).

How to Test for Estrogen Imbalance?

Sex Hormone Panels

Saliva, serum, and urine tests can measure estrogens and other sex hormones.

The DUTCH Complete dried urine test looks at the specific estrogen metabolites in the urine and reports how much of each metabolite is present to give an idea of overall liver biotransformation and balance.

A hormones panel like the Comprehensive Plus Profile offered by Doctor’s Data can shed light on sex hormones and related biomarkers.

Liver Function

Since unused estrogen is primarily metabolized by the liver in processes that require vitamins and minerals to work properly, hepatic function should be assessed along with a micronutrient panel to evaluate imbalances in vitamins and minerals.

Comprehensive Stool Test

Once the liver processes estrogen, it moves into the gut for further modification and elimination. When there is a healthier mix of bacteria in the GI tract, excess estrogen is more easily eliminated from the body via stool, so it does not lead to problems. The GI360 Profile Test provides a comprehensive stool analysis to examine the microbiome's abundance and diversity.

Toxic Burden

The Total Mycotoxin Panel by RealTime Laboratories, the Environmental Pollutants Profile (EPP) by US BioTek, and the Heavy Metals, 21 Toxic, Urine (24-hour) by Access Medical Laboratories can all help practitioners assess the total toxic burden patients are facing and look at how endocrine-disrupting chemicals may be contributing to estrogen imbalances.

‍Genomics

A functional medicine genomic lab test can assess several genes impacting estrogen processing. Estrogen metabolism in the liver to prepare it for elimination out of the body involves enzymes known as cytochromes like CY1B1 (Cytochrome P450 1B1) and a cycle known as methylation that involves many processing steps involving MTHFR (Methylenetetrahydrofolate reductase) and COMT that require vitamins B6, B12, and folate to metabolize estrogen. When all of these steps work well, unneeded estrogen can be safely excreted into the gut and removed from the body to help maintain balance.

How to Treat Estrogen Imbalance

Estrogen balance is influenced by genetics, diet, alcohol, environmental exposures, lifestyle, and medications, especially antibiotics and hormonal contraceptives. These factors can directly influence hormone levels and impact the estrobolome, gut bacteria that metabolize estrogens and affect their balance.

Eat a Hormone Balancing Diet

Eating a more high-fiber whole foods diet creates greater bacterial diversity in the gut and a balanced estrobolome. High-fiber plant-based foods like nuts, seeds, legumes, beans, and vegetables help keep estrogen balanced by keeping the bowels moving regularly to excrete extra estrogen. Adequate quality protein is also essential for optimal liver detoxification.

Including fermented foods like sauerkraut and kimchi increases bacterial diversity, while prebiotic-rich foods like chicory, asparagus, garlic, unpeeled raw carrots, and Jerusalem artichokes promote the growth of beneficial bacteria.

Reduce alcohol and caffeine intake

Reducing alcohol and caffeine helps balance hormones since these can burden the liver and disrupt estrogen metabolism.

Supplements

Supplements may help rebalance estrogen depending on the pattern of imbalance within the different forms of estrogen.

Calcium-d-glucarate (CDG) can help support the excretion of excess estrogen and allow more estrogen to leave the body in the stool.

Diindolylmethane (DIM), a compound found in cruciferous vegetables like broccoli, influences estrogen metabolism.

Magnesium supports the COMT enzyme in the liver to promote the healthy excretion of estrogen.

Avoid Xenoestrogens

Since manufactured xenoestrogens mimic natural estrogens and alter the microbiome, reducing exposure helps restore balanced hormones. The following are helpful tips for avoiding these:

  • Minimize plastic use, especially when heated.
  • Opt for non-chemical plant-based laundry and household cleaning products without synthetic fragrances.
  • Avoid phthalates, stearalkonium chloride, and parabens in personal care products.
  • Opt for organic food whenever possible.

Balance Exercise

Regular moderate-intensity exercise helps keep estrogen levels balanced.

Ghrelin

Ghrelin is the hunger hormone involved in appetite stimulation, increased food intake, and increased fat storage. When the stomach is empty, ghrelin is released and sends messages to the hypothalamus in the brain, indicating that your stomach is empty and needs food. This hormone also impacts sleep/wake cycles, reward-seeking behavior, taste sensation, and carbohydrate metabolism.

Regardless of your weight, when you cut back your food intake and try to lose weight, ghrelin levels increase and make you hungry. Until you nourish your body and eat adequate fuel, ghrelin causes the metabolism to slow down to preserve energy as a natural response to protect you from starvation.

Research suggests that although people with obesity have lower ghrelin levels, they are more sensitive to its effects which can contribute to overeating.

Ghrelin Imbalance Symptoms

The following symptoms may indicate a ghrelin imbalance:

  • extreme hunger
  • weight gain and difficulty losing weight
  • anxiety and stress
  • fatigue
  • fertility issues

How to Test for Ghrelin Imbalance?

Ghrelin levels can be measured in the blood.

How to Treat Ghrelin Imbalance

Eat regularly

Fasting and starvation cause ghrelin levels to increase. Ghrelin levels generally begin to rise about three hours after eating. Maintaining a regular eating schedule that works for your body and avoiding crash diets and extreme calorie restriction can help stabilize ghrelin, manage hunger, and avoid extreme cravings that can lead to imbalanced food choices.

Prioritize high-quality sleep

Poor or irregular sleep increases levels of ghrelin. Getting regular adequate amounts of high-quality sleep can help stabilize hunger and weight.

Build muscle mass

Regular exercise focusing on building and maintaining muscle mass can help keep hunger, ghrelin, and weight balanced. Higher amounts of muscle have been associated with lower levels of ghrelin.

Don't overtrain

While exercise is beneficial, it is essential to avoid over-training, as this can wreak havoc with ghrelin levels. When you engage in intense cardiovascular total-body exercise such as running long distances or long sessions of boot camp frequently, your body produces more ghrelin. This is the body's way of seeking out energy to fuel the activity, as this hormone makes us feel hungry.

Neuropeptide Y

In addition to leptin, insulin, and ghrelin, neuropeptide Y (NPY) is an important hormone for regulating metabolism, appetite, and hunger. Neuropeptide Y is produced in your brain and nervous system and sends signals that stimulate appetite and decrease energy expenditure in response to fasting or stress. It stimulates food intake, with a preference towards carbohydrates, increases motivation to eat, and reduces the time between desiring food.

In these ways, NPY is associated with weight gain and obesity. More specifically, NPY influences body weight by stimulating the creation of new fat cells and promoting the build-up of fat stores, especially in the abdomen. Under chronic stress and with consumption of a high-sugar diet, more NPY is released, which in turn increases appetite for more food and weight gain. These impacts also contribute to increased inflammation which worsens obesity and other chronic health issues.

Neuropeptide Y Imbalance Symptoms

The following symptoms may indicate an NPY imbalance:

  • increased appetite
  • weight gain, especially in the abdomen
  • mood changes
  • irregular menstruation

How to Test for Neuropeptide Y Imbalance?

NPY and its metabolites can be measured in blood, although the test is not widely available.

How to Treat Neuropeptide Y Imbalance

Exercise consistently

Regular and consistent exercise may help decrease NPY levels and regulate appetite.

Manage stress

Activation of the sympathetic nervous system during the response to stress results in the secretion of NPY. Therefore, maintaining an effective and regular stress management practice can help regulate NPY levels. For example, mindfulness-based mind training to enhance stress resilience resulted in lower plasma NPY levels after exposure to stressful events.

Eat a balanced diet low in processed sugars and fats

Since high-fat, high-sugar diets particularly increase NPY levels, eating a balanced whole foods-focused diet that avoids processed sugars and fats may help keep this hormone balanced.

Glucagon-Like Peptide-1

Glucagon-like peptide-1 (GLP-1) is a hormone produced by the gastrointestinal tract when nutrients enter the intestines. GLP-1 influences hunger and appetite by making you feel full when you eat and helps the body release insulin and keep blood sugar balanced. Specifically, GLP-1 increases insulin and decreases glucagon levels. It also delays stomach emptying, resulting in reduced blood glucose levels. Β 

Overall, GLP-1 lowers appetite, enhances satiety or fullness, reduces food intake, and causes weight loss. In obesity, there are problems with GLP-1 signaling. Studies suggest that weight gain may induce functional deficits in GLP-1 signaling that facilitate the maintenance of a higher body weight.

Because of its role in blood sugar metabolism and weight, a class of drugs that target GLP-1 (GLP-1 agonists) has been developed. They are used to improve blood sugar control, weight, and waist circumference/central obesity in people with type 2 diabetes who have poor blood sugar control and are taking anti-diabetic therapy by mouth.

Glucagon-Like Peptide 1 Imbalance Symptoms

The following symptoms may indicate a GLP-1 imbalance:

  • blood sugar fluctuations
  • weight changes
  • changes in appetite

How to Test for Glucagon-Like Peptide-1 Imbalance?

Glucagon-Like Peptide-1 can be measured in the blood but is not commonly measured outside of a research setting.

How to Treat Glucagon-Like Peptide-1 Imbalance

Eat adequate protein

Adequate protein is required to mediate appropriate GLP-1 signaling and regulate appetite and hunger. Protein-rich foods like whey protein and yogurt have been shown to increase GLP-1 levels and regulate appetite.

Nourish and maintain a healthy microbiome

Short-chain fatty acids (SCFAs) are mainly produced when microbes in the gut ferment partially- and non-digestible carbohydrates like prebiotic fibers and resistant starches, especially from plant foods. This fermentation of "indigestible" prebiotics to SCFAs by gut bacteria then modulates the release of gut hormones controlling insulin release and appetite, including GLP-1. A well-balanced, anti-inflammatory diet incorporating a variety of plant-based foods promotes a variety of beneficial bacteria. It also suppresses potentially detrimental species, which helps to optimize the production of SCFAs and balance metabolism and weight. Consuming a wide variety of plant foods and sources of fermentable fiber helps to feed the good bacteria in your gut so that they can produce adequate amounts of SCFAs.

Peptide YY

Peptide YY is a hormone made in the small intestine alongside glucagon-like peptide 1 after eating. It travels in the blood to the brain, where it decreases appetite and makes you feel full, as well as acting in the stomach and intestine to slow down the movement of food through the digestive tract. Β 

Sufficient levels of peptide YY play a major role in regulating appropriate food intake and decreasing the risk of obesity. PYY levels may be lower in those with obesity, contributing to an increased appetite, overeating, and weight gain.

Peptide YY Imbalance Symptoms

The following symptoms may indicate a PYY imbalance:

  • dysregulated appetite
  • hunger
  • weight changes

How to Test for Peptide YY Imbalance?

While Peptide YY has been measured in blood for research purposes, it is not routinely measured.

How to Treat Peptide YY 1 Imbalance

Consume resistant starch

Consuming dietary resistant starch feeds the good bacteria in the gut and increases PYY, which promotes satiety and fullness and can aid in weight loss. Good sources of this prebiotic resistant starch include green bananas and plantains, cooked and cooled rice or potatoes, beans, peas, and lentils (white beans and lentils are the highest), and whole grains, including oats and barley.

Eat an anti-inflammatory diet with adequate amounts of protein

An anti-inflammatory diet like the Paleo diet, including sufficient amounts of protein and plant-based foods like vegetables, may raise PYY levels.

Cholecystokinin

Cholecystokinin (CCK) is released from the duodenum (the first portion of the small intestine) after a meal and leads to the release of bile from the gallbladder and digestive enzymes from the pancreas. Similar to GLP-1, CCK also acts as a fullness hormone and an appetite suppressant when food is plentiful. It helps suppress your appetite while you are digesting food by making your stomach feel physically full, activating the vagus nerve, and increasing the release of the fullness hormone leptin.

CCK is also involved with energy production, protein synthesis, body temperature and metabolism regulation, and anxiety.

People with obesity may have a reduced sensitivity to the appetite-regulating effects of CCK, which may lead to chronic overeating and weight gain. Over time, this can further reduce CCK sensitivity. In addition, people who carry a specific variant of the cholecystokinin gene appear to have a 60% increased risk of obesity.

Cholecystokinin Imbalance Symptoms

The following symptoms may indicate a CCK imbalance:

  • appetite changes
  • hunger
  • weight imbalances
  • anxiety
  • impaired gastric emptying (gastroparesis)
  • impaired gallbladder function (biliary dyskinesia)

How to Test for Cholecystokinin Imbalance?

While CCK can be measured in blood, it is not routinely measured.

How to Treat Cholecystokinin Imbalance

Eat enough protein

Adequate protein helps to regulate appetite and hunger in part by increasing CCK and, therefore, feelings of fullness.

Exercise consistently

Regular and consistent exercise may help increase CCK levels to regulate appetite.

Summary

Many hormones work together in your body to maintain equilibrium. Leptin, cortisol, insulin, estrogen, ghrelin, neuropeptide Y, glucagon-like peptide-1, peptide YY, and cholecystokinin all influence weight balance. When one or more of these hormones is out of balance, weight gain and difficulty losing weight can occur, even when you're eating right and exercising.

If you experience difficulty maintaining a balanced weight or any of the other symptoms discussed above, functional medicine laboratory testing could help assess these hormonal factors that may be contributing.

This information about hormone levels and insights into some of the potential factors contributing to imbalances in these hormones can allow you and your doctor to target a plan to bring things back into balance.

It can be very disheartening and frustrating when you make choices and diet changes to balance your weight, yet your clothes still fit uncomfortably, and your weight doesn't seem to respond. There are so many trends and approaches to weight management that are promoted. But so often, these only work for a short time.

Often stubborn weight imbalances are rooted in hormonal issues, not willpower. How your body carries weight and responds to food and movement is significantly influenced by a symphony of hormones that work together to regulate many processes in the body.

Several hormones influence weight. These hormones work together to regulate metabolism, hunger, and fullness. Fortunately, many lifestyle changes and approaches can often help support balanced hormones and weight.

Here you can learn about some of these, including leptin, cortisol, insulin, estrogen, ghrelin, neuropeptide Y, Glucagon-Like Peptide-1, peptide YY, and cholecystokinin and how you can help maintain their balance to support a healthy weight. Β 

Note: Every body is different, and weight goals are very individual. This is not to shame or judge any body type. If you struggle with an eating disorder and feel this might be triggering, please work with your providers to discuss what is best for your needs, goals, and body.

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Hormones That Affect Weight Management

Weight balance involves much more than calories taken in and calories burned off. There is much more involved in the human body than basic thermodynamics.

Hormones are chemical messengers that help to coordinate different functions by carrying signals throughout the body via the blood to organs, muscles, and other tissues. The levels of hormones need to be maintained within a certain range to allow the body's processes to function in a balanced way. In many cases, even tiny changes can have significant effects throughout the body.

Metabolic hormones significantly influence body weight, metabolism, hunger, and energy. The body is designed for survival and has mechanisms designed to help it maintain balance. This delicate balance can be disrupted by factors like environmental exposures, chronic stress, a lack of sleep, poor gut health and microbiome balance, and more. When hormones are out of balance, they can affect your body, including your weight.

Stubborn weight imbalances are commonly rooted in hormonal issues, not a lack of willpower. Restriction and intense exercise can make it harder to find balance due to how they impact hormones. Sometimes, when the body doesn't receive adequate nutrition, it can trigger a metabolic and hormonal response that leads to holding onto weight and even storing extra body fat as an adaptation and preservation.

Leptin

Leptin is a hormone primarily produced by fat cells to help keep food intake and weight balanced over the long term. Leptin is referred to as the satiety hormone because it influences feelings of fullness and satisfaction from eating. When leptin binds to its receptors in the brain, it sends signals to inhibit food intake and increase energy expenditure.

When leptin drops, the body receives the signal that more fuel is needed and that it must eat and save more energy. Therefore, low leptin may cause your metabolism to slow down as the body tries to hold onto fat.

When high levels of leptin chronically stimulate the brain, it can stop responding normally to the feedback loop. When leptin resistance occurs, you may not get the sensation of feeling full or satiated and are driven to eat more even though your body has enough fat stores and energy. This lack of satiety and decreased metabolism that occurs in leptin resistance may contribute to weight gain in the form of fat storage.

Leptin Imbalance Symptoms

Leptin imbalances and resistance result in a diminished ability of leptin to signal satiety or fullness, suppress appetite and increase the body's energy usage. This may lead to the symptoms of leptin resistance, including:

  • increased appetite or constantly feeling hungry
  • increased food intake despite having adequate energy stores or excess amounts of body fat
  • weight gain with calories taken in and stored as fat instead of burning them as energy
  • weight-loss resistance and difficulty keeping weight off

How to Test for Leptin Imbalance?

The Metabolomic Profile measures several markers of fat stores, including leptin and adiponectin, as well as metabolic markers of glucose balance and insulin function to help assess the risk of leptin resistance and metabolic syndrome.

How to Support Leptin Balance

Leptin Resistance Diet

Inflammation and overnutrition play key roles in the development of leptin resistance. A balanced, nutrient-dense, anti-inflammatory diet may help reduce elevated leptin and inflammation. This type of diet is beneficial for the following reasons:

  • It provides a metabolically-appropriate amount of calories.
  • It's rich in fiber.
  • It's free of gluten that can leak into the bloodstream and inhibit leptin binding to its receptors in the brain, potentially contributing to leptin resistance.
  • It focuses on vegetables, legumes, and other high-quality proteins like wild fish and grass-fed meats.
  • It includes omega-3-rich foods such as salmon or sardines, flax seeds, and walnuts while reducing omega-6 intake from factory-raised meats and dairy products.
  • It limits inflammatory foods like fried and processed foods, refined sugars, factory-raised meats, and sugary drinks.

Time-restricted eating and fasting

Time-restricted eating, calorie restriction, or fasting may improve leptin sensitivity for some individuals. Eating late in the day, especially after 8 pm, has been associated with higher leptin resistance levels, increased hunger, and more weight gain. Some studies suggest that fasting may help reduce inflammation and reset leptin receptors, encouraging weight management. The length and frequency of this type of approach must be individualized by a knowledgeable provider.

Move regularly

Incorporate regular, consistent exercise to support the body's ability to regulate appetite, reduce abdominal obesity, and regulate leptin levels to optimize metabolic health.

Get enough sleep and practice good sleep hygiene

A lack of adequate sleep, poor sleep habits, and altered circadian rhythms can dysregulate leptin and contribute to leptin resistance. For most people, going to bed at a consistent time before 10 pm and getting at least 7-9 hours of good-quality sleep may help balance leptin and weight.

Cortisol

With stressors like imbalanced blood sugar, infections, or emotional stress, the adrenal glands secrete the steroid hormone cortisol. Under stress, cortisol helps to mobilize energy and increases heart rate to contribute to the "fight or flight" response. This hormone acts on the liver, muscle, adipose tissue, and pancreas to increase the availability of blood glucose to the brain. Β 

Chronic physical and emotional stressors may contribute to chronically elevated levels of cortisol. Cortisol increases appetite and signals the body to influence metabolism to store fat. Over time, elevated cortisol may lead to many health issues, including metabolic imbalances like type 2 diabetes, heart disease, sleep disturbances, and weight gain.

Overtraining is a stressor on the body. Intense cardio exercise elevates cortisol levels, impairs insulin sensitivity, and contributes to fat accumulation as the body goes into a heightened stress mode. If the body is in a constant calorie deficit because your exercise level is too high and your food intake too low, it gets the message that it must slow down all functioning to conserve energy.

Cortisol Imbalance Symptoms

The following symptoms may indicate a cortisol imbalance:

  • weight gain or difficulty losing weight
  • increased appetite
  • sleep difficulties
  • heart disease
  • high blood pressure
  • anxiety
  • depression
  • fatigue
  • gastrointestinal upset like constipation, bloating, or diarrhea
  • headache
  • irritability
  • problems with memory and concentration
  • low libido
  • irregular menstruation and ovulation
  • slow recovery from exercise

How to Test for Cortisol Imbalance?

Cortisol levels and adrenal function

Cortisol should be measured throughout the day to ensure it's rising and falling appropriately with an Adrenal Function Profile or CAR Profile, which uses a six-point saliva collection to analyze cortisol patterns.

How to Support Cortisol Balance

Manage stress

Unmanaged chronic stress is associated with metabolic dysfunction and leptin resistance, particularly through the impacts on inflammation and blood lipids. Finding a practice that is meaningful for you to manage stress is critical to a balanced metabolism in the long term.

Get optimal sleep

As with leptin and many other hormones, cortisol secretion follows a natural 24-hour cycle, peaking in the morning and declining during the day. To maintain this circadian pattern, it is important to go to bed at a consistent time before 10 pm and get at least 7-9 hours of good-quality sleep.

Pay attention to light

Avoiding blue light from screens a few hours before bedtime and exposing yourself to natural sunlight first thing in the morning may help to keep cortisol levels balanced in their natural cycle.

Exercise, but don't overdo it

Regular enjoyable exercise can improve sleep quality, reduce stress, and help to support balanced cortisol and weight over time. Mindful forms of movement like yoga and tai chi can be especially useful in managing stress and balancing cortisol levels.

Consider adaptogens

Herbs like ashwagandha, Asian ginseng, and astragalus are adaptogens that are calming and help the body adapt to stress. When used appropriately, they may help modulate and support balanced cortisol.

Insulin

Insulin is a hormone produced by the pancreas that helps maintain balanced blood sugar. Your body secretes insulin, especially after meals, to direct the transfer of glucose from food into your liver, muscles, and fat cells for either energy or storage, depending on your body's needs at that time.

When working well, insulin helps the body maintain energy balance by not allowing blood glucose to spike too high or for too long. But sometimes, the cells can stop responding normally to insulin, leading the pancreas to work harder to release enough insulin to stabilize blood sugar levels. Over time, the pancreas' ability to release insulin decreases as insulin resistance develops.

When there is excess insulin and sugar in the blood, it signals your body to store that excess sugar. Once the liver and muscles are full, excess energy is stored as fat, which may contribute to weight gain over time. Insulin issues can also contribute to metabolic imbalances such as metabolic syndrome, type 2 diabetes, and non-alcoholic fatty liver disease (NAFLD).

Insulin Imbalance Symptoms

The following symptoms may indicate an insulin imbalance:

  • shakiness or lightheadedness
  • cravings for sweets or carbohydrates
  • headaches
  • irritability if meals are delayed
  • mood swings
  • brain fog
  • fatigue or energy fluctuations
  • unstable blood sugar levels
  • increased thirst
  • increased urination, especially at night
  • blurry vision or vision changes

How to Test for Insulin Resistance?

Blood Sugar and Metabolism Markers

Several tests can evaluate blood sugar balance and insulin function.

Together, these can identify insulin resistance when sugars remain in the blood, causing inflammation and damage to blood vessels, which may lead to metabolic syndrome, heart disease, type 2 diabetes, and NAFLD.

The Metabolomic Profile can help assess the risk of metabolic syndrome by evaluating many of these metabolic markers of glucose balance and insulin function as well as several markers of adiposity like leptin and adiponectin.

How to Support Insulin Balance

Eat a low-glycemic whole-foods diet

Diets rich in fiber, vegetables, legumes, and other high-quality proteins like wild fish and grass-fed meats like the Mediterranean Diet are associated with more balanced weight and fat distribution, less insulin resistance, and improved markers of inflammation and fat and sugar metabolism. This approach focuses on high-fiber and complex carbohydrates and avoids processed and added sugars to keep blood sugars balanced.

Eat healthy fats

In particular, polyunsaturated omega-3 fatty acids in foods like salmon and walnuts may positively impact insulin balance, blood pressure, and triglycerides for overall metabolic health.

Move regularly

Studies show a strong association between physical inactivity and obesity with metabolic dysfunction like insulin resistance. Incorporate regular, consistent moderate exercise to support the body's ability to handle sugars and reduce abdominal obesity.

Balance the microbiome

The microbiome influences weight balance by impacting your hormones and blood sugar. A diverse plant-focused diet rich in dietary fiber supports balanced gut bacteria that promote a healthy gut lining and proper digestion, weight, and metabolic balance. Prebiotic foods like garlic, bananas, and asparagus feed beneficial gut bacteria. Probiotics in naturally fermented foods like sauerkraut and miso promote microbial diversity to help regulate insulin levels, weight, triglycerides, and inflammation.

Supplement strategically

The herbs Cinnamomum cassia (Chinese cinnamon) and Gymnema sylvestre may help regulate appetite by influencing insulin, glucose, and leptin levels.

Manage stress and get enough sleep

Unmanaged chronic stress and inadequate or disrupted sleep are associated with insulin imbalances and metabolic syndrome. Finding a meaningful practice for managing stress and maintaining a regular sleep routine with consistently adequate sleep is vital for a balanced metabolism in the long term.

Estrogen

Estrogen is a crucial hormone for bones, mood, female characteristics, and sexual and reproductive function. In addition to being made in the ovaries, adrenals, placenta, and fat tissue, estrogen metabolism is regulated by gut bacteria and impacted by environmental exposures.

When estrogen gets imbalanced because there is too much of the wrong form or when it's not in balance with progesterone (so-called estrogen excess or estrogen dominance), it can make it hard to manage weight. Imbalances in estrogen, both too high and too low, can contribute to weight gain or difficulty losing weight.

Weight management with estrogen dominance can be challenging because fat tissues can make more estrogen. Increased fat cells also lead to increased inflammation, which may contribute to weight management challenges and can lead to even more estrogen in the body.

Estrogen imbalances can occur due to exposure to environmental toxins (endocrine-disrupting chemicals), chronic stress, or poor gut health. Liver health and genetics can also impact estrogen levels.

The estrobolome is a collection of gut bacteria that helps metabolize and modulate the body's circulating estrogen. Imbalances in gut bacteria may lead to imbalances between the forms of estrogen that may promote estrogen-related symptoms.

Estrogen Imbalance Symptoms

The following symptoms may indicate an estrogen imbalance:

  • weight gain, especially around the butt, hips, and thighs
  • difficulty losing weight
  • bloating and digestive upset
  • acne
  • low libido
  • irregular periods
  • tender, swollen, or fibrocystic breasts
  • headaches
  • hot flashes
  • endometriosis
  • fibroids
  • mood swings
  • polycystic ovarian syndrome (PCOS).

How to Test for Estrogen Imbalance?

Sex Hormone Panels

Saliva, serum, and urine tests can measure estrogens and other sex hormones.

The DUTCH Complete dried urine test looks at the specific estrogen metabolites in the urine and reports how much of each metabolite is present to give an idea of overall liver biotransformation and balance.

A hormones panel like the Comprehensive Plus Profile offered by Doctor’s Data can shed light on sex hormones and related biomarkers.

Liver Function

Since unused estrogen is primarily metabolized by the liver in processes that require vitamins and minerals to work properly, hepatic function should be assessed along with a micronutrient panel to evaluate imbalances in vitamins and minerals.

Comprehensive Stool Test

Once the liver processes estrogen, it moves into the gut for further modification and elimination. When there is a healthier mix of bacteria in the GI tract, excess estrogen is more easily eliminated from the body via stool, so it does not lead to problems. The GI360 Profile Test provides a comprehensive stool analysis to examine the microbiome's abundance and diversity.

Toxic Burden

The Total Mycotoxin Panel by RealTime Laboratories, the Environmental Pollutants Profile (EPP) by US BioTek, and the Heavy Metals, 21 Toxic, Urine (24-hour) by Access Medical Laboratories can all help practitioners assess the total toxic burden patients are facing and look at how endocrine-disrupting chemicals may be contributing to estrogen imbalances.

‍Genomics

A functional medicine genomic lab test can assess several genes impacting estrogen processing. Estrogen metabolism in the liver to prepare it for elimination out of the body involves enzymes known as cytochromes like CY1B1 (Cytochrome P450 1B1) and a cycle known as methylation that involves many processing steps involving MTHFR (Methylenetetrahydrofolate reductase) and COMT that require vitamins B6, B12, and folate to metabolize estrogen. When all of these steps work well, unneeded estrogen can be safely excreted into the gut and removed from the body to help maintain balance.

How to Support Estrogen Balance

Estrogen balance is influenced by genetics, diet, alcohol, environmental exposures, lifestyle, and medications, especially antibiotics and hormonal contraceptives. These factors can directly influence hormone levels and impact the estrobolome, gut bacteria that metabolize estrogens and affect their balance.

Eat a Hormone Balancing Diet

Eating a more high-fiber whole foods diet creates greater bacterial diversity in the gut and a balanced estrobolome. High-fiber plant-based foods like nuts, seeds, legumes, beans, and vegetables may help keep estrogen balanced by keeping the bowels moving regularly to excrete extra estrogen. Adequate quality protein is also essential for optimal liver detoxification.

Including fermented foods like sauerkraut and kimchi increases bacterial diversity, while prebiotic-rich foods like chicory, asparagus, garlic, unpeeled raw carrots, and Jerusalem artichokes promote the growth of beneficial bacteria.

Reduce alcohol and caffeine intake

Reducing alcohol and caffeine may help balance hormones since these can burden the liver and disrupt estrogen metabolism.

Supplements

Supplements may help support balanced estrogen depending on the pattern of imbalance within the different forms of estrogen.

Calcium-d-glucarate (CDG) may help support the excretion of excess estrogen and allow more estrogen to leave the body in the stool.

Diindolylmethane (DIM), a compound found in cruciferous vegetables like broccoli, may influence estrogen metabolism.

Magnesium supports the COMT enzyme in the liver to promote the healthy excretion of estrogen.

Avoid Xenoestrogens

Since manufactured xenoestrogens mimic natural estrogens and alter the microbiome, reducing exposure may help restore balanced hormones. The following are helpful tips for avoiding these:

  • Minimize plastic use, especially when heated.
  • Opt for non-chemical plant-based laundry and household cleaning products without synthetic fragrances.
  • Avoid phthalates, stearalkonium chloride, and parabens in personal care products.
  • Opt for organic food whenever possible.

Balance Exercise

Regular moderate-intensity exercise may help keep estrogen levels balanced.

Ghrelin

Ghrelin is the hunger hormone involved in appetite stimulation, increased food intake, and increased fat storage. When the stomach is empty, ghrelin is released and sends messages to the hypothalamus in the brain, indicating that your stomach is empty and needs food. This hormone also impacts sleep/wake cycles, reward-seeking behavior, taste sensation, and carbohydrate metabolism.

Regardless of your weight, when you cut back your food intake and try to manage weight, ghrelin levels increase and make you hungry. Until you nourish your body and eat adequate fuel, ghrelin may cause the metabolism to slow down to preserve energy as a natural response to protect you from starvation.

Research suggests that although people with obesity have lower ghrelin levels, they are more sensitive to its effects which can contribute to overeating.

Ghrelin Imbalance Symptoms

The following symptoms may indicate a ghrelin imbalance:

  • extreme hunger
  • weight gain and difficulty losing weight
  • anxiety and stress
  • fatigue
  • fertility issues

How to Test for Ghrelin Imbalance?

Ghrelin levels can be measured in the blood.

How to Support Ghrelin Balance

Eat regularly

Fasting and starvation may cause ghrelin levels to increase. Ghrelin levels generally begin to rise about three hours after eating. Maintaining a regular eating schedule that works for your body and avoiding crash diets and extreme calorie restriction may help stabilize ghrelin, manage hunger, and avoid extreme cravings that can lead to imbalanced food choices.

Prioritize high-quality sleep

Poor or irregular sleep may increase levels of ghrelin. Getting regular adequate amounts of high-quality sleep can help stabilize hunger and weight.

Build muscle mass

Regular exercise focusing on building and maintaining muscle mass may help keep hunger, ghrelin, and weight balanced. Higher amounts of muscle have been associated with lower levels of ghrelin.

Don't overtrain

While exercise is beneficial, it is essential to avoid over-training, as this can affect ghrelin levels. When you engage in intense cardiovascular total-body exercise such as running long distances or long sessions of boot camp frequently, your body may produce more ghrelin. This is the body's way of seeking out energy to fuel the activity, as this hormone makes us feel hungry.

Neuropeptide Y

In addition to leptin, insulin, and ghrelin, neuropeptide Y (NPY) is an important hormone for regulating metabolism, appetite, and hunger. Neuropeptide Y is produced in your brain and nervous system and sends signals that stimulate appetite and decrease energy expenditure in response to fasting or stress. It stimulates food intake, with a preference towards carbohydrates, increases motivation to eat, and reduces the time between desiring food.

In these ways, NPY is associated with weight gain and obesity. More specifically, NPY influences body weight by stimulating the creation of new fat cells and promoting the build-up of fat stores, especially in the abdomen. Under chronic stress and with consumption of a high-sugar diet, more NPY is released, which in turn increases appetite for more food and weight gain. These impacts also contribute to increased inflammation which may affect obesity and other chronic health issues.

Neuropeptide Y Imbalance Symptoms

The following symptoms may indicate an NPY imbalance:

  • increased appetite
  • weight gain, especially in the abdomen
  • mood changes
  • irregular menstruation

How to Test for Neuropeptide Y Imbalance?

NPY and its metabolites can be measured in blood, although the test is not widely available.

How to Support Neuropeptide Y Balance

Exercise consistently

Regular and consistent exercise may help decrease NPY levels and regulate appetite.

Manage stress

Activation of the sympathetic nervous system during the response to stress results in the secretion of NPY. Therefore, maintaining an effective and regular stress management practice can help regulate NPY levels. For example, mindfulness-based mind training to enhance stress resilience resulted in lower plasma NPY levels after exposure to stressful events.

Eat a balanced diet low in processed sugars and fats

Since high-fat, high-sugar diets particularly increase NPY levels, eating a balanced whole foods-focused diet that avoids processed sugars and fats may help keep this hormone balanced.

Glucagon-Like Peptide-1

Glucagon-like peptide-1 (GLP-1) is a hormone produced by the gastrointestinal tract when nutrients enter the intestines. GLP-1 influences hunger and appetite by making you feel full when you eat and helps the body release insulin and keep blood sugar balanced. Specifically, GLP-1 increases insulin and decreases glucagon levels. It also delays stomach emptying, resulting in reduced blood glucose levels. Β 

Overall, GLP-1 lowers appetite, enhances satiety or fullness, reduces food intake, and may support weight management. In obesity, there are problems with GLP-1 signaling. Studies suggest that weight gain may induce functional deficits in GLP-1 signaling that facilitate the maintenance of a higher body weight.

Because of its role in blood sugar metabolism and weight, a class of drugs that target GLP-1 (GLP-1 agonists) has been developed. They are used to improve blood sugar control, weight, and waist circumference/central obesity in people with type 2 diabetes who have poor blood sugar control and are taking anti-diabetic therapy by mouth.

Glucagon-Like Peptide 1 Imbalance Symptoms

The following symptoms may indicate a GLP-1 imbalance:

  • blood sugar fluctuations
  • weight changes
  • changes in appetite

How to Test for Glucagon-Like Peptide-1 Imbalance?

Glucagon-Like Peptide-1 can be measured in the blood but is not commonly measured outside of a research setting.

How to Support Glucagon-Like Peptide-1 Balance

Eat adequate protein

Adequate protein is required to mediate appropriate GLP-1 signaling and regulate appetite and hunger. Protein-rich foods like whey protein and yogurt have been shown to increase GLP-1 levels and regulate appetite.

Nourish and maintain a healthy microbiome

Short-chain fatty acids (SCFAs) are mainly produced when microbes in the gut ferment partially- and non-digestible carbohydrates like prebiotic fibers and resistant starches, especially from plant foods. This fermentation of "indigestible" prebiotics to SCFAs by gut bacteria then modulates the release of gut hormones controlling insulin release and appetite, including GLP-1. A well-balanced, anti-inflammatory diet incorporating a variety of plant-based foods promotes a variety of beneficial bacteria. It also suppresses potentially detrimental species, which helps to optimize the production of SCFAs and balance metabolism and weight. Consuming a wide variety of plant foods and sources of fermentable fiber helps to feed the good bacteria in your gut so that they can produce adequate amounts of SCFAs.

Peptide YY

Peptide YY is a hormone made in the small intestine alongside glucagon-like peptide 1 after eating. It travels in the blood to the brain, where it decreases appetite and makes you feel full, as well as acting in the stomach and intestine to slow down the movement of food through the digestive tract. Β 

Sufficient levels of peptide YY play a major role in regulating appropriate food intake and decreasing the risk of obesity. PYY levels may be lower in those with obesity, contributing to an increased appetite, overeating, and weight gain.

Peptide YY Imbalance Symptoms

The following symptoms may indicate a PYY imbalance:

  • dysregulated appetite
  • hunger
  • weight changes

How to Test for Peptide YY Imbalance?

While Peptide YY has been measured in blood for research purposes, it is not routinely measured.

How to Support Peptide YY Balance

Consume resistant starch

Consuming dietary resistant starch feeds the good bacteria in the gut and may increase PYY, which promotes satiety and fullness and can aid in weight management. Good sources of this prebiotic resistant starch include green bananas and plantains, cooked and cooled rice or potatoes, beans, peas, and lentils (white beans and lentils are the highest), and whole grains, including oats and barley.

Eat an anti-inflammatory diet with adequate amounts of protein

An anti-inflammatory diet like the Paleo diet, including sufficient amounts of protein and plant-based foods like vegetables, may raise PYY levels.

Cholecystokinin

Cholecystokinin (CCK) is released from the duodenum (the first portion of the small intestine) after a meal and leads to the release of bile from the gallbladder and digestive enzymes from the pancreas. Similar to GLP-1, CCK also acts as a fullness hormone and an appetite suppressant when food is plentiful. It helps suppress your appetite while you are digesting food by making your stomach feel physically full, activating the vagus nerve, and increasing the release of the fullness hormone leptin.

CCK is also involved with energy production, protein synthesis, body temperature and metabolism regulation, and anxiety.

People with obesity may have a reduced sensitivity to the appetite-regulating effects of CCK, which may lead to chronic overeating and weight gain. Over time, this can further reduce CCK sensitivity. In addition, people who carry a specific variant of the cholecystokinin gene appear to have a 60% increased risk of obesity.

Cholecystokinin Imbalance Symptoms

The following symptoms may indicate a CCK imbalance:

  • appetite changes
  • hunger
  • weight imbalances
  • anxiety
  • impaired gastric emptying (gastroparesis)
  • impaired gallbladder function (biliary dyskinesia)

How to Test for Cholecystokinin Imbalance?

While CCK can be measured in blood, it is not routinely measured.

How to Support Cholecystokinin Balance

Eat enough protein

Adequate protein helps to regulate appetite and hunger in part by increasing CCK and, therefore, feelings of fullness.

Exercise consistently

Regular and consistent exercise may help increase CCK levels to regulate appetite.

Summary

Many hormones work together in your body to maintain equilibrium. Leptin, cortisol, insulin, estrogen, ghrelin, neuropeptide Y, glucagon-like peptide-1, peptide YY, and cholecystokinin all influence weight balance. When one or more of these hormones is out of balance, weight gain and difficulty losing weight can occur, even when you're eating right and exercising.

If you experience difficulty maintaining a balanced weight or any of the other symptoms discussed above, functional medicine laboratory testing could help assess these hormonal factors that may be contributing.

This information about hormone levels and insights into some of the potential factors contributing to imbalances in these hormones can allow you and your doctor to target a plan to bring things back into balance.

The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

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