Podcast Episode 55 Transcript – Can Your Hormones Be the Reason You Aren’t Losing Weight?

Aidan Muir:

Hello, and welcome back to the Ideal Nutrition podcast. My name is Aidan Muir, and I’m here once again with my cohost Leah Higl, and this is episode 55 where we’ll be talking about whether your hormones can be the reason you aren’t losing weight.

Aidan Muir:

So going through a little bit of background stuff, one of the most complex conversations I think to have, is this concept of calories in, calories out, and is that what controls weight loss and everything like that, or controls everything to do with that. Or is it hormones? A lot of people would be like, it’s not calories in, calories out, it’s hormones. But I think the bit that is often overlooked is that, hormones is factored in already. Calories in, calories out, is a simple formula that’s a really complex kind of topic, that factors in that.

Aidan Muir:

I don’t want to jump too far ahead of myself, because we’re literally going to be talking about how it’s factored in, but it is the kind of stuff we’re going to be covering. We’re going to be covering how it factors in. And giving a bit of background before we go further, it’s like well, what hormones could play a role in this, listing a few off? Thyroid hormones, insulin, cortisol, estrogen, testosterone, it’s a long list. Then there’s your hunger hormones like leptin and ghrelin and other hunger informant hormones.

Aidan Muir:

It’s a long list, and we’re going to try and go through as many of them as we can individually, but we could be here for hours if we wanted to-

Leah Higl:

100%.

Aidan Muir:

Yeah, so we’re just going to go through them individually, and just see how it goes and try and keep it to a reasonable timeframe as well.

Leah Higl:

We’ll do the cliff notes version of all of these hormones. So obviously it’s a big topic. So let’s kick it off with thyroid hormones. So your thyroid hormones influence a lot of different bodily functions, functions that generally require energy and calories. So if your thyroid hormones are low, like what we see in hypothyroidism and conditions like Hashimoto’s and things like that, if thyroid hormones are low, then those bodily functions are being interrupted and then potentially we see a decrease in energy expenditure from those particular functions.

Leah Higl:

Obviously way more complex than what I’ve just laid out, there’s a lot of different hormones that come into play within that, but having a reduction or reduced kind of thyroid hormones, can decrease the calories out portion of that calories in, calories out equation. And we actually see this in a really real way. So we were actually talking off air before we started filming, of the things that we see in hypothyroidism, so an underactive thyroid condition, that is a real sign of a reduction of energy expenditure. So things like brain fog, constipation, fatigue, feeling cold more easily. All of these things are signs that the body is slowing its basal metabolic rate, and that is due to these thyroid hormones.

Leah Higl:

So it can absolutely have an effect on that equation.

Aidan Muir:

Yeah. And it makes so much sense, because the body’s not just burning calories for no reason, it’s doing it for a function, it’s doing it for something like that. And the reason why thyroid hormones play a role in that, is because your thyroid are kind of controlling these functions, they’re influencing these functions.

Leah Higl:

Yeah.

Aidan Muir:

If you have lower thyroid hormones, it’s down-regulated, these functions are down-regulated, your body is therefore then spending less calories on these functions. That’s why it plays a role there.

Aidan Muir:

The next one we’re going to be talking about is insulin, and this is probably the biggest one. This is going to be the… A lot of people will be like, “It’s not calories, it’s insulin. Insulin is what matters.” And every time I’m like… Because this is stuff that I’ve been reading about for years, and years, and years, but every podcast I do I’m like, “I’m just going to look through stuff again, look through what are people saying from all perspectives and everything like that.”

Aidan Muir:

And one of the most common things you will see from people will be like, “It’s not calories, it’s insulin,” is they will say certain statements like, the key to weight loss success is to control your insulin, specifically keeping insulin as low as possible. And then they will use that to be followed up by something like, the solution is to keep carbs as low as possible. And that’s complex on a few levels, because firstly, not only do carbs raise insulin, so does protein. We’ve got to factor that in every time that conversation comes up. But let’s take it a bit further to look through that further.

Aidan Muir:

So insulin’s main role is to take glucose from the blood, and then store it in muscle, store it in fat. So it could be stored as fat, or it could be stored as glycogen within the muscle, or it could be stored as muscle as well to a certain degree as well. But taking that another step further, one of the biggest factors in this kind of discussion is that, insulin inhibits lipolysis. So that’s the breakdown of fat, it inhibits fat breakdown. It also increases lipogenesis, which means taking fat from the blood and storing it as body fat.

Aidan Muir:

You can see how easy it is to see that mechanism and be like, “That’s the most important thing.”

Leah Higl:

Yeah, 100%. I can totally see where people are getting that from.

Aidan Muir:

Yeah, and if you simplify it down to just one hormone, it therefore looks like this is the only thing or the main thing we need to focus on. But when you dig deeper, it’s like well, insulin inhibits fat breakdown because you’ve literally just eaten something. It’s more efficient for the body to use nutrients that you’ve just eaten, than it is to mobilize fat from its own fat cells to be used. It’s easier just to use the fat stored in your blood for example, it’s more efficient.

Aidan Muir:

And the other complex aspect of this when you simplify it down is, it’s not like only one thing can happen at a time. We have heaps of hormones working at once. Glucagon for example, does the opposite of insulin, and these hormones don’t just switch on and off. The better way to think about it I should say is, it’s like a dimmer switch rather than a light switch. They don’t go completely on and off, you can be losing fat while insulin is in your system, it is still possible. It is a complex interplay.

Aidan Muir:

And the other thing as to why it would never be as simple as just insulin, although insulin is a massive factor, is that insulin is storing something obviously. It has to have something available to be stored, it has to have fat in the blood to be stored, it has to have glucose in the blood to be stored. These are the substrates, and glucose and fat are made up of calories, that’s why calories has to be a factor here. Because if somebody was in a calorie deficit, they would have less available of these things to be stored, and the nett result could result in fat loss. That’s why a lot of these things matter, that’s why it’s an interplay.

Aidan Muir:

I could talk about that for so long, because it’s so much deeper than that. But without even just looking at mechanisms, we can also look at outcomes, because outcomes is something that matters. And there’s a lot of research on this of course, but using one example which I think is a great example of this, is there’s a metabolic ward study by a guy named Kevin Hall, obviously he did that research with other people as well, and it was done under conditions where they matched calories completely.

Aidan Muir:

They gave one group a ketogenic diet, and they gave one group a lower fat diet, but calories were matched. And both groups lost the same amount of fat, even though insulin was 22% lower in the law carb group than the low fat group. I’ve got to mention that point there about insulin being lower, because it’s like you could criticize so many aspects of that study. You can criticize heaps of things about every study pretty much.

Aidan Muir:

If the argument is that insulin’s the most important thing, or if the argument is that insulin’s the only thing that matters, and nobody should be arguing that only one thing matters, but if somebody happened to be making that argument, you can’t really rationalize that way when in that study 22% lower insulin they lost the same amount. And then one final thing on that point I guess is that, even in groups where people have higher insulin because they’re insulin resistant, for example people with diabetes, we see the same fat loss on low carb versus low fat diets, even though insulin would be different as well.

Leah Higl:

Yeah, I think any time you’re looking at one hormone, you’re not seeing the bigger picture-

Aidan Muir:

Yeah.

Leah Higl:

… of the endocrine system in the body. But we’re going to do the next hormone that we’ll focus on independently, and that’s cortisol. So cortisol is kind of known as the stress hormone, I suppose we think of it as kind of a negative hormone in that it is associated with stress, but it does have plenty of positives in the body, it is there for a reason. So one thing it is associated with, is a reduction in inflammation. So there are roles for cortisol in the body, but we’re going to talk about this in a few contexts.

Leah Higl:

So the first couple of contexts, we’ll talk about cortisol is, in a couple of disease states. So we’ve got Cushings Syndrome, which is high cortisol levels. Now this is typically associated with potential weight gain that can occur, as well as an increase in appetite and cravings, so in this particular disease state. Other things come alongside this like fatigue, and hypertension, irritability, thinning of the hair, and rounding of the face. So a lot of other symptoms of this particular condition, but it is associated with weight gain, increased appetite, et cetera.

Leah Higl:

Second context would be Addison’s Disease. So this is where you experience low cortisol levels, and that is associated with low appetite and weight loss can occur with that disease state. So obviously there is some kind of link here potentially, but where it becomes less strong is when we’re looking at things like, stress-induced elevated cortisol levels. So it seems that on average it does tend to increase calorie intake, but we don’t have kind of hard research to link stress with weight gain or weight loss. So there’s not a strong link there.

Aidan Muir:

Yeah, it can go both ways as in, there is research supporting that it’s linked with those, but it’s like-

Leah Higl:

It’s not one way or the other. Does that make sense?

Aidan Muir:

Yeah.

Leah Higl:

Yeah, yeah. So it’s not like cortisol levels is definitely causing wight gain, or it’s definitely causing weight loss, we have kind of research showing both outcomes. So it’s not clearly linked to one or the other.

Leah Higl:

So fourth context would be research in obesity just generally. So obese subjects do typically report higher stress levels than the controls, but there hasn’t really been a huge correlation between cortisol levels on average as a part of that.

Leah Higl:

So the assumption that I guess stress equals excess cortisol levels, may be not as strong as we would think was.

Aidan Muir:

Yeah, it’s not that simple.

Leah Higl:

It’s not as simple as that, and that’s probably the underpinning of every single hormone or hormone group we’re talking about, is it’s not that simple. So that’s just something to be aware of I suppose. And the research doesn’t really link cortisol with obesity on average, so we know that that can’t be a main factor. It’s not that just increased cortisol levels is causing the obesity crisis or anything like that, just like any of these hormones in isolation is not the answer.

Aidan Muir:

Yeah. And I guess doubling down on that hormones in isolation thing, if you listen to this podcast and you come to a conclusion that it’s either calories or hormones, that’s the wrong conclusion. There’s an interplay between both, they both affect each other.

Leah Higl:

Yes.

Aidan Muir:

Hormones affect calorie intake and calorie expenditure, and those things affect hormones as well. And I guess with the cortisol thing, it’s one of those things where you can hear people talk about it and it makes sense when you hear it, like people talk about you’re doing X activity, which increases stress, and then they’ll use the word like, that lays down belly fat, is the common example.

Leah Higl:

Yes.

Aidan Muir:

And it sounds nice, but that’s why it’s important for us to actually look at the research and be like, “Those who are obese on average, do not have higher cortisol level.” It’s very hard to be like, “Cortisol is the reason people are in certain positions,” when you look at it from that angle.

Leah Higl:

100%. And I think some of this comes from the fact that cortisol does play a role in water regulation, so that you can have… or be retaining more water if you have higher cortisol levels. So if you do have stress levels that are high and that results in higher cortisol levels, and then you’re retaining more water, you’ll probably feel like you’ve potentially gained body fat or body weight. Obviously on the scale, so that could be playing a role on our thoughts of that as well.

Aidan Muir:

Yeah. So that’s when it plays a role. Yeah, complex. So another one that plays a huge role obviously, is hunger hormones. So we’ve got leptin and ghrelin, but unfortunately once again, they’re not overly simple. I’m going to start off with the simple aspect, and then go a little bit more complex.

Aidan Muir:

So leptin is most well-known for being a fullness hormone, ghrelin is most well-known for being a hunger hormone. And on short term timeframes in particular, we can see this really clearly like, when you eat far less calories, the normal or far less food volume, the normal ghrelin typically increases. In response to eating too little, your body makes you hungrier to encourage you to eat more. That’s a really good system from a self-preservation kind of setting. So when we eat less, we get hungrier.

Aidan Muir:

Leptin alternatively, is a fullness hormone. Based on that logic when you over consume food, you get full and you don’t continue to overeat is the kind of concept. But when we’re looking at the question of are hormones the reason why it’s more difficult to lose weight for example, taking that to the next level would be like, without further context I would have made the assumption many, many years ago that people who have more body fat, surely would have lower leptin levels on average… higher… yeah, lower leptin levels on average, because leptin is a fullness hormone. So I assumed that those with more body fat, would have less of that hormone that keeps you full, and that’s why it’s easier to overeat, and vice versa.

Aidan Muir:

But something that is a massive caravel in all of this, is that those with more body fat typically have higher leptin levels. And that’s just fascinating, because it’s a fullness hormone, and it’s not what you’d assume. And I guess the biggest explanation for that is that, the more leptin you have, the more resistant you get to leptin, is a common kind of example. It’s like the more body fat you have, the more leptin you have, the more resistant you get to leptin, the less of an effect it has anyway. So over the long term it doesn’t necessarily matter that much.

Aidan Muir:

Leptin also from another angle, plays a role in energy expenditure as well. So it’s not just fullness, it plays a role in energy expenditure. So once again, if somebody short term has too few calories, it’s going to decrease energy expenditure. If they have too many calories, it increases energy expenditure. Not a massive amount. It’s just one of those pieces in the puzzle, but it is another factor.

Aidan Muir:

On that topic as well, ghrelin is also pretty hit and miss in terms of you’d assume that levels of ghrelin, because it’s a hunger hormone, people with higher body weight. So you’d probably assume that they have higher levels of ghrelin, making it easier to overeat. But once again, that’s not necessarily the case, it seems like people with higher BMIs, their ghrelin levels are quite similar to those with lower BMIs. It doesn’t seem to be a massive factor there.

Aidan Muir:

There can be exceptions to this though. Like for example, with Prader-Willi Syndrome, it’s a syndrome where amongst a lot of other symptoms, people… it’s like they have no off switch to their appetite, they just want to eat, and eat, and eat. They typically have quite high ghrelin levels, and that’s probably a factor as to why their appetite is so much higher, and the desire to eat is so much higher.

Aidan Muir:

And another exception is also, bariatric surgery, their ghrelin levels are often lower, which is kind of cool because it’s not just like a decrease in stomach capacity or anything like that, it actually affects hormones as well, so that’s super interesting.

Aidan Muir:

And then I think that kind of hunger and fullness hormone’s topic up as well, there are other hormones that play a role. Just listing a few, there’s neuropeptide y, glucagon-like peptide, Cholecystokinin, peptide yy. It just goes on and on, there’s so many. And I simplified it down to the two most common ones that most people are going to be a little bit more familiar with, but this is why these two hormones by themselves don’t massively influence things, because there’s so many other hormones that play a role in our hunger and fullness too.

Leah Higl:

Yeah, I find hunger and fullness hormones really interesting. I just think it’s a really cool part of research, but it’s just so complex.

Aidan Muir:

Yeah, so complex.

Leah Higl:

A piece of the puzzle. So we’ll get into estrogen now, because that is something that can play a role to a certain extent. So we know that estrogen does play a role in body fat distribution, so even heading into women in post-menopause, are going to have a different body fat distribution because of that reduction in estrogen as that part of life occurs. So we know there’s a change there and it plays a role.

Leah Higl:

And then we can also think of estrogen, as typically being anabolic as well. So in times in our menstrual cycle where we see estrogen being quite high… I keep switching between estrogen and estrogen. But let’s go with estrogen. So when we have high estrogen levels, we tend to actually be slightly stronger, which is cool. So it kind of goes to show that it can have an effect pretty widely on our body, but generally we’re thinking of it as a pretty anabolic hormone. That’s all I kind of want to touch on in regards to estrogen, but I do want to touch on the hormonal changes that occur when we’re talking about the pill, or hormonal contraception just in general, so whether it’s depo shot, patch, whatever it might.

Leah Higl:

I think this is such a wormhole when it comes to not only weight gain, but just as a topic in general, how it affects our body. So temporary side effect of hormonal contraception, can be an increase in fluid retention. I think a lot of people can attest to that who’ve been on this kind of hormonal contraception, but especially estrogen based ones. So they are known for having that temporary effect when you do start taking them.

Leah Higl:

Progesterone based contraception on the other hand, are known to stimulate appetite a little bit, or can in some people. Interestingly enough when we look into the research, there was a review of 45 studies on hormonal contraception, and found there was no link between the pill and long term weight gain when compared to a placebo. So I think that’s pretty interesting, because just in talking to women and getting people’s first hand accounts, it changes a lot in your body and I think a lot of people experience weight gain, or even weight loss for some people. It can have a really huge impact.

Leah Higl:

Like I said, it’s a big wormhole, I don’t even think that the research has gotten to a point where we know exactly what’s going on with each of these different kinds of contraceptions, it’s a mine field. But I think there absolutely can be an effect on things like hunger, satiety, cravings, mood, how you feel, and that can all affect calories in, calories out. And then there’s the potential effect of does it change resting metabolic rate a bunch of things that it could potentially be affecting.

Aidan Muir:

Yeah. Such a complex topic as well, and I feel weird as a guy talking about that because we do have that review, that one being on average, that doesn’t seem to have changed.

But everybody experience some change in some way shape or form to hunger and mood variables.

Leah Higl:

Everybody’s going to have a different… Even looking at the packaging of the pill and stuff, it always says potential side effect, weight gain. That’s there because some people are experiencing it likely. So you can’t write it off, I don’t reckon.

Aidan Muir:

Yeah. So then the probably last one we’ll do, so we’ll do testosterone. So increased testosterone is normally linked with gaining size, even just jumping straight to people using it as an anabolic steroid as a performance enhancing drug, automatically assume people are going to gain size. But what is quite interesting is that, the research on introducing testosterone replacement therapy in those low testosterone who also are obese, is that it seems to help people lose weight in that scenario.

Aidan Muir:

And there’s also research showing that on overage, those who are classified by BMI as being obese, on average have 30% less testosterone, which is a fascinating kind of thing to think about and be like… I don’t know, it’s not something that I inherently would have assumed without the research being there. There’s heaps of potential explanations for it, but it is also a factor being how do hormones play a role in this, it seems like lower testosterone seems to be linked with that.

Aidan Muir:

So it’s another factor where it’s like, this could be a factor in things being more difficult for losing weight as well.

Leah Higl:

So I guess to summarize it up, do we think hormones can be the reason you aren’t losing weight?

Aidan Muir:

I never think it’s as simple as being, “I can’t lose weight because X thing,” But it is an added barrier, and it is another variable in the piece of the puzzle in terms of what you’re trying to overcome.

Leah Higl:

Yeah, if it’s increasing calories in through appetite regulation not being managed well, or it’s affecting calories out through a reduction in metabolism in some way, it can have so many effects on that equation.

It’s the same thing, when we’re talking about calories in and calories out, we’re also talking about all these interplays between hormones that are happening.

Aidan Muir:

Yeah, I reckon that’s the best one we’ve done, so yeah, we’ll leave it there. So this has been episode 55 of the Ideal Nutrition podcast, and thank you so much as always for listening.