Weight loss: What's hampering your fight in the battle of the bulge?

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by Dr. Angela DeRosa, DeRosa Medical / Special to azfamily.com

GMAZ interview by Stella Inger

Posted on April 8, 2013 at 11:54 AM

Updated Wednesday, Oct 30 at 8:11 AM

PHOENIX -- Obesity is the nation’s No, 2 cause of preventable death, increasing risk for developing type II diabetes, coronary artery/heart disease, breast, colon and other cancers, hypertension, stroke, and other health conditions. Eating right and regular exercise are important, but the dreaded “middle age spread” is not all due to years of TV, donuts, beer and bonbons. As we age, it becomes harder to fight the battle of the bulge due to hormonal imbalances. Here’s a simplified overview of how it happens.

Insulin helps our bodies convert food to glucose (sugar), and deliver it through the bloodstream. Testosterone helps glucose enter the muscles, where it’s metabolized, or burned off for energy. When testosterone is low, excess glucose builds up in the blood, triggering the pancreas to send out more insulin to lower blood sugar. Insulin then triggers hunger and cravings, so we eat, and the cycle of highs and lows begins again. Over time, the liver starts converting all the excess glucose into fat.

Thyroid hormones drive the body’s metabolic engine and glucose is the fuel. The thyroid gland depends on testosterone to function properly, and the body needs testosterone to metabolize glucose properly, so it’s another vicious cycle. When thyroid is balanced, the body burns glucose efficiently. When it’s too high (hyperthyroidism), fuel burns too fast. If it gets sluggish or starts to fail (hypothyroidism) the fuel burns very slowly. One in three women and one in five men will be hypothyroid by age 50, so to lose weight and keep it off, testosterone and thyroid levels must be in balance. But there’s more.

Chronic stress also triggers weight gain. Adrenal glands produce cortisol, which also stimulates glucose production. Under stress, cortisol levels spike to help the body quickly produce energy needed in “fight or flight” situations. Once the threat is gone, cortisol falls back to normal. Under chronic stress, levels stay elevated, producing more glucose, and excess is stored as fat, especially around the mid-section.

With age, stress, and hormonal imbalances all contributing to excess weight, it’s important to have hormone levels properly tested, evaluated, and if necessary, treated through hormone replacement therapy and/or thyroid hormone. The benefits clearly outweigh the risks of remaining overweight.


Dr. Angela DeRosa is a nationally recognized expert in the field of Internal Medicine and Women's Health. DeRosa Medical has locations in Scottsdale, Sedona and Chandler. For more information, call 480-619-4097 or visit DeRosaMedical.com.

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