Hormonal Belly: Men Versus Women

Reviewed by Jeremie Walker, MD, MBA · April 23, 2024

You exercise regularly and eat as many nutritious meals as possible. Yet, the scale says you’re gaining weight, not reducing it. And that stubborn excess weight around your waistline just won’t budge. So what’s up?

Even a minor change in our hormone levels can cause extra belly fat in some cases.

Hormones play a role in a variety of biological functions, including stress, metabolism, sexual desire, and hunger. If a person lacks specific hormones, it can lead to abdominal weight gain, which is referred to as a hormonal belly.

So, how can you tell if those love handles are just a few extra pounds from a pizza and wine binge or if they’re a sign of anything more serious? Here are five symptoms that your hormones are at fault for and what to do about them.

What is a Hormonal Belly?

Hormonal belly fat, also known as visceral abdominal fat, is a type of fat that accumulates in and around your internal abdominal organs as a result of metabolic inflammation. Unlike other types of fat, hormonal belly fat is stubborn and often resistant to conventional weight loss strategies; diet and exercise may have limited impact on reducing it. This is because hormonal belly fat is primarily triggered by specific hormones involved in regulating our metabolism. These hormones can influence fat storage and distribution.

Excess fat that accumulates around the midsection is also referred to as “central obesity.” People with this pattern of fat accumulation are at increased risk of several health conditions:

  • Type 2 Diabetes: Excess visceral fat is associated with insulin resistance and impaired glucose metabolism.
  • Cardiovascular Disease: Visceral fat contributes to inflammation and can lead to heart-related issues.
  • Cancer: Some studies suggest a link between visceral fat and certain cancers, although more research is needed.1,2 

Lifestyle choices play a significant role in hormonal balance. Factors such as an unhealthy diet, sedentary lifestyle, inadequate sleep, and chronic stress can disrupt hormonal equilibrium. 

Hormones Behind Your Belly Fat 

1. Insulin

Abdominal obesity is linked to insulin resistance, which impairs the body’s ability to utilize glucose and fatty acids effectively. This condition frequently progresses to type 2 diabetes. Furthermore, insulin resistance, along with other metabolic changes, can contribute to a cascade of adverse effects in what’s called “metabolic syndrome.” These include inflammation and dysfunction in the blood vessels, an abnormal lipid profile, and hypertension. Collectively, these factors significantly increase the risk of developing heart disease.8–10 The impact of abdominal obesity is so profound that even individuals who maintain a normal total body weight may exhibit this risk profile.11–14 

2. Cortisol 

Cortisol, a hormone produced by the adrenal glands, is essential for normal function and plays a crucial role in our body’s response to stress. It’s an integral part of the “fight or flight” mechanism. However, when cortisol levels become excessive, it can have detrimental effects. Elevated cortisol—whether produced by the body or as a result of taking corticosteroid medications—disrupts the balance of carbohydrate and fat metabolism. It promotes fat storage, particularly around the waist area. 

3. Leptin

Leptin is a hormone produced by fat cells that signals the brain when the stomach is full. Under normal conditions, this helps to prevent overeating. However, excess belly fat can lead to leptin resistance, where the brain fails to recognize satiety cues. This creates a harmful cycle, contributing to further accumulation of abdominal fat.

4. Sex hormones: estrogen and testosterone

To begin, let’s clarify that although these hormones are sometimes referred to as either male or female, both estrogen and testosterone are present in men and women. What differs is the concentration of each hormone in either sex. 


During menopause, estrogen levels decline significantly, leading to fat accumulation around the midsection rather than the thighs and gluteal area.3,4 


Testosterone is primarily responsible for the male sexual characteristics. Factors such as genetics, chronic conditions, obesity, and aging can lead to a decline in testosterone levels. This reduction may result in decreased muscle mass and increased fat accumulation around the waist. 

RELATED: Testosterone Replacement Therapy (TRT)

Hormonal Belly in Men

In general, men are more prone to accumulating fat in the abdominal region compared to women.4,5 This tendency is often attributed to lower testosterone levels, a condition known as hypogonadism. As explained above, several factors can lead to a decline in testosterone. This, in turn, increases the risk of obesity, type 2 diabetes, and cardiovascular disease—all related to insulin resistance. On a positive note, testosterone replacement therapy has shown promise in reversing these effects.6 Opt Health physicians can guide you through this process from the comfort and privacy of your own home. 

Hormonal Belly in Women

Hormonal belly fat is commonly observed in menopausal women and those with polycystic ovary syndrome (PCOS).3,7 Among the latter group, insulin resistance is a common associated factor. Both conditions are associated with various metabolic changes and an imbalance between estrogen and testosterone. Menopause leads to a significant reduction in estrogen, while PCOS is marked by high levels of testosterone, insulin, and cortisol.7 However, there’s hope: estrogen replacement therapy can potentially reverse these metabolic changes, especially when combined with appropriate dietary and lifestyle changes.4

Signs You May Have a Hormonal Belly

Are you noticing something amiss with your waistline, but struggling to identify the cause? Keep an eye out for these common signs associated with a hormonal belly: 

  • Vigorous exercise and and continued dieting that yield no results
  • Frequent sugar cravings
  • Intense mood swings 
  • Irregular periods
  • Ongoing levels of stress 
  • Difficulty falling asleep despite feeling exhausted

Ways to Get Rid of Hormonal Belly Fat

There’s no magic pill, but there are effective steps you can take to tackle hormonal belly fat. Let’s explore them:  

1. Eat better foods. 

Optimizing your nutrition is essential for getting rid of that hormonal belly fat.

  • Reduce carbohydrates: Reducing carbohydrate intake—specially refined carbohydrates—is crucial for combating hormonal belly fat. Replace sugary treats with complex carbohydrates from vegetables and fruits.
  • Prioritize protein: Ensure you consume enough protein, preferably from animal sources. Protein supports muscle health and helps regulate your appetite better than carbohydrates.
  • Don’t fear fat: Healthy fats play a pivotal role in overall health for a multitude of reasons. They are a vital source of essential nutrients, including omega-3 fatty acids and cholesterol, which is necessary for hormone synthesis. Furthermore, fats contribute to satiety, aiding in appetite regulation, and are instrumental in maintaining hormonal balance.15 

2. Stack winning daily habits. 

  • Start exercising. Physical activity is essential for cardiovascular health and maintaining or building lean muscle mass, which increases your basal metabolic rate. Aim for a balanced mix of aerobic, strength, and flexibility training. Exercise is one of the best ways to increase your longevity.
  • Get enough sleep. Your hormones naturally restore and recharge your body at night. Cultivate a healthy sleep routine to maintain balanced hormone levels. And don’t forget to limit phone use, social media, and controversial topics before bed.
  • Reduce stress. Easier said than done, but prioritize stress reduction. Chronic stress can have severe consequences. Consider relaxation techniques like yoga, meditation, or deep breathing. 
anxious middle aged man | 5 Signs Of Hormonal Belly & How To Get Rid of It

The Bottom Line: It Won’t Go Away on Its Own

Remember that hormonal belly fat is influenced by more than just diet and exercise. If you’re struggling to see the scale move in the right direction, consider seeking professional assistance.

At Opt Health, we offer comprehensive consultations and hormone level assessments. We will work together to create a personalized treatment plan tailored to your needs, which may include hormone replacement therapy such as TRT.  


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  2. Scully T, Ettela A, LeRoith D, Gallagher EJ. Obesity, Type 2 Diabetes, and Cancer Risk. Front Oncol. 2021;10:615375. doi:10.3389/fonc.2020.615375
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