Some hormone imbalances can lead to physical symptoms, including abdominal weight gain. People sometimes refer to this as a “hormonal belly.”

Some fat around the abdomen is typical. However, if a person gains fat in this area for no apparent reason, it could result from a hormonal condition.

In this article, we discuss the different causes of hormonal belly and treatment options.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Hormonal belly refers to weight gain around the abdomen due to a hormonal imbalance. It is not a distinct medical condition but a potential symptom of something else.

Many factors can affect a person’s body weight and shape. This includes diet, exercise, sleep, and genetics. However, if no other factors explain abdominal weight gain, there may be a hormonal cause.

Some potential causes of hormonal belly include:

  • underactive thyroid
  • high cortisol
  • leptin resistance
  • low or high estrogen, or low testosterone, in males
  • menopause, fluid retention, or polycystic ovary syndrome (PCOS) in females

The thyroid is a gland in the neck that releases hormones that help control metabolism, which is how the body uses energy. As a result, these hormones affect weight gain and loss.

Hypothyroidism, or an underactive thyroid, is a condition that occurs when the thyroid gland does not produce enough thyroid hormones. When this happens, many of the body’s functions slow down.

A common symptom of an underactive thyroid is weight gain, often around the abdomen. However, the American Thyroid Association states that the weight gain may not necessarily be due to the build up of fat, but the accumulation of salt and water.


A doctor can prescribe levothyroxine for hypothyroidism. This is a medication that mimics natural thyroid hormones. A person can expect to lose less than 10% of body weight during treatment, as most of the weight gain is salt and water.

Once a person’s thyroid levels are in the typical range, their ability to gain and lose weight is the same as those without hypothyroidism.

Cortisol is a stress hormone that plays a key role in the “fight, flight, or freeze” response, which is how the body responds to perceived danger.

When a person feels under threat, the adrenal glands produce more cortisol. In short bursts, stress is not harmful. However, when frequent or prolonged, it can result in various effects, including increased fat storage. Chronic stress can also:

  • raise the risk of cardiovascular disease
  • weaken the immune system
  • interfere with menstruation and pregnancy

If the body produces very high levels of cortisol for an extended period, this could be a sign of Cushing’s syndrome, which is a potentially serious condition. The symptoms can include:

  • fatty hump between a person’s shoulders
  • increase in fat around the base of a person’s neck
  • thin legs and arms
  • easy bruising
  • weakened muscles
  • purple stretch marks along the abdomen, hips, under the arms, and breasts

Certain drugs, especially glucocorticoids, may cause Cushing’s syndrome. Pituitary tumors can also cause this disease.


Treatment depends on the cause. If a person has Cushing’s syndrome, treatment may include drug changes or surgery to remove a tumor.

If cortisol levels increase due to stress, reducing stress and increasing relaxation may help.

Fat cells release a hormone known as leptin. This hormone plays an important role in weight regulation, creating a sensation of fullness. This prompts a person to stop eating.

When signaling between leptin and the brain works as it should, it helps people know when they have had enough to eat.

However, people with obesity have more fat cells and, therefore, high levels of leptin. In theory, this should mean the person feels full frequently, but if signaling stops working properly, a person can develop leptin resistance. This means the brain does not respond to the hormone as it should.

Doctors do not fully understand what causes leptin resistance, but genetics, changes in brain chemistry, and inflammation may play a role.


There are no specific medications for leptin resistance yet. However, reducing fat cells in the body may reduce leptin. A 2019 paper suggests that reducing leptin levels may allow the brain to become sensitized to it again, but more studies are necessary to confirm this.

Learn about other reasons for feeling hungry.

Some causes of a hormonal belly in males are as follows:

Low testosterone levels

Testosterone is the most abundant male sex hormone, although females produce it too. This hormone helps determine typical male characteristics, such as body and facial hair. Testosterone also promotes muscle growth.

In males, testosterone levels decrease as males age. A deficiency can halt muscle growth and lead to weight gain.

Testosterone deficiency can occur due to certain medical conditions, such as Noonan syndrome. It can also occur due to damage to or the removal of the testicles. Other causes include infection, autoimmune conditions, chemotherapy, and pituitary gland disease.

A doctor may prescribe testosterone supplements or recommend lifestyle changes, such as more exercise and a reduced calorie diet.

Learn more about low testosterone levels.

Low or high estrogen

Although estrogen is more abundant in females, it is also important for males. Low levels of estrogen in males can cause low sexual desire and excess fat around the belly.

However, the reverse is also true. According to a 2018 article, high estrogen levels can also cause weight gain in males under 60.

A doctor may recommend medications to treat low or high estrogen.

Learn more about estrogen in males.

The following are causes of hormonal belly in females:


According to the Office on Women’s Health (OWH), PCOS is common, affecting approximately 1 in 10 females of reproductive age.

People with PCOS have higher levels of male sex hormones and higher insulin levels. Insulin is a hormone that affects how the body turns food into energy. As a result, people with PCOS may gain weight, particularly around the abdomen.

Medications to lower testosterone and increase estrogen may help ease PCOS symptoms. Other drugs, such as metformin, may ease insulin resistance. Dietary changes and exercise may also help.

Learn more about PCOS and its treatment.


When a person begins the transition into menopause, female sex hormones, such as estrogen, start to decrease. At the same time, visceral fat around the abdomen can increase.

A 2018 study suggests that hormone replacement therapy may help reduce this. A person can also exercise regularly and maintain a balanced diet.

Learn more about losing weight during menopause.

Period-related fluid retention

Some people retain more fluid in the body during their period. This can cause bloating, especially around the stomach, which may look like weight gain.

A 2023 study of 42 white females in Greece found that participants gained around 0.5 kilograms in weight during menstruation. This was mostly due to the body retaining more water. After a period, a person may lose this weight again when fluid retention subsides.

It is unclear why this happens, so more studies are necessary to confirm the results.

Learn more about ways to reduce period bloating.

Reducing belly fat may involve different strategies depending on the cause. For example, a doctor may recommend medications, dietary changes, or lifestyle changes for people with hormonal imbalances.

Other tips that may help with excess weight include:

  • Calorie adjustment: Weight gain can result from a person consuming more energy from food than they need each day. A person may find it helpful to adjust the calories they consume to match their activity level.
  • Resistance training: Resistance exercises can help people reach a moderate weight while increasing muscle mass. A 2021 review of studies found that at least 4 weeks of this type of exercise reduced visceral fat, too.
  • Avoiding alcohol: A large 2022 study of white older adults in the United Kingdom found a link between alcohol consumption and visceral fat. Cutting down on alcohol consumption may help.
  • Getting enough sleep: Insomnia has links to weight gain. Adequate sleep may lower leptin levels, as well as cortisol.

Learn more about how to reduce belly fat.

Here are some questions people often ask about a hormonal belly.

What causes hormonal belly?

Many hormone shifts can lead to abdominal weight gain, from thyroid disorders to the menstrual cycle. In males, it may result from low testosterone levels or changes in estrogen levels. In females, it can occur due to PCOS, fluid retention, or menopause.

What are the treatments for hormonal belly?

The treatment will depend on the cause. A doctor may recommend medication to balance the hormones that are causing the problem. Dietary and lifestyle changes may also help.

How do I know if I have a hormonal belly?

Many things can lead to abdominal weight gain. It may not be possible for a person to find out if they have a hormonal belly on their own.

However, if weight gain or bloating happens around menstruation, it only occurs around the abdomen and is not due to changes in diet or physical activity; the cause could be hormonal.

A doctor can determine if a person has a hormone imbalance by performing tests.

Hormonal belly is when a person gains weight around the abdomen due to hormonal fluctuations. This could be due to changes in thyroid, adrenal, reproductive, or other hormone levels.

The conditions that cause hormonal belly weight may also cause other health problems, so it is a good idea to see a doctor for a diagnosis. Treatment may include medications or lifestyle changes, such as diet and exercise.