Hormone Deficiency Link to Obesity

By James S. Nagel, M.D.

Several reasons explain the obesity epidemic in Western societies. The most commonly recognized explanation is the wide use of “junk food” as our staple diet, coupled with a “sedentary lifestyle.” Obesity may also be considered the result of widespread nutritional deficiency in the setting of excess calorie intake. However, a not so commonly recognized mechanism for obesity is the progressively declining levels of hormones in our bodies as we age. As the levels of human growth hormone, testosterone, and estrogen decline in men and women, we see a loss of muscle function and strength coupled with an increase in fat mass. This also leads to the development of central obesity (excess fat deposits around the trunk of the body, although not around the arms and legs), in which there is an increase in age-related dysfunction and disease such as insulin resistance, diabetes, hypertension, cardiovascular disease, arthritis, and numerous other health problems.

One of the undesirable aspects of aging is the change in body composition. Dr. Barry Sears once wrote that instead of looking like world-class athletes, most Americans look more like Porky Pig, and for many Americans this change in body composition is directly related to declining hormone levels. The impact of hormones on obesity and body conformation is most apparent and obvious in the transformation that takes place throughout the teenage years, when hormone levels skyrocket. The adolescent body generally has a high fat mass and a low muscle mass. As the level of human growth hormone rises, along with levels of testosterone in men and/or estrogen in women, there is generally a significant shedding of body fat and an increase in muscle mass. In the setting of plenty of exercise and good nutrition, our hormones will transform each individual into his or her ideal physical conformation based on genetic potential.

The ideal male or female body conformation can be generally maintained with the help of human growth hormone and the other sex hormones until about the age of 30 to 35, after which we see a significant decline in hormone levels and a subsequent transformation toward the aging body type, which is characterized by central obesity and loss of muscle mass. Dr. Daniel Rudman, M.D., published an article in The New England Journal of Medicine on human growth hormone in which he stated that “the overall deterioration of the body that comes with growing old is not inevitable.” We now realize that a lot of the changes that come with aging, such as a loss of lean body mass and an increase in visceral fat and insulin resistance, are a function of a deficiency of human growth hormone and other sex hormones. Levels of human growth hormone peak at puberty and begin to decrease at age 21. By age 30 to 35, we begin to see the age-related conformational changes taking place in the body because of declining levels of human growth hormone. By age 60, most adults secrete human growth hormone at a rate indistinguishable from that of hypopituitary patients who, because of organic lesions in the pituitary gland, no longer secrete significant amounts of human growth hormone. The fall in the secretion rate of human growth hormone that comes with aging coincides with changes in body composition and lipid metabolism that are similar to changes seen in adults with human growth hormone defi ciency. However, with the use of human growth hormone therapy to treat age-related human growth hormone deficiency, we often see a return to a more youthful body composition, along with a reduction in total and visceral fat and an increase in lean body mass.

Numerous studies have demonstrated that low-dose human growth hormone treatment, combined with dietary restriction, resulted not only in a decrease of visceral fat but also in an increase of muscle mass, with a consequent improvement of the insulin resistance observed in obese type II diabetes patients. Numerous studies have demonstrated that long-term human growth hormone

replacement is safe and beneficial. It has also been associated with a decrease in abdominal fat by as much as 46 percent. In Science, 1997, this was explored: “A number of aspects of the aging process of the endocrine system invite the development of ‘routine’ medical intervention programs offering long-term replacement therapy with one or more hormones, in order to delay the aging process and to allow us to live for a longer period in a relatively intact state.”

Dr. James S. Nagel M.D. Chico, CA 530-893-0105

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