No matter how many salads I ate, no matter how many yoga classes I attended, the numbers on the scale refused to budge," Dhara thought to herself. She blamed her eating habits for her stubborn weight gain until a visit to her doctor revealed the real culprit: hormonal imbalance. Like Dhara, many people struggle with weight issues because of hormonal imbalances rather than their lifestyles. These signs can be identified early, and the real cause could then be diagnosed and remedied.

Weight issues are not the result of diet and exercise. Hormones also affect metabolism and hunger and the rate in which fat is stored. According to this chiropractor and acupuncturist, Dr Pranav Vyas based in Chicago suburbs, took to social platform TikTok and shared five signs that hormones could be ruining the fat-loss game:

1. Difficulty Losing Weight Despite Effort

You have tried all of the fad diets, exercise routines, and counted calories but no movement in scale. It may be hormonal imbalance.

Some of the main hormones that significantly affect weight loss include insulin which is associated with regulation of blood sugar level and cortisol, which is your stress hormone. High cortisol enhances activity of hunger and appetite and keeps metabolism from working effectively. No dieting will be enough to get you off those excess pounds with such a hormonal imbalance.

2. Stubborn Midsection Fat

Well if you happen to have a "beer belly" or "muffin top" that refuses to budge, hormones may be a part of the problem. For men: Decreased testosterone leads to increased fat accumulation around the center of the abdomen. Fat tissue itself makes things worse because the body converts testosterone into estrogen from the fat cells. For women: Menopause typically brings about a decline in estrogen, redistribution of fat to the center of the body.

These hormonal imbalances make it incredibly difficult to lose belly fat through dieting or exercise alone.

3. Weight Gain in Hips, Thighs, or Buttocks

If your weight is piling on the lower body, estrogen might be the cause. For example, it has been noted that as women advance toward menopause, their estrogen levels become low, leading to noticeable changes in the distribution of fats. Weight gain in those areas may also be associated with the other manifestations of menopause like flashes of heat or mood swings.

4. Loss of Muscles and Flabbiness

Are your work out making you flabber rather than strong? To date, while exercising regularly, loss of muscle can be linked with hormonal imbalances. Stress elevates levels of cortisol, which contributes to the degradation of muscle tissue. Low testosterone and estrogen contribute to low muscle mass. This impacts metabolism and helps in weight gain.

Minimal body muscles make your body burn less calories hence gaining weight is hard as well.

5. Increased Appetite

Be to blame ghrelin, the "hunger hormone"

Ghrelin signals your brain to feed, although it can stimulate overeating at high levels. This may cause:

- Calorie restriction

- Poor sleep

- Certain diseases such as metabolic syndrome

Might you regain weight after weight loss even when you have decreased considerably? It is possible due to the reason that even when you have lost substantial weight, increased ghrelin levels will make it difficult to retain the weight lost and lead to cycles of weight regain.

What to Do Next?

If these symptoms ring any bells, it is time to see a doctor. Hormonal imbalance can be controlled by:

• Lifestyle modifications (stress management, good sleep).
• Medical treatment in the form of hormone therapy or medicines.
• Nutrition change harmonized with proper hormonal balance.

4 Effective Exercises to Help Manage Hormonal Weight Gain

Strength Training: Focus on weightlifting or bodyweight exercises like squats, lunges, and push-ups to build muscle. Muscle burns more calories, boosting metabolism and reducing fat storage, especially around the midsection.

HIIT (High-Intensity Interval Training): Alternate between short bursts of intense activity and rest to burn fat more efficiently and increase metabolism.

Yoga: Poses like Downward Dog and Warrior help reduce stress, balancing cortisol levels, which can aid in weight management and muscle retention.

Cardio: Activities like brisk walking, running, or cycling can improve overall fat loss, supporting hormonal balance and helping reduce weight.

For someone living with obesity today, the treatment conversation has become more complex and, in many ways, far more hopeful. With newer weight-loss pharmacotherapies offering significant results, patients and clinicians now have more options than ever before. The key question is no longer whether medication or surgery is better, but rather which approach or combination of therapies is most appropriate for a particular patient.

Obesity is a chronic, relapsing disease that can affect much more than body weight. It is closely linked to severe metabolic comorbidities, including type 2 diabetes, hypertension, obstructive sleep apnoea, fatty liver disease, joint problems and reduced quality of life. Treatment must therefore focus not merely on short-term weight loss, but on long-term metabolic health and sustained weight maintenance.

How Newer Weight-Loss Medicines Are Changing Treatment

Newer anti-obesity medicines, including GLP-1-based and related therapies, have significantly expanded the options available to patients. They can support meaningful weight loss and improve metabolic health when combined with appropriate nutrition, physical activity and behavioural support. They may be particularly useful for patients who are not ready for surgery, those who need to improve their health before an operation, or those who experience weight recurrence after previous treatment.

However, these medicines do not work in the same way for everyone. Long-term treatment may be required, while side effects, affordability, access and adherence can influence outcomes. Some patients may also regain weight after stopping treatment. In India, the cost and continued access to these therapies are therefore important considerations when planning long-term care.

Also read: Is ‘Ozempic Face’ Influencing The Beauty Industry? Global Cosmetic Brand Highlights A New Trend Amid GLP-1 Boom

Why Bariatric Surgery Remains An Important Option

For patients with severe obesity, particularly those with established metabolic complications, metabolic and bariatric surgery remains an important treatment option. Procedures such as sleeve gastrectomy, Roux-en-Y gastric bypass and one-anastomosis gastric bypass can influence appetite, gut hormones and glucose metabolism, in addition to reducing stomach capacity. This can result in substantial weight loss and improvement in conditions such as diabetes and sleep apnoea.

The decision to undergo surgery should be based on factors such as the severity of obesity, associated illnesses, previous treatment attempts and the patient's readiness for an operation and long-term follow-up. Surgery is not an endpoint; nutritional care, lifestyle changes and regular monitoring remain important afterwards.

Also read: Swiss Team Including Indian Scientists Develops Electric Implant To Lower Blood Sugar Without Insulin Or Drugs

Combining Medication, Surgery And Lifestyle Changes

Weight regain also needs to be viewed in the context of obesity as a chronic disease. Treatment may need to evolve over time, with medicines, surgery and lifestyle interventions playing different roles at different stages. A patient may use medication before surgery to improve metabolic health, while another may require medication later to manage weight recurrence. This approach allows treatment to adapt to the patient's changing needs rather than treating weight loss as a one-time goal.

Technology is also influencing how bariatric surgery is performed. Technology has fundamentally elevated precision in minimally invasive bariatric procedures. Robotic-assisted surgical systems, such as the da Vinci Surgical System provide three-dimensional visualisation and wristed instruments that flex and rotate with dexterity far exceeding the human hand.

Operating at a dedicated console, the surgeon maintains full control throughout the procedure, as the system translates hand movements in real time with built-in tremor filtration. These capabilities are particularly advantageous during complex reconstructive procedures such as gastric bypass, where precise suturing, micro-dissection, and delicate tissue handling are paramount.

The technology, however, works within a broader surgical ecosystem. Patient selection, surgical expertise, standardised protocols, anaesthesia and postoperative care remain central to achieving good outcomes.

What Real-World Experience With Robotic Bariatric Surgery Shows

Our real-world experience of 545 patients undergoing robotic bariatric surgery with the da Vinci Surgical System showed consistent outcomes across procedures, including in patients with severe obesity. There were no conversions to open or laparoscopic surgery, the 30-day post-discharge complication rate was 2.02%, and no mortality was reported during follow-up.

At one year, mean BMI reduced from 44.55 to 32.68 kg/m², while outcomes in patients with BMI ≥50 kg/m² remained broadly comparable with the overall cohort. For patients, this translates into predictable perioperative outcomes and meaningful weight reduction, while for surgeons, the experience demonstrates how robotic assistance can be integrated into bariatric practice, including the management of technically challenging cases.

The changing obesity landscape ultimately calls for a comprehensive, personalized approach to treatment. Anti-obesity medications have expanded the options available to patients, while metabolic and bariatric surgery remains the cornerstone intervention for those who require substantial, durable weight loss and metabolic improvement. Neither approach should be viewed in isolation from nutrition, physical activity, behavioral health, and long-term follow-up.

High-intensity interval training (HIIT) has gained popularity among those who wish to achieve a good workout in a short amount of time. But for those with high blood pressure, the challenge is an important one: Can they attempt HIIT, or is it too much for the heart?

The answer, in short, lies with the individual. Having high blood pressure does not mean that a person has to avoid vigorous exercise, but the intensity has to be suitable considering the blood-pressure control and cardiovascular risk, fitness levels and other medical issues.

In India, where hypertension has become a growing public health concern, an ICMR-INDIAB study which looked at more than 113,000 people across the country, put the overall prevalence of high BP at 35.5 per cent among adults aged 20 years and above. It was higher among men and the urban population.

Blood-pressure control remains a concern in India as the WHO-India estimates that around 220 million people live with hypertension but only about 12 per cent have their BP under control.

So where does HIIT come in?

HIIT, which involves alternating short periods of high-intensity workout followed by recovery periods, can actually be beneficial. HIIT is not forbidden among those with high blood pressure, but the individual has to take stock of several factors before starting such exercises.

Those who are physically active, have good blood-pressure control, and no other concerns can probably take on HIIT workouts. But those who are sedentary and/or have poor blood-pressure control may have to work their way up. This is an important point to consider as HIIT might offer a good workout, but a hard-hitting workout is not always good for your blood pressure.

Also read: Heart Racing During Garba: Is It Adrenaline Or A Warning Sign?

Start with assessment, not max intensity

Among those who are new to exercise and have hypertension, jumping into an intense HIIT workout may not be the best move. A doctor would look at blood pressure, age, exercise history, cardiovascular risk and symptoms before advising on the most appropriate way forward.

A sedentary person should start with brisk walking, for example, before working their way up to cycling or jogging, and then adding higher intensity workouts, or interval training. It is about pace and control, and not going all out right at the start. Not only is that risky for those with hypertension, it could also lead to severe injuries.

Pay attention to exercises that help you warm up and cool down, and avoid stopping abruptly immediately after a vigorous round of exercise. While doing strength-based HIIT, people should avoid holding their breath, as this can cause blood pressure to spike. Make sure you train with a qualified trainer who can guide you through your workouts safely, and with the right advice.

Also read: Melissa McCarthy’s Weight Loss Mindset: Can It Help Break The Cycle Of Yo-Yo Dieting?

What about people with uncontrolled BP?

This is the point where exercising caution is important. People with high blood pressure who have persistently high or poorly controlled readings should not assume that every form of exercise is a good idea for them just because it is termed healthy.

Unexplained chest pain or discomfort, breathlessness or dizziness, fainting or unusual palpitations during exercise are signs that a person should stop their workout and get to a doctor rather than powering through the routine.

Those on antihypertensive medication will also need to take stock of their medication, how their blood pressure is behaving, and how their body is responding before deciding on the best approach to exercise.

The goal is sustainable cardiovascular fitness

For Indians looking to get into intense workouts, HIIT can be a part of a physically active lifestyle, but the aim should be cardiovascular fitness, not necessarily high-intensity workouts. Physical activity continues to be an important pillar in the management of blood pressure, alongside a balanced diet, weight control, adequate sleep, reduced salt intake, medication when needed and regular health check-ups.

So the right question for a person with hypertension is not: ‘Can I push myself as hard as possible’, but ‘What intensity is appropriate for my heart and blood pressure?’

By Dr. Debdatta Majumdar, Senior Consultant - Interventional Cardiology, Narayana RN Tagore Hospital, Mukundapur, Kolkata

Garba season is back, bringing hours of energetic dancing. While this aerobic activity naturally raises your heart rate, prolonged, high-intensity sessions can strain the cardiovascular system. In 2023, 10 people died within 24 hours while performing Garba.

So, how do you distinguish a normal exercise response from a warning sign?

Why Does Your Heart Race During Garba?

Dr. Anesh Jain, Cardiologist, Ruby Hall Clinic, Pune, told HealthandMe that two factors drive a faster heartbeat during Garba:

• Exercise: Working muscles need more oxygen, making the heart pump faster.
• Adrenaline: Loud music, excitement and crowds trigger adrenaline release, further increasing heart rate.

Also read: Weekend Workouts: Why Sudden Intense Exercise May Put Stress on Your Heart

When Is A Racing Heart Normal?

Dr. Nimit Shah, Consultant Interventional Cardiologist, Saifee Hospital, Mumbai, told HealthandMe that the heart beats faster during Garba to supply oxygen-rich blood to working muscles.

A normal exercise response typically involves:

• A steady increase in heart rate that matches the intensity of dancing.
• Breathing that settles with rest.
• A heartbeat that gradually slows after stopping.

However, a sudden or irregular heartbeat, or one that remains unusually fast despite rest, should not be ignored.

Warning Signs: When To Stop Dancing

Dr. Anesh advised stopping immediately if you experience:

• Unusual breathlessness: Struggling to speak or catch your breath.
• Chest discomfort: Pain, pressure or heaviness in the chest, arm, neck, shoulder or jaw.
• Dizziness: Feeling lightheaded or faint.
• Irregular palpitations: A pounding, skipping or erratic heartbeat.
• Persistent rapid heartbeat: A heart rate that does not settle with rest.

Chest pain, severe breathlessness or fainting requires emergency medical attention.

Read More: Strong Enough for HYROX, But Is Your Heart Fit Enough?

What Increases Heart Strain During Garba?

Several factors can increase the risk of complications:

• Dehydration: Heavy sweating causes fluid and electrolyte loss, potentially contributing to palpitations.
• Sudden intense exercise: Hours of vigorous dancing can strain the body, particularly in people unaccustomed to exercise.
• Low blood sugar: Fasting or inadequate food intake can cause weakness, dizziness and a rapid heartbeat.
• Excessive caffeine: Caffeine and energy drinks can trigger palpitations in some people.

“Prolonged dancing, dehydration, excessive sweating and inadequate food intake can put stress on the body,” Dr. Nimit said.

People with heart conditions, high blood pressure, diabetes or a history of abnormal heart rhythms should take extra precautions.

How To Protect Your Heart During Garba

Dr. Nimit recommended warming up, gradually increasing dance intensity, taking regular breaks and staying hydrated. Avoid prolonged dancing in hot, crowded venues.

Other precautions include:

• Eat adequately before dancing.
• Get enough sleep.
• Avoid excessive caffeine and energy drinks.
• Consult your doctor about safe exercise levels if you have a heart condition.

What To Do If Your Heart Starts Racing

If your heartbeat feels unusually fast or irregular:

• Stop dancing and move to a cooler, well-ventilated area.
• Rest in a comfortable, supported sitting position.
• Sip water if you are fully alert and can swallow normally.
• Seek medical help if symptoms persist. Call emergency services for chest pain, severe breathlessness or fainting.

Do not push through symptoms or rely on hydration and breathing exercises to manage possible cardiac warning signs.

The experts advised that Garba should be a celebration, not a test of endurance. Recognizing warning signs, taking breaks and respecting your limits can help you dance safely.