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.

Long considered a standard tool for assessing body weight, Body Mass Index (BMI) may not be as reliable as once believed. A new study shows that relying on BMI can incorrectly classify people as overweight or obese.

When a team of Italian researchers used the gold standard technique of dual-energy X-ray absorptiometry (DXA) to measure body fat in the general population, they found that the traditional WHO-approved BMI classification system misidentified a significant number of people as having overweight or obesity.

How Is The BMI Wrong?

A total of 1,351 adults of mixed gender aged between 18 and 98 years were checked for their body weight using the DXA system.

The results, published in the journal Nutrients, revealed that more than one-third (34 percent) of those with obesity defined by BMI had been misclassified and should be in the overweight category.

For those with an overweight BMI, DXA showed that more than half – 53 percent – had been misclassified – three quarters of those misclassified fall into the normal weight category, while the other quarter should have been classified as having obesity.

The DXA analysis found that the prevalence of overweight and obesity across the cohort was around 37 percent overall (23.4 percent overweight, and 13.2 percent obesity, compared to 26.2 percent and 14.1 percent with BMI).

“In the past few years, there has been a lot of criticism of the BMI system due to its inability to accurately capture body fat percentage or distribution, to correctly categorise weight status based on adiposity,” said Professor Marwan El Ghoch, of the Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Also read: Your BMI Does Not Reflect Your Health: New Study Warns How It Misses A Key Health Aspect

Despite these concerns, BMI as a weight classification system continues to be used in the general population in primary healthcare (i.e., general practitioners) and non-clinical (i.e., policy and health insurance) settings, he added.

The researchers urged revising public health guidelines to consider combining direct body composition or their surrogate measures, such as skinfold measurement or body circumference, with the waist-to-height ratio, with BMI, while assessing weight status in the general population.

Waist-to-Height Ratio May Be More Accurate: The India Story

In January 2025, India revamped its obesity guidelines, and the new approach focused on abdominal obesity and comorbid diseases, rather than just BMI.

According to the redefining team, it was essential to move beyond BMI-only approaches to tackle the ever-growing number of people related to other major health risks. They stated that while BMI can be a screening tool, obesity must be defined by body fat.

“BMI should be used for screening purposes, but obesity should be confirmed ideally by a measure of body fat wherever feasible, or another measure such as waist circumference, WHR, or Waist-to-height ratio,” Dr. Naval Vikram, Professor of Medicine, at AIIMS, New Delhi, was quoted as saying to IANS at the time.

Also read: 41 million children aged 5-19 living with high BMI in India: Study

What Do The New Guidelines Say

It recognizes abdominal fat — closely linked to insulin resistance — as a key factor in the diagnosis. It integrates the presence of comorbidities — such as diabetes and cardiovascular disease — into the diagnostic process.

The revised guidelines also introduce a two-stage classification system, addressing both generalized and abdominal obesity.

Stage 1 Obesity: Increased adiposity (BMI > 23 kg/m²) without apparent effects on organ functions or routine daily activities.

Stage 2 Obesity: Advanced state of obesity with increased BMI more than 23 kg/2, and abdominal adiposity; excess Waist Circumference or Waist-to-Height Ratio.

What if your gym routine is doing far more than helping you stay fit? Research is increasingly showing that exercise, especially strength training, plays a powerful role in keeping your brain sharp, focused and resilient over time. In fact, Dr Sudhir Kumar, a neurologist at Apollo Hospital in Hyderabad also pointed this out by quoting the study Randomised Controlled Trial of Resistance Exercise and Brain Ageing Clocks.

The study showed that resistance training could reduce brain age by up to two years. This means strength workouts could help the brain maintain characteristics that are seen in younger people.

It Is Not Just About Muscles

For a long time, workouts were seen as a way to build muscle or lose weight. Now, experts suggest that resistance training can also support brain health in meaningful ways. Regular strength training has been linked to slowing down brain ageing, with some studies suggesting it may even reduce the brain’s biological age by a couple of years.

This means that beyond physical strength, your brain could function more efficiently, particularly in areas like memory and reasoning.

Sharper Focus And Better Memory

One of the most noticeable benefits of working out is how it improves everyday thinking. People who engage in regular strength training often report better focus, improved memory and stronger decision-making abilities.

It becomes easier to stay on track with tasks, manage distractions and process information more clearly. Over time, these small improvements can make a big difference in both personal and professional life.

What Happens Inside Your Brain

The real transformation happens beneath the surface. Exercise triggers the release of chemicals that support brain cells and strengthen the connections between them.

This helps improve neuroplasticity, which is the brain’s ability to adapt, learn and form new memories. It also supports white matter, the network that allows different parts of the brain to communicate effectively.

In simple terms, your brain becomes faster, more flexible and better at handling challenges.

A Natural Way To Reduce Brain Fog

Exercise also helps tackle inflammation in the body, which is often linked to brain fog and cognitive decline. Strength training supports anti-inflammatory processes that protect brain health over time.

This is why many people feel mentally clearer and more energized after a consistent workout routine.

You Do Not Need Intense Training

The best part is that you do not need extreme workouts to see benefits. Experts suggest that even two to three strength training sessions a week can support brain health.

Simple movements like squats, push-ups or resistance band exercises are enough to activate both your body and mind.

Today, the fitness scene has gained much traction among the Gen Z population. With more and more young people spending time in the gym and working out, it is important for fitness enthusiasts to remember the importance of leg stiffness and its impact on spine health. Leg stiffness has the potential to cause unnecessary strain on the spine and back during workouts.

From a neurosurgical point of view, we see that the spine is not just a mechanical support structure but a sensitive pathway through which the spinal cord and nerve roots run. Repeated micro-strain caused by poor flexibility can cause young patients to suffer early degenerative changes that may cause nerve irritation.

We also see that strengthening the abdominal muscles is essential in stabilizing the spine, thereby preventing disc injuries. Early intervention in minor complaints, such as back stiffness or nerve pain, is essential in preventing more serious problems that may need surgical intervention.

The Link Between Leg Stiffness And Spine Health

The muscles in your legs are important for your spine's health. The hamstring, hip flexor, and calf muscles are all significant players in the movement and positioning of your spine. Leg stiffness has the potential to cause unnecessary strain on the spine and back. Leg stiffness limits the movement and positioning of the hips and the spine.

When these muscle groups are tight, they alter pelvic alignment and increase load on the lumbar spine. Over time, this abnormal biomechanics can lead to disc stress and facet joint overload.

In neurosurgical practice, we often see young patients presenting with early symptoms of nerve compression where underlying muscle imbalance and stiffness play a contributory role.

Common Gym Mistakes That Increase The Risk

For young people, the main focus in the gym is on strength training, while flexibility and rest are ignored. This makes the condition of the legs stiffer. Another common error is improper posture while performing certain exercises in the gym. When the legs and hips are inflexible, proper posture is difficult, which causes pressure on the spine.

Sitting for a long time, studying, playing games on gadgets, etc., causes the hip flexors and the hamstring muscles in the legs to become stiffer, which causes pressure on the spine.

From a clinical standpoint, improper lifting techniques combined with stiffness can increase the risk of lumbar disc prolapse and nerve root irritation, conditions frequently encountered in spine clinics.

Tips to Prevent Spine Problems In The Gym

• Warm-ups: It is important to warm up the body before performing weightlifting exercises in the gym. It is recommended that the warm-up process take at least 5–10 minutes.

• Flexibility: It is important to include flexibility exercises in the gym routine, as they help in the proper movement of the legs, which in turn helps in preventing spine problems.

• Proper Posture: It is important to maintain proper posture while performing certain exercises in the gym, like squats, deadlifts, etc.

• Stretching After Workouts: This will help in the release of tension in the muscles and prevent the buildup of stiffness.

• Balance of Training and Recovery: This will help in maintaining the flexibility of the muscles and the spine.

Additionally, from a neurosurgical perspective, core strengthening plays a crucial role in stabilizing the spine and reducing the risk of disc-related injuries. Early attention to minor symptoms like back stiffness or radiating pain can prevent progression to more serious conditions requiring intervention.

Common Spine Problems To Avoid

Common spine problems to avoid during gym workouts include Herniated Disc, Sciatica, Spondylolisthesis, and Muscle Strain. These can occur from poor form, heavy lifting, or lack of warm-up.

In advanced cases, such conditions may lead to nerve compression requiring specialized evaluation and, rarely, surgical management. However, most of these issues are preventable with correct technique and conditioning.

Fitness enthusiasts in the Gen Z generation need to understand that it is very important to develop strength in the body while at the same time maintaining flexibility. The solution to the problem of a stiff leg is the foundation of protecting the spine and improving workout performance. This is achievable through the right warm-up, correct workout, and correct lifting.

Dr. Gaurav Batra is a Consultant - Neurosurgeon (Brain & Spine) at Max Hospital, Vaishali.