Cardiometabolic · Body composition
Unexplained weight gain
Weight that arrives without a change in diet or activity is almost always hormonal. The pattern of where it lands - belly, hips, face - tells you which system to investigate first.
Feels like
Does this sound like you?
- 5–15 lb gained in under 6 months with no change in habits
- Midsection softness even while exercising
- Clothes fit differently before diet does
- Cravings you can't out-discipline
What to measure
The biomarkers that explain this symptom.
Grouped by the panel that tests them. We usually recommend running the top two panels together - patterns only show when you can see biomarkers next to each other.
Panel
metabolic
- Fasting InsulinRises years before glucose does. The single most predictive marker of weight-loss resistance.
Panel
thyroid
- TSH / Free T3Hypothyroid weight gain is real - usually 5–10 lb over 6 months with fatigue and cold intolerance.
Panel
hormones
- Cortisol (AM)Chronically elevated cortisol drives central adiposity regardless of calories.
- EstradiolPerimenopausal estradiol decline shifts fat storage from hips to belly.
- Testosterone (Free)PCOS pattern: high free T + low SHBG + insulin resistance.
Patterns we see
Three common clusters.
Your specific pattern will be unique, but most people land in one of these.
01
Insulin-forward
Fasting insulin 10+, fasting glucose still normal. Earliest catchable stage.
02
PCOS-adjacent
Free testosterone high, SHBG low, irregular cycles.
03
Perimenopausal shift
Estradiol variable, weight moved from hips to belly in <2 years.
Ready to look?
Order the metabolic + hormones panels.
Running the top two panels together is what lets us see patterns. Add a third if you want a fuller picture - most people benefit from the trio.
Further reading
From our journal
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