Leptin resistance is one of the most overlooked hormonal imbalances, and it could be why weight loss feels like an uphill battle no matter how clean you eat or how much you exercise.

It's one of the most common hidden drivers of weight gain that I see in my telehealth practice, and it's nearly impossible to turn this condition around on your own if you don't know what's going on.

A functional medicine approach can help you get to the root of your weight loss resistance for more sustainable treatment and long-term weight management. Let's get into it.

A Closer Look At Leptin Resistance

Leptin is a hormone produced in the adipose tissue by adipocytes, or fat cells, that regulate hunger and energy balance. (1)

One of leptin’s jobs is to tell your brain to use the body’s fat stores for energy. Leptin resistance occurs when the hypothalamic cells in the brain stop responding to or recognizing leptin’s signals. (2)

When this happens, your brain will turn on all of the hunger signals it can to make up for what it thinks is a food deficit and help your body get back to energy homeostasis. You could simply look at food and gain weight if you’re experiencing issues with your leptin system.

Leptin also influences the activity of neuropeptides (chemical messengers that regulate hunger and satiety). Impaired leptin signaling can cause these messengers to go into overdrive, increasing cravings and appetite.

A big trigger for leptin resistance is chronic inflammation, which dulls the brain’s leptin receptor sites. Impaired signaling pathways cause your body to produce more leptin to account for what it believes are low leptin levels, resulting in hyperleptinemia, or high levels of leptin. (3)

Those already struggling with obesity and/or high triglycerides are at a higher risk of leptin resistance because of the effects of both on the blood-brain barrier.

Patients with uncontrolled diabetes and imbalanced insulin levels may also have issues with leptin sensitivity. (4) Addressing leptin resistance can improve insulin sensitivity and vice versa.

Sleep deprivation, stress, a high-fat diet, and a lack of exercise can make your symptoms worse and increase leptin concentrations.

Symptoms

Common symptoms of leptin resistance include:

• Difficulty losing weight and keeping it off
• Overeating
• Constant hunger or hyperphagia (abnormally high appetite)
• Food cravings, especially for sugar
• Excess body mass, particularly in your mid-section
• High blood pressure (5)
• High cholesterol
• Chronic fatigue
• Body pain (6)
• Sleep issues
• Difficulties managing stress
• Insulin resistance

Long-term leptin resistance can lead to more weight gain and a higher risk of cardiovascular disease, fatty liver disease, and metabolic disorders like type 2 diabetes. (7)

Low leptin levels, or hypoleptinemia, are less common and generally caused by congenital leptin deficiency or mutations in the leptin gene. They may also happen as a result of eating disorders. (8)

Low leptin symptoms include fatigue, trouble concentrating, mood swings, and a reduced metabolism.

LISTEN: Maggie Berghoff: Inflammation Insights, Skincare and Pantry Swaps, & Essential Health Tips for Parents

Healing From Leptin Resistance

As with most health journeys, treating leptin resistance starts with the basics of reducing stress, getting good sleep, and eating the right foods. When it comes to leptin resistance, medications will never get to the root of the problem, like optimizing these fundamental parts of your lifestyle.

A holistic, functional medicine approach is also not just focused on helping you lose weight, but helping you restore your overall health and wellbeing.

Run The Right Tests

To determine if a patient truly has leptin resistance and not some other underlying condition, I run a simple blood test to measure serum leptin levels. Optimal fasting leptin levels should be 4 to 6 ng/dL.

This lab isn’t commonly run in mainstream medicine because there is no medication for it. If there were, everyone would be tested for high leptin.

If labs confirm leptin resistance, I’m not necessarily done with testing. In functional medicine, we always want to get to the root cause so that we can actually reverse the problem from the source. So if your hormone receptors aren’t responding to leptin, I will often run additional tests to try to figure out why.

Depending on your other symptoms, risk factors, and individual health profile, these may include additional hormone tests, gut microbiome testing, and/or testing for inflammatory markers.

Cultivate A Healthy Sleep Routine

People with poor sleep habits are more likely to be leptin-resistant. Inadequate sleep can also disrupt the balance of ghrelin, another hunger hormone, messing with your satiety even further. (9) Aim for a consistent sleep schedule of 7-9 hours of quality sleep per night.

If you’re having trouble getting to bed, prioritize your nightly routine. Avoid caffeine close to bedtime and find what works to calm your brain, like reading or meditating. Put down the smartphone at least an hour or 2 before going to sleep.

Avoid the late-night snacks. Eating after 8 p.m. is associated with higher leptin resistance levels and more weight gain.

Implement Specific Dietary Changes

There is no single diet to get your leptin levels in the ideal range. Since leptin is a peptide hormone, not a nutrient, there are no foods high in leptin, either. But if you’re looking to reverse leptin resistance, you can absolutely use food to help target the causes.

Eat a diet high in fiber over carbohydrates to support satiety and stabilize your blood sugar. High-fiber foods include a variety of vegetables, legumes, and whole grains.

It's also worth incorporating foods that support secretion of another hormone, GLP-1 (which promotes satiety and stabilizes blood sugar) to help support healthy hunger signaling.

READ: The 7 Best Natural Ways To Boost GLP-1 Levels 

Avoid inflammatory foods like deep-fried or processed foods, especially processed meat, white flour, and refined carbs. Limit sugary foods and drinks, and alcohol.

Since inflammation is a primary factor in leptin resistance, eat more anti-inflammatory foods whenever you can. Common anti-inflammatory foods include:

• Berries
• Fish rich in omega-3 fatty acids
• Avocados
• Broccoli
• Green Tea
• Turmeric
• Dark chocolate
• Extra virgin olive oil

For more on how to eat to overcome leptin resistance, check out my article here.

Intermittent fasting is also a good strategy to combat inflammation, improve autoimmune conditions, and get your body weight to a happy place. It’s also good for the neurons in the brain responsible for energy expenditure and hunger signals.

Studies show periods of fasting reduce inflammation in the hypothalamus, your body’s link between your endocrine and central nervous systems (CNS). (10)

Reduce Your Stress Levels

Chronic stress is associated with high cortisol levels, which can increase inflammation and impair leptin signaling. Too much cortisol secretion can also promote body fat mass storage, especially in the belly.

Focus on managing stress through relaxation techniques like deep breathing, meditation, or yoga. Prioritize self-care, schedule breaks throughout the day, and engage in activities you enjoy that promote mental relaxation.

This may also mean prioritizing your work-life balance and learning the art of saying “no” to new responsibilities you can’t handle without excess stress. Reducing stress isn’t just good for leptin resistance. It’s essential to every aspect of your mental and physical health.