As of my current understanding, you need calories to get fat, how can some hormonal issues lead to weight gain? Where does all the energy comes from?
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It’s a misconception that hormonal issues directly lead to weight gain. They do not reduce your basal metabolic rate. You still need to be eating in a caloric surplus to gain weight, and even with PCOS/diabetes/whatever a person with one of those conditions will lose the same about of fat on 1200 calories a day as someone without those conditions.
The thing that leads to weight gain with these conditions is water retention and messed up hunger cues. I personally have PCOS, and depending on where I am in my cycle I can hold on to 7+ lbs of water. This makes it appear like I’m not losing any fat when I’m in a calorie deficit, because the rate at which I retain water is faster than the rate at which I lose fat. When I chart weight loss over months though, the fat loss is evident. Your hunger cues can also be insane with hormonal issues, which is why it’s frustrating to be told to exert willpower and just eat less – your body thinks it’s starving when it’s not. However, calories in calories out is simply thermodynamics, and hormonal issues don’t change this.
Edit: forgot to add this – hormonal issues can cause your effective calories out to be lower by reducing non exercise activity thermogenesis (NEAT). A lot of the calories we burn come from fidgeting and puttering around, but when you’re bedbound with fatigue that part of the calorie budget is decreased. This can make it feel like your basal metabolic rate is decreased and you’re inherently burning less calories, but it’s not the case.
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