If you’ve been doing “all the right things” and still watching the scale creep up, here’s a question we don’t ask nearly enough:

Could your gut be part of the problem?

And no — this isn’t about willpower or having a “slow metabolism.”
This is about something much more interesting (and fixable): your gut barrier.

Your gut lining is only one cell thick — basically a super smart coffee filter. Its job? Let nutrients in and keep troublemakers (toxins, undigested food particles, bacteria fragments) out.

When that lining gets irritated or inflamed, it can become more “porous” — a bit like a screen door with a stretched-out mesh. This is what has been coined “leaky gut” or increased intestinal permeability.

What happens next? ⤵️

Those tiny “leaks” can trigger low-grade inflammation, which can:

• Increase cravings
• Raise insulin levels
• Slow down fat burning
• Increase bloating
• Make weight loss feel impossible

Sound familiar? Read on …

Research shows a connection between ‘leaky gut’ (increased intestinal permeability) and the following: 🔗read more.

• Troublesome belly fat
• Blood sugar dysregulation
• Increased inflammation
• Harder time losing weight

It’s not that leaky gut causes all weight gain — but it can absolutely stack the deck against you.

Sometimes it’s like the classic “chicken or the egg” question—did the weight gain cause the leaky gut, or was it the other way around? In these cases, I suggest taking a two-pronged approach, because the truth is, we might never know for sure.

And here’s the kicker…

Shifts in our hormones, especially estrogen and progesterone, that occur with hormone imbalances or in the perimenopause/menopause transition can:

• Shift the gut microbiome
• Contribute to inflammation
• Slow down digestive motility
• Make blood sugar swings more dramatic
• Create more “stubborn” weight around the midsection

A stressed, irritated gut + shifting hormones = the perfect metabolic storm. 🌩️

The good news? This is something we can actually do something about.

In functional medicine, we like data, not guessing. So we often use:

1. GI-MAP Stool Test

A comprehensive DNA-based stool test that looks for: 🔗read more.

• Bacterial overgrowths
• Yeast overgrowth (Candida)
• Parasites
• Gut inflammation
• Enzyme output
• Zonulin (a marker associated with gut permeability)

This can help us understand why the gut is irritated.

2. Lactulose/Mannitol Test

This is another functional test for intestinal permeability and tells us how well your gut barrier is working. 🔗read more.

3. Additional labs when indicated:

• Hormone panel (especially if there are suspected hormone imbalances or in the perimenopause transition)
• Adrenal hormones – DHEA and cortisol
• hs-CRP and ferritin (inflammation markers)
• Fasting insulin and HbA1c (to investigate blood sugar regulation)
• CMP and liver function markers (comprehensive metabolic panel)

Testing helps us create a plan that’s specific to your body — not a generic gut protocol pulled from TikTok.

Here are some high-impact, low-stress strategies you can start this week:

🍽️ 1. Eat whole, colorful foods

Vegetables, fruits, lean proteins, nuts, and seeds all help nourish beneficial bacteria and strengthen your gut lining. Aim for about 25–35 grams of fiber daily, and if increasing fiber upsets your gut, add it gradually to let your body adapt—this could also indicate something like SIBO (small intestine bacterial overgrowth), which may require proper testing. Fiber feeds the “good bacteria” in your gut. In addition, be sure to include fermented foods like kefir, sauerkraut, and plain, unsweetened Greek yogurt which provide healthy probiotics. Collagen-rich foods like quality bone broth are another great way to support a healthy gut lining. Here is the bone broth that my patients seem to like the most.

💧 2. Cut back on the big irritants

• Ultra-processed snacks
• Sugary foods
• Artificial sweeteners
• Excess alcohol
• Frequent NSAID use
• Antibiotics

These can all ‘poke holes’ in the gut lining.

🧘‍♀️ 3. Work the “stress–gut axis“

Stress increases gut permeability.
Simple daily practices — deep breathing exercises, progressive muscle relaxation, walking in nature, journaling, sleep support — these practices can make a surprising difference when done consistently.

Due to the gut-brain axis – stress in particular is an important component.

🚶‍♀️ 4. Move daily

Not for just calorie burning — for blood sugar support and lowering inflammation.

🍽️ 5. Eat mindfully and slowly

Studies show that around 32 chews per bite before swallowing is the ideal number to aim for. This helps support healthy digestion and stimulates digestive enzyme secretion, which is key for nutrient absorption and overall digestive health. Try to avoid eating in a rushed or distracted state, as it activates the nervous system. When your nervous system is in a heightened, sympathetic mode, digestion isn’t prioritized—you want it calm and in a parasympathetic state, also known as the “rest and digest” mode. 🔗 read more.

(Always check with a clinician that knows your body before starting anything.)

1. L-Glutamine

A favorite because gut cells eat glutamine as their main fuel. It can support repair and reduce permeability. 🔗PMID 24965526

2. Zinc Carnosine

Long history of research showing support for the gut lining. Especially helpful for those with heartburn, bloating, or chronic irritation. 🔗PMID 1677920

(There are others, but these two have the most consistent benefits and best tolerability.)

➡️Here is a product that I commonly recommend in my practice.

If you are noticing stubborn weight, bloating, food cravings, or feeling inflamed — your gut may be quietly contributing. This is especially true if there is hormone dysregulation or for those in perimenopause/menopause.

The good news – the gut is a system we can actually heal.

If you want clarity, testing, and a step-by-step plan personalized for YOU, this is one of my favorite areas to help patients reclaim their energy, metabolic health, and confidence. While I don’t have a magic wand or secret eraser and I don’t run a ‘weight loss clinic’ – using a functional medicine approach, my team and I can help you uncover root causes that are holding you back and build a plan alongside you to restore wellness. Reach out for a complimentary consultation. 🔗learn more here.