Thyroid Belly? Experts Reveal the Real Cause—and How to Shrink It Fast, Naturally

“Thyroid belly,” the abdominal weight gain that’s thought to go hand-in-hand with low thyroid conditions, has gained a lot of attention on social media recently. But the truth about the condition—and how to manage it—is more complex than it may appear. 

The thyroid is a small, butterfly-shaped gland in the neck. It produces hormones that regulate everything from metabolism to heart rate to body temperature. However, several factors (including autoimmune disorders) can impair the thyroid gland’s ability to release these crucial hormones, leading to hypothyroidism or low thyroid, which affects about 17 percent of women in the US. It’s also becoming more common, with the prevalence of low thyroid doubling since 2002.

Since the thyroid affects so many of the body’s processes, hypothyroidism has wide-ranging symptoms, such as fatigue, sensitivity to cold, constipation, dry skin, depression and weight gain, particularly in the abdomen. Here’s everything to know about what thyroid belly is, what it looks like and what you can do to get rid of it. 

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What is thyroid belly and what causes it?  

First things first: Not everyone with low thyroid function gains weight in the midsection or otherwise, says Sarah Fishman, MD, PhD, an endocrinologist specializing in diabetes, thyroid disorders and weight loss at Premiere Endocrine in New York City. In a 2024 study in Frontiers in Endocrinology, 47 percent of women with hypothyroidism reported gaining weight. 

And the American Thyroid Association notes that most people with hypothyroidism only gain about 5 to 10 pounds of water weight. Additionally, Dr. Fishman says that any weight gain people with hypothyroidism do experience may not be restricted to just their belly. 

That said, there is evidence that having a slow thyroid issue puts you at greater risk of gaining visceral fat, Dr. Fishman says. This type of fat, which is linked to long-term health issues such as heart disease, type 2 diabetes and high cholesterol levels, isn’t always visible. But when it is, it tends to show up around the abdomen because it accumulates around the organs. Insufficient thyroid hormone levels can increase the risk of insulin resistance, which promotes visceral fat gain.

What’s more, constipation is one of the most common symptoms of hypothyroidism, per the Frontiers in Endocrinology study. Being backed up can lead to bloating, which can also cause a change in how you notice your waistband fitting and lead to a visible thyroid belly. 

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What a thyroid belly looks like (and what it doesn’t)

While viral posts online may claim that a thyroid belly has a very specific shape—namely, a soft, doughy pooch on your lower belly—there’s no research proving that these specific features are linked to underactive thyroid issues. People can carry weight gain caused by hypothyroidism anywhere, Dr. Fishman says. 

Still, visceral fat, constipation and fluid retention can all give the appearance of a wider waist or a thyroid belly. But whether it feels soft or firm and where exactly on the stomach it sits may vary by individual. 

Expert-backed ways to shrink a thyroid belly

If you have thyroid problems and notice an increase in belly fat, there are steps you can take to lose weight and flatten your midsection. Here’s what works:

Manage your hypothyroidism 

The first thing you should do to address a thyroid belly or any other hypothyroid symptom is to see a doctor. “You doctor can order thyroid function tests (starting with TSH and free thyroid hormones), relevant nutrient testing and assess for other potential causes of weight gain or co-occurring conditions such as insulin resistance,” says Bojana Jankovic Weatherly, MD, (aka Dr. Bojana) who is double board-certified in internal and integrative medicine and is the founder and CEO of Bojana MD, a boutique medical practice in New York City.

“Based on the test results and symptoms, he or she can come up with a plan for treating the condition,” she adds. “This may involve thyroid hormone support, addressing underlying metabolic issues, nutrient support, nutritional assessment and an exercise regimen.”

For many people, treatment involves taking synthetic thyroid hormones to replace the thyroid hormone their gland should be producing, Dr. Fishman says. In some cases, people with very mild hypothyroidism may not need thyroid medications, but your doctor will likely ask you to test your thyroid levels regularly and begin prescribing hormones if they dip or you develop symptoms.

If you’ve gained weight as a direct result of hypothyroidism, starting thyroid hormones may help you reverse that weight gain. “Having higher levels of thyroid hormone is going to lead to decreases in fat around the organs, increased metabolic activity and increased brown fat activity,” Dr. Fishman says. 

But both Dr. Fishman and Dr. Jankovic Weatherly note that people with hypothyroidism often gain weight for reasons unrelated to their levels of thyroid hormone, so treating their condition, while important, isn’t necessarily a magic bullet for weight loss. 

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Watch your sodium intake 

Eating too much sodium can encourage your body to hold onto water, worsening the bloating that could be contributing to your thyroid belly. Stephanie Wells, RD, a registered dietitian based in Dallas, Texas, suggests aiming to stay below 2,300 mg of sodium per day and being especially careful to avoid sneaky sources of salt, such as processed foods. Discover more ways to reduce water weight here.

A word of warning: The goal is not to completely eliminate salt from your diet. In fact, iodized salt is an important dietary source of iodine, a nutrient that’s crucial for thyroid health. Just aim to season responsibly. 

Eat gut-friendly foods

Roughly 91 percent of women don’t get enough fiber each day, according to the American Society For Nutrition.  Women aged 51+ should be aiming for at least 21 grams a day, and those ages 19 to 50 need 25 grams. Trying to hit these amounts helps prevent constipation and reduces bloating that can cause or worsen a thyroid belly. 

Aim for a mix of insoluble fiber (found in green vegetables, whole grains and nuts and seeds) and soluble fiber (found in fruits, legumes and root vegetables). The former helps add bulk to the stool and promotes laxation, which makes it easier to “go,” while the latter benefits blood sugar, cholesterol and the good bacteria in your gut to promote overall digestive health. (See more natural constipation remedies here.) 

Note: There’s some evidence that a high-fiber diet, especially one that includes fiber supplements, may interfere with the absorption of thyroid hormone, although the research is mixed, per the journal Pharmaceuticals. Talk to your doctor before significantly increasing your fiber intake.

Tweak your eating habits

No one diet’s best for people with thyroid conditions like hypothyroidism, but Dr. Bojana notes that there are eating strategies that can help you maintain a healthy weight that’s right for you. 

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For instance, if your hypothyroidism triggered metabolic syndrome, strategies that help balance your blood sugar may be useful, Dr. Bojana says. One easy tweak to adopt is eating meals in this order: first, fill up on fiber-rich vegetables, protein foods and healthy fats, then eat your carbs. This has been shown to minimize post-meal blood sugar spikes, according to research in the journal Nutrients. 

Other people may benefit from time-restricted eating, which is when you limit your food intake to a specific window each day, Dr. Bojana says. “I want to stress that it doesn’t work for everyone, but it can be an effective strategy for some people.” 

Again, there’s no one universal “best” diet—especially when it comes to shrinking a thyroid belly—so it’s essential to work with your healthcare provider to help you find the right option for your health background and lifestyle.