Have I gained weight since yesterday? My jeans that fit last week are way too tight now and my stomach feels like I swallowed a cannonball. I blame the pizza I had for dinner the night before but even then I only managed half before feeling full. It’s morning now and I’m still not hungry.
Once again, my gut dictates my clothing choices for the day, the lycra leggings that have plenty of stretch and an oversized t-shirt that kind of goes with it.
Trusted friends throughout lockdown, they’d somehow been pushed to the back of the closet as life outside picked up steam again. However lately it doesn’t seem to matter what I eat or don’t eat, my clothes are getting tighter and tighter. I’m still training. So what’s up?
Well it seems I’m not alone. A straw poll of friends and co-workers shows they share my struggles — “I’ve added a stone to the wall in the last year and haven’t changed my diet” — is a recurring theme.
While lockdown restrictions certainly haven’t helped, none of us have drastically changed our eating habits. And yet we’re still gaining weight. We are all around the same age, late 40s, early 50s, most of us are perimenopausal and some are in menopause. Is that what makes us gain weight?
dr Brenda Moran, of the Danu Menopause Clinic in Mallow, Co Cork, says weight gain around the time of perimenopause and menopause can be multifactorial.
“For the majority of people, they aren’t doing anything wrong, but unfortunately, due to age-related declines in metabolism and basal metabolic rate – which tend to decrease with age regardless of hormonal changes – people have to work harder to maintain that same weight.” This can mean changing diet if there is scope, or increasing exercise,” she adds.
“For the majority of people, they’re doing nothing wrong, but unfortunately, due to age-related declines in metabolism and basal metabolic rate — which tend to decrease with age regardless of hormonal changes — people have to work harder to maintain that same weight.”
According to Nigel Denby, menopause nutritionist and founder of harleystathome.com.
“The total weight gain is about 10 kg or a stone and a half. That’s really significant. That’s a good dress size.” He agrees with Dr. Moran agrees and says it’s a perfect storm for weight gain. A decline in muscle tissue that begins after age 35 can also contribute.
Taking action early to prevent this is key, he says. “Muscle tissue is absolutely necessary because it determines metabolic rate and the ratio of fat to lean muscle tissue that you have largely determines your metabolic rate, so as we lose muscle tissue with aging, your metabolic rate slows down. Women have another disadvantage: when estrogen levels start to fall, the rate at which they lose that muscle tissue increases, accelerating weight gain. So even if you don’t change anything in your diet, you will gain weight.”
So if estrogen deficiency is to blame, will HRT fix this problem? Well no, is the short answer. “You won’t reach premenopausal estrogen levels, even if you take HRT your body will still age, so whatever you do to control your weight during perimenopause or menopause, you will do it for the rest need of your life. Here you have to think sustainably and it has to be tailored to the foods you like,” says Denby.
Someone recently suggested cutting back on carbs to shed the extra pounds, but Denby is quick to point out that “a healthy relationship with food and exercise—this is about a lifestyle change.”
“A lot of the quick-fix faddy diets really aren’t sustainable. Not only is that not helpful now, but it really needs to be avoided,” says Denby. “Cutting something like that puts you in danger later. There is so much guilt about food and misinformation. The unfortunate thing is that overall healthy eating guidelines aren’t as sexy as keto or intermittent fasting or the South Beach diet, but the reality is they’re not changing.
“That midlife weight gain doesn’t happen overnight, it accumulates over time and will take six months to a year to address, but if you address it the right way, you’ll never have to do it again. Everything that goes into your mouth now has to have nutritional value, you have to take care of your bones, your heart health, your diet has to be really balanced and nutritious. This is not the time to skimp on vitamins or minerals,” he adds.
But there must still be things we can cut out. There are – but we may not like the answers. “Studies have shown that caffeine, alcohol, foods high in sugar — can worsen menopausal mood symptoms and vasomotor symptoms (hot flashes and night sweats) in some people. They have shown that smokers tend to have more severe vasomotor symptoms than non-smokers,” says Dr. moran
Sometimes, however, the scales swing wildly through no fault of my own (I swear it) – the jeans that fit yesterday no longer close today. That can’t be weight gain, right? Is this fluid retention?
“The peri/menopause can be a busy time for people in general due to work and family commitments and living in a busy, fast-paced world with high levels of stress. Stress can also be a risk factor for aggravating stomach conditions, such as bloating, which are usually characterized by fluid retention.”
“The peri/menopause can be a busy time for people in general due to work and family commitments and living in a busy, fast-paced world with high levels of stress. Stress can also be a risk factor for aggravating stomach conditions like bloating, which are usually characterized by fluid retention,” says Dr. moran
However, she advises discussing any new bloating or new GI symptoms with a doctor. The list of possible causes is long and it should not be assumed that these are just hormonal changes.
dr Louann Brizendine, author of The Upgrade and founder of the UCSF Women’s Mood and Hormone Clinic in San Francisco, says having a good relationship with your doctor and reviewing all of your symptoms is crucial during the transition to menopause.
“If you have fatigue, dry hair and skin, and weight gain, you may have an underactive thyroid, as it’s 10 times more common in women. During the transition years, have all of your blood work done, as well as your bone density scan.”
But what if you’ve already done all this and you’re still feeling bloated? Fluid retention can be more common at this point in a woman’s life, Denby agrees. If they’re already on hormone replacement therapy, the progesterone “can make them a little swollen and a little bit fluid-retaining, that usually goes away.” But he adds that there’s a mountain of evidence that HRT doesn’t make you fat.
“There is a group of women who seem to respond by gaining weight. What you might want to do is that if you feel tremendously better on your HRT, you can still lose what you’ve gained. I’ve never worked with a woman who can’t lose this weight. Most women need to cut back about 300 or 400 calories a day. They aim for between half a pound and two pounds a week. If you lose even more, it’s too fast.”
“The other critical thing is that a lot of women don’t think about exercise when they think about weight loss. They think about calorie restriction, and even when they think about exercise, it’s usually aerobic exercise, so they go to zumba or run or go to the gym and do classes… They have to do strength exercises.
“It’s non-negotiable and that could be pumping weights in the gym but it absolutely doesn’t have to be – it could be Pilates, it could be using resistance bands, it could be using your own bodyweight, but you will do it.” If you do that to replace the muscle tissue you’re using, you can turn back time.”
And as an added bonus, any form of aerobic exercise can help reduce perimenopausal/menopausal symptoms like hot flashes, mood swings, or trouble sleeping, says Dr. moran
It is important that you not only check with our doctors, but also with ourselves. No one said it would be easy. I can go on a diet and drive away happily for a few weeks, but then it all falls apart in a moment of stress or on a long drive where the only edible food at the gas station is a big bar of chocolate begging me to take it with me home. So what’s the best way to go about it?
“Do whatever it takes to get you on your way. That means proper nutrition, exercise, sleep, meditation, connecting with friends and supporters like exercise coaches, and classes and nutrition programs that focus on wellness as well as nutrition. If you have clinical depression or anxiety, tell your doctor and seek treatment. Don’t suffer alone. Grab it.”
“Do whatever it takes to get you on your way. That means proper nutrition, exercise, sleep, meditation, connecting with friends and supporters like exercise coaches, and classes and nutrition programs that focus on wellness as well as nutrition. If you have clinical depression or anxiety, tell your doctor and seek treatment. Don’t suffer alone. Go for it,” advises Dr. Brizendine.
She adds that aiming to increase your exercise each week by using a tracking device and recording what you eat at each meal, starting with a two-week chart, can get you off to a good start. Aim for a high-protein Mediterranean diet, which we actually need more of as we age, she says.
dr Moran agrees, “Women often prioritize themselves last. They are busy multitaskers juggling different roles such as work, as CEOs of the family unit, they often have a caring role for children or their parents. Her time is almost never her own.
“But to perform at your best in all of these different roles, prioritizing yourself and your health is paramount. Never ignore symptoms. Make time to exercise or take a class. Take the time to plan your meal for the week—or delegate it to other interested family members. Learn to say no when necessary. Make time for your hobby or passion.”
Nigel Denby says we have to be realistic too. “You have to have specific, measurable goals. For example, “Now I’ll walk 2,000 steps, I’ll try to walk 5,000”. That is absolutely realistic. If it’s not something you don’t want to do for the rest of your life, then it’s too hard. You won’t stick to that. It has to be sustainable and tailored to what you already love to do.”
All three experts agree. Much like the oxygen mask on an airplane, women need to put themselves first for a little while each day so we can deal with the other things life throws at us.
https://www.independent.ie/life/health-wellbeing/ive-put-on-a-stone-in-the-last-year-and-my-lifestyle-hasnt-changed-the-truth-about-menopause-and-weight-gain-41826118.html “I Walked A Rock In The Last Year And My Lifestyle Hasn’t Changed” – The Truth About Menopause And Weight Gain