This article has been written by Sally Norton, a UK-based medical doctor and weight-loss consultant.
With two-thirds of us overweight or obese, and all of us ladies facing the menopause at some stage, the double whammy of weight-loss struggles and menopausal woes is going to face a lot of us. Many women feel that their weight gets harder and harder to manage the older they get…and yet, several scientific studies show no convincing link between weight gain and the menopause itself.
After 15 years as an NHS weight loss surgeon, managing hundreds of women who were really struggling with their weight. I noticed a pattern. Many of them were women in their 40s, starting to run into trouble sleeping, thinking straight, multitasking, or generally just coping with life. And they were increasingly depressed with their weight loss struggles after years and years of failed diets.
A fair number had been started on anti-depressants – but these were women who just couldn’t understand why they were losing their normal joy in life, their superwoman ability to manage everything that family, work and life in general was throwing at them …and they put it down to their weight.
I thought there was more to it than just their weight and general low mood, so I started investigating the link between weight, hormones and the peri-menopause.
Whilst studies don’t show a clear link between the menopause itself and weight gain, I believe there are 9 reasons we struggle with our weight at just about the same time that the peri-menopause and menopause hits us…..
Many of us have been on and off diets for years. In fact, 65 % of us have tried to lose weight in some way and a whopping 2 million women are going on fad diets in any one year. But studies show that fad diets rarely lead to long term weight loss.Your body keeps thinking you are starving, every time you crash diet, and so it thinks it is doing you a favour by stockpiling a lot of fat-storing energy!
Then, repeated failures leave us feeling demoralised, gaining more weight than we lost …plus causing long-lasting harm to our bodies and minds. So maybe those years of yo-yo dieting are catching up on us? The point is, that we approach the menopause already struggling with our weight, having tried and failed to get it under control for years and then IT JUST GETS EVEN HARDER. Doesn’t seem fair, does it?!
We move less, as our joints become a bit stiffer – which means we burn up less energy anyway. And the menopause can play havoc with our bladder control as the pelvic floor loses its strength and the change in hormones gives us the feelings of urgency, cystitis and loss of control…and that can put some women off exercising.
Our body needs less energy than growing energetic teenagers, or when we were pregnant, breast-feeding or running around after young children… and yet we often carry on eating the same! Studies show that we may need around 200kcals less a day than we did in the past…and it’s very easy to eat 200kcals without noticing it!
What’s more we lose muscle too – a condition known as sarcopaenia – at around 8% per decade after 40. Muscle is more metabolically active – that means it burns more energy – helping us to lose weight even when we are sitting on the sofa! Yo-yo dieting leads to more muscle loss too. So, less muscle = less calories burned = more weight gain.
There is some evidence that lower levels of ‘fat-burning’ brown fat may contribute to the middle-age spread too….an area being heavily researched at the moment.
Changing hormones around the menopause can also affect the way we store fat – around the middle rather than on the hips ……where men traditionally put on their fat, in fact. Making you more of an apple than a pear shape. Fat around the middle is more likely to be associated with heart disease, diabetes, liver disease and more so is worth avoiding if you can.
And don’t forget the psychological reasons too – maybe we have less to occupy our time as kids leave home. Or we may be busy caring for older relatives as well as stroppy teenagers. That puts extra pressure on many of us at a time when our energy may be low and our irritability high!
We may be over-stretched in high-pressure jobs (and the peri-menopausal brain-fog does nothing to help, of course!) or worrying about our own health or finances – all of which can cause stress and over-eating.
And we may be starting to lose our self-esteem –focusing more on the increasing wrinkles than our increasing life-experience. Some women who have prized their looks may find it difficult, even subconsciously, if they are watching their daughters blossoming as they feel they are sagging.
When you look at everything that’s going on at this time of life, it’s surprising that anyone manages to control their weight at all, to be honest!
But don’t despair. Once you realise there are many reasons why the weight creeps on, you can do something about it.
So what can you do from today?
Serve yourself smaller portions – you need less food than you used to.
Make sure that portion is full of good nutritious food that will protect your health as well as help your weight. The menopause carries an increased risk of heart disease and more so choose fresh fruit and veg, oily fish, nuts, wholegrains and white meat over red to reduce your risk.
Reduce the intake of sugar and processed foods– enemies of weight-loss and more likely to increase abdominal fat.
Keep active.Studies show that exercise (especially in the cold!) increases our fat-burning friends – muscle and brown fat. And, the more we exercise the more we strengthen our muscles, bones and increase our proprioception –nerve-related protection around our joints which protect us from the risk of hip and other fractures. These are common in older women due to bone-thinning, muscle weakening and joint instability and we need to do all we can to reduce that risk.
Address those areas that are causing you anxiety and stress, as cortisol, the stress hormone, encourages abdominal fat deposition.
Consider talking to your own doctor about HRT. HRT doesn’t seem to cause weight gain – in fact, it may prevent that abdominal fat building up so it may be worth discussing with your doctor, especially if you are experiencing other debilitating symptoms such as night sweats. Yes, some people, including doctors, are worried about the slight increase in risk of breast cancer, heart disease and more…but that risk is slight. And, don’t forget that the risk of breast cancer, heart disease and other issues are also increased by our weight. So, if we can lose weight we will reduce our risk of all those things anyway.
So you may be approaching the menopause – but it doesn’t have to be a negative change. Use it as an opportunity to reappraise your mind-set around weight-control. No more dieting – instead make some small and sustainable changes in your lifestyle that will help you both lose weight and keep it off for good. Plus, help you keep mind and body healthy for many years to come.
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Last Updated June 2018Download as PDF