I finally feel motivated to share some of my own menopause trials and tribulations, namely, my struggle with the old “weight around the middle.” The spare tire. The muffin top. Call it what you want, but menopause has finally brought me to my knees.
It wasn’t the hot flashes, the night sweats, the vaginal dryness, or the irritability and irrational behavior. I managed to overcome them all. Well, not the irritability and irrational behavior. In fairness, that predated menopause. But THIS????? I decided to pull from my bag of tricks to face this head on.
Why You Gain Weight In Menopause and What To Do About It…
DECLINING HORMONE LEVELS
The decline in key sex hormones like estrogen and testosterone is the main reason for weight gain in menopause. These hormones regulate metabolism and signal fat breakdown. Some research suggests that estrogen can block hunger signals which helps you eat less. One study followed normal weight premenopausal women over a five year period of time. Those women who entered menopause a few years into the study had higher total fat mass especially around the middle compared to when the study began (me raising hand and nodding my head vigorously.)
Lower testosterone and reduced growth hormone levels also lead to reduced muscle mass. Muscle burns more energy at rest than fat so reducing your baseline muscle leads to lowered metabolism. This translates into weight loss resistance when you try to eat less or gaining weight despite eating the way you’ve always eaten. Admittedly I used to be able eat like a teenage boy going through a growth spurt with few repercussions. Now? Not so much. Losing weight is never easy, but now menopause makes it nearly impossible.
WHAT I DID ABOUT DECLINING HORMONE LEVELS:
Drank Wine
First I tried drinking more wine. For reasons that remain unclear, this strategy failed. As did eating a sleeve of gluten free cookies at night before bed. Both of these maneuvers gave me more hot flashes at night so I couldn’t sleep. Then I woke up too tired to exercise. Arguably, the wine probably added calories in the form of liquid sugar and the cookie debacle was self explanatory. A minute on the lips, a lifetime on the hips, so the saying goes…
Hormone Replacement Therapy
Next I moved on to hormone replacement therapy (HRT) with estrogen, progesterone and testosterone. Some research suggests that HRT can help women improve muscle mass, increase metabolism and lose weight. I would say in my experience as a prescriber of HRT is that about 20% of women achieve improvement in weight as a result of HRT alone. It is a big win for many other issues, but weight loss is not necessarily a slam dunk. Of course, I was not one of the lucky ones in that department so I moved on to Plan C.
Eat Less
Next I decided to — drumroll — not eat as much food. I know. CRAZY IDEA, right? Over age 50 you burn about 300 calories less a day than your former 30 year-old self. How’s that for annoying?
Most weight loss experts all sort of agree. Calorie restriction, regardless of the type of diet you choose, will result in weight loss. This means that you can try Keto, Paleo, Atkins, plant-based, low carb, or Mediterranean diet as long as you are eating less calories. So choose whatever nutrition plan you can actually stick to…
I am not fully on board with this because I do believe that sticking to a diet means the diet has to be anti-inflammatory, low in sugar, and high in nutrients and satiating protein and fat. Eating in a way that doesn’t wreck your insulin and cortisol is critical to staying on track and not fighting your way to lower calorie intake.
Check out this article that contains a handy tool to calculate calories for weight loss.
INTERMITTENT FASTING
One strategy to eating less is to not eat or “fast” for certain periods of time. According to a Harvard review article intermittent fasting can change body composition through loss of fat mass and weight. A systematic review of 40 studies found that intermittent fasting was effective for weight loss, with a typical loss of 7-11 pounds over 10 weeks.
Three ways to do this:
- Alternate day fasting — Alternating between days of no food restriction with days where you eat only one meal a day at 25% of daily calorie needs. Example: Mon-Wed-Fri consists of fasting or 400-500 calories a day, while alternate days have no food restrictions. This to me sounds sadistic and preposterous. So, no…
- Whole-day fasting — 1-2 days per week of complete fasting or up to 25% of daily calorie needs, with no food restriction on the other days. Example: The 5:2 diet approach means no food restriction five days of the week, cycled with a 400-500 calorie diet the other two days of the week. This could be doable actually and I think I will try this just for “fun.” I clearly have a distorted definition of fun people.
- Time-restricted feeding — This was my choice. Eating only during a designated window of time and technically fasting all the other hours of the day. As an example, I ate my first meal around 1pm and my last meal by 7 or 8PM with fasting during the remaining hours of the day. This technique is usually super helpful for my patients as it reduces insulin exposure (a hormone responsible for storing fat) and usually has a side benefit of eating less overall than you would eat over a 12 hour eating window. Not so for me. I managed to shove down just as much in this reduced time window as I could when eating all day long.
WHEN ALL ELSE FAILS, BIOHACK YOUR BODY
Finally, I decided to try a metabolism boosting program that works on several levels, one of which is promoting more of your own growth hormone production. Growth hormone, which declines as we age, improves testosterone production, maintains muscle mass, promotes weight loss and improves sleep. Win, win, win and win.
I’m using an injection of a peptide called semorelin nightly paired with low dose naltrexone, a compounded medication that when used in low doses reduces insulin levels and reduces appetite. I threw in a sublingual spray containing amino acids and vitamins that accelerate your body’s innate fat burning capabilities. You DO have to pair this with a reduction in calories consumed, but it reportedly helps to keep you on track and accelerates weight loss. The result? TBD – Stay tuned! I’ll let you know how this pans out.
AGING AND MUSCLE LOSS
Aging in and of itself leads to loss of muscle and increased fat. As we just discussed, less metabolically active muscle means calories are not burned off as easily and weight starts to go up. Research suggests that we lose 3-8% of our muscle every decade after 30 years of age. That would make me, oh, 40% fat….yikes!! What happened to the your body is 70% water? Now I’m at 110% – not happy!!
WHAT I DID TO ADDRESS MUSCLE LOSS
I definitely noticed my muscle development had taken a huge hit during the pandemic. This was in large part my fault as I had given up on actual exercise. The lack of in person gym left me to my own devices at home. I got this awesome workout doodad called “THE MIRROR” where you have your own private digital instructor giving you all manner of classes at any intensity level you desire for as long a class as you like, with or without equipment. All at the touch of an app. I was thrilled.
Who needs a gym? Apparently I do. Doing a 15 minute “chair” yoga class while texting seemed to be less effective than my pre-Covid in-person, Cardio / Kickbox / Fight For Your Life, hour-long classes at Equinox under the watchful eye of a 5-8 cross fit marathoning former iron woman. The motivation was just not there anymore. And I’m not alone. One study, looked at older vs younger adults of all sexes. They found that 60% of those in the older group had no intention in participating in regular exercise compared to 25% of those in the younger age group. I’ve been a hugely dedicated and disciplined exerciser my whole life. Now? Nope. Could kind of care less.
STRENGTH TRAINING IS KEY
I had convinced myself that playing doubles tennis was actually exercise. The thing is, for me, it’s not. Doubles is fun. It gets you moving. It’s social. It’s a lot of things, but at the age of 54, it’s not exercise. So, I doubled down and just basically forced myself to do “The Mirror” strength training at least four days a week for 30 minutes a day. Muscles are starting to peek out of hiding. It takes WAY more time than when you are younger. So, all I can say is, you need the motivation to just get on the horse of strength training. Find what will work for you but if you don’t build muscle in menopause, you don’t have a chance at controlling weight.
TAKE IN ENOUGH PROTEIN TO BUILD MUSCLE
Body builders and people who make muscle development a job swear by downing protein within an hour of a muscle building workout. The idea being that breaking down muscle requires adequate protein to build it back up. Some researchers suggest that you don’t have to cram protein in immediately after your workout. A 2017 Medicine & Science in Sport & Exercise study found that when men drank 22 grams of protein after their workouts, they didn’t build more muscle than those who didn’t, though all study participants took in a sizable amount of protein during the day.
Bottom line is make sure you are getting enough protein THROUGHOUT the day, about 0.9-1.6grams/kg of ideal body weight if you are working out pretty aggressively. Scale it back if you are not working out as intensely.
Here is Ben Greenfields suggestion for building muscle. He’s a major body bio hacker and in excellent shape. So…he’s doing something right.
- Take whatever you’ve got (body weight, light weights, bands, etc.) and go to maximum fatigue.
- Do this by using a normal tempo and max out with high reps, or go super-slow and max out with low reps.
- Use a suspension trainer or resistance bands to add load if you have access to them. This reduces the need for unsightly and expensive weights at home.
- Make sure you’re getting adequate protein from your diet (1- 1.6g/kg body weight).
- He’s also into supplementing with creatine and essential amino acids to support muscle protein synthesis.
SLEEP PROBLEMS GET WORSE IN MENOPAUSE
Research shows that lack of sleep can contribute to weight gain. One 16 year study showed that women who slept five hours or less per night weighed more (gaining on average 33 lbs over a 16 year period), compared to women who slept seven hours or more per night.
Hot flashes, night sweats, anxiety, drinking more at night, eating cookies in bed — these are things that can keep you up at night. Not only are you more likely to gain weight JUST from not getting enough sleep, the problem is compounded by being too tired to then exercise the next day. Lack of sleep also increases food cravings and carb intake, so all of this adds up to weight gain and difficulty staying on track.
Check out my blog post for specific recommendations: 9 strategies for getting better sleep and Benefits of Better Sleep. Also consider working with our health coaches on hacking your sleep today!
HOW I HACKED MY SLEEP
- I set a cool room temperature to 66 degrees — ignore the person shivering uncontrollably next to you.
- Made my room completely black by unplugging all electronic devices, wearing a sleep mask and taking magnesium 400mg at bedtime and insomnitol 2 at bedtime.
- I wear blue-light blocking glasses after 8pm if I am looking at a computer or phone or TV screen to try to preserve my own melatonin production at night.
- I avoid wine at all costs. This wrecks my sleep. Most alcohol does as a matter of fact, but if I stick to the occasional tequila, lime juice, no sugar and seltzer, I’m good with sleep.
IN SUMMARY
There is a lot that you can do. Not everything works for everyone. Here are the key points:
- You do have to reduce your calories that you have always eaten in the past
- You do have to choose a nutrition plan you can stick to
- You do have to avoid sweets and wine daily. Use these judiciously
- You do have to exercise, preferably including strength training
- You do have to balance your hormones — namely insulin and cortisol and consider balancing estrogen, progesterone and testosterone
- You do have to get plenty of sleep, 7 to 8 hours at least
- After that, you need to dig deeper and work with a functional medicine MD to figure out what is standing in the way of you and not having a muffin top. If that sort of thing bothers you
That does it for this episode of Share The Health. If you want to learn more about how Redefining Health Medical can help with your menopause weight loss, please contact us!
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For more information about my wellness programs and my practice, check out my website drsadaty.com. Hey Look! You are already here…
Ready for the legal disclaimer? Information offered here is for educational purposes only and does not constitute medical advice. As with any health recommendations, please contact your doctor to be sure any changes you wish to consider are safe for you!