Menopause & perimenopause

Perimenopause and menopause weight gain — causes and solutions

by Marcy Holmes, NP, Certified Menopause Clinician

As many women enter perimenopause or approach menopause, they find themselves experiencing unexplained weight gain — especially around the waists and hips — despite their best attempts to diet. Often the methods of weight management that worked for them for years are suddenly ineffective. In fact, weight gain in the abdomen is one of the most common complaints of perimenopausal women. Yet most women have been told that an extra 10–20 pounds is simply a rite of passage at this time of life and they should just accept their “middle-age spread.”

But you absolutely do not have to. There is no reason why you should settle for anything at this stage of your life, let alone weight gain. Sure, things may get a little more complicated during perimenopause. Hormonal fluctuations, many years of exposure to toxins, and your body’s natural proclivity for retaining estrogen–producing fat cells at this time can result in some extra weight. But it doesn’t mean you’re stuck with it.

Menopause weight gain

The same metabolic set point holds true for your post-menopausal body as it did before “the change.” Menopause weight gain is just another symptom resulting from your system being out of balance. To restore balance, you need to figure out what is going on at the core of your physiology and emotions.

One of the many joys of menopause is the stripping away of the masking effects of estrogen. While this process may cause some symptoms, it becomes much easier to get a handle on what’s not functioning well for you. Many patients have conditions such as insulin resistance or adrenal fatigue that have been developing for a long time, but it is only after estrogen levels dip that they are able to notice the symptoms — and make the necessary changes to fix them.

Why does menopause weight gain occur so universally for women? It depends on the individual, but there are a few causes that are very common. Your fat cells and your hormones are part of a system-wide biofeedback network that orchestrates your appetite, metabolism, heat regulation, digestion, and detoxification. Any chronic disturbance in the crosstalk among systems has the potential to cause weight gain (and a host of other menopausal symptoms, like hot flashes and food cravings).

The causes of unexplained weight gain

Each day we discover more about the intricate nature of hormones and weight, but one vital link is the one between insulin, metabolism and body fat. For years, many women followed the conventional low-fat, high-carbohydrate diet, with lots of processed foods (pasta, breads, most snacks, beer and wine, etc). Over time this diet can create a condition known as insulin resistance. When you are insulin resistant your body converts every calorie it can into fat — even if you’re dieting. The result is that while you are gaining weight, your cells are actually starving!

A second basic link lies between stress and body fat. Stress hormones, like cortisol, block weight loss. This is sometimes called the “famine effect”: despite adequate food, the body interprets prolonged stress as a famine, and once again goes into hoarding mode — which it does very effectively.

Stressors can be emotional, physical, or even diet-related. Bingeing, yo-yo dieting, unaddressed food sensitivities, and severe calorie restriction are all forms of stress. Most of us are under tremendous amounts of stress — often more than we realize — and much of it is prolonged and unremitting, which can lead to chronic inflammation and a metabolic disorder called adrenal imbalance.

These mechanisms all work together — and many of us combine a high-stress life with a low-fat, high-carb diet. This creates such a powerful hormonal imbalance that weight gain is almost inevitable. What’s more, high-carb diets cause neurotransmitter imbalances that lead to food cravings. Because your body can’t readily maintain optimal blood sugar and serotonin levels, you are compelled to have snacks and caffeine to make yourself feel better. But they only exacerbate both insulin resistance and adrenal exhaustion while adding body fat. This is a vicious cycle.

For women in perimenopause, another weight gain issue is widely fluctuating estrogen levels, and for menopausal women, diminished levels of estrogen. As the estrogen production of your ovaries falls, your body turns to secondary production sites, including body fat, skin, and other organs. If your body is struggling to maintain its hormonal balance, body fat becomes more valuable. Often your body is balancing estrogen loss with maintaining bone mass, for which it needs additional fat cells. Of course, if you are stressed and on a low-fat diet, your body will struggle to keep all these balls in the air — and refuse to let go of extra body fat.

Chemicals and toxins add to the problem

Note that artificial sweeteners are not a solution, but part of the problem. They may lack caloric content, but some mimic sugar so well that the body produces insulin to metabolize them — contributing to insulin resistance. This can actually lower your blood sugar level, which is why many of these products contain caffeine to compensate for the drop in energy. Unfortunately, the caffeine also worsens any problems you may have with adrenal fatigue.

In addition, adding more artificial chemicals to your body at this time can exacerbate the “toxic load” you are carrying. By midlife, most women have had years of cumulative exposure to allergens, pesticides, plastics, chemicals, heavy metals, bacteria, and other poisons and irritants. Artificial and biological debris that can’t be eliminated gets stored in our fat cells.

Over time, a woman’s system can get so gummed up by toxins that it just can’t function well — and it is often the case that the more fat cells she has, the more toxins she has stored. When a woman begins to lose weight dramatically, like on a crash diet, these toxins get released into the body in a flood and can cause miserable symptoms. The body at this point just wants to get back to homeostasis (even if what it interprets as normal isn’t healthy), and will sabotage even the best intentions to lose weight.

The toxic load may be just one part of a broader pattern of inflammation — which often shows up during menopause. Dysbiosis, yeast and food sensitivities, and an immune system imbalance can short-circuit weight loss. Toxicity triggers the immune system to be on full alert, as do any unaddressed food allergies. Many women have been sensitive to certain foods for decades but only realize it after they lose estrogen’s soothing effect on the digestive tract.

The truth about weight loss during menopause

So the truth is, weight loss is not about willpower or calories in/calories out. Both are myths given to us by the diet industry that doom us to failure. Fad diets simply don’t work — over 95% of dieters gain back the weight they lose and more — because they oversimplify a very complicated process. One that is more complicated during menopause because of the many factors I’ve described.

The links between hormonal balance, toxicity, inflammation and body fat aren’t the only factors that block weight loss. Unresolved emotional issues are often the root cause of unhealthy eating habits — and they can be their own kind of toxin!

We have learned that you have to get healthy before you can lose weight and keep it off. Once you establish baseline health, your body will naturally seek and maintain its ideal weight. The first step is to follow nutritional and lifestyle guidelines like those we suggest in our Personal Program.

Menopause is no reason to accept someone else’s idea of what your limitations are — in fact the opposite is true! There is no better time than now to begin building a stronger health foundation. This is the time in your life to discover the best in yourself, including your power to finally deal with the core issues that may have hindered your earlier weight loss efforts.

 

Last Modified Date: 08/15/2012
Principal Author: Dixie Mills, MD, FACS