by Marcelle Pick, OB/GYN NP
I think we can all agree that over the years women’s lives have really changed – our cultural expectations, our feminist expectations, and our personal expectations all combined with advancing technology have dramatically changed our day to day lives. Think about our grandmothers or great grandmothers – they stayed home and cooked the meals, often taking all day to prepare, setting aside dedicated time to visit with friends or take care of family responsibilities and experienced a much different pace than women today. This isn’t to say that these wonderful women didn’t work hard! They did! Today’s woman may prepare a meal, while answering work emails, responding to texts from children requesting rides, while supporting a friend going through crisis…all at the same time! This scenario doesn’t take into consideration the physical stress her body might be handling at that very moment – significant hormonal shifts could be happening at the same time – particularly if she hasn’t eaten in a balanced meal within the past few hours, if she hasn’t been sleeping, or if her sex hormones are out of balance. We are very complex beings! Our bodies respond to stress in a physical way.
Weight – particularly weight gain is a prominent topic with most of my patients. Some see the pounds sneaking on gradually; others tell me that overnight 20 pounds have jumped onto their bodies. Most tell me that they have tried to cut calories, increase exercise and at times have taken some dietary supplements. It seems as though these women are doing all the right things. These patients are always, yes always surprised when I steer our conversation to the stress in their lives. What does stress have to do with weight gain?
Our adrenal glands, walnut sized glands which sit atop our kidneys, govern our stress response and help regulate many other body processes can become imbalanced. We’ve all heard the stories about mothers having a surge of strength to lift a car off their injured child – this amazing strength comes from a surge of adrenaline and cortisol from the adrenal glands! This is exactly how our bodies were designed. These hormones mobilize energy product from fats and carbohydrates In a perfect world, we would experience that surge, then our stress would pass.
For many women today, periods of intense stress never stop and our adrenal glands keep producing the hormones they should, but begin to become unbalanced. Then our bodies start preparing for the worst by storing calories – our primal body kicks in – being stingy with how calories are used and insuring that it will have calories – and fat to pull from when needed. When are bodies are flooded with cortisol, we are less sensitive to leptin. Leptin is the hormone that makes us feel full – when less sensitive to it; we eat more than we normally might. Our bodies are wise – holding onto calories help us survive!
Women with adrenal imbalance most often experience weight gain around their middle – their waist grows disproportionately to other areas – we call this visceral fat depositing. When our bodies are not struggling with constant stress, cortisol, glucose and insulin all work together to keep our blood sugar stable. When we haven’t eaten for several hours, our glucose (blood sugar) drops and a message is sent to the adrenal glands to release cortisol. This cortisol mobilizes fat, amino acids (from our muscles) and glucose (from glycogen in the liver). All of this keeps your body and brain fueled in the absence of food, preventing low blood sugar also known as hypoglycemia. Insulin helps glucose into the cells and cortisol maintains glucose levels in the blood.
With long term stress, both insulin and cortisol remain high in the blood. Extra glucose is stored in the form of fat , primarily in abdominal fat cells. This is also known as visceral fat. Scientific studies have shown that fat cells have unique stress hormone receptors for cortisol and that there are more of these receptors on the fat cells in the abdomen than anywhere else in the body! Most women are shocked to learn that this visceral fat is not inactive! It seems as though the fat itself can act as an endocrine organ that reacts to the stress response – and will continue to build on to the abdominal fat deposits. What a terrible cycle to fall into! The answer is to help the adrenal glands get back into balance.
Where do you start? By eating!
Like many of my patients, you may be surprised, too! Yes, eating more instead of less is one of the keys. You want to convince your body that its not in danger of starving – and the way to do that is to eat – making sure you are making good choice to provide the nutrients you need.
Eating regularly is the way to go! We know that cortisol is integral to maintaining good blood sugar levels and stable blood sugar levels keep your adrenal glands from working overtime. When you get too hungry, you send the message that cortisol is needed – and the unhealthy cycle will start. To prevent this, I recommend three balanced meals and two snacks per day. Eating within one hour of waking lets your cortisol reach its morning peak, relieving your adrenals from maintain fast blood sugar levels. A healthy balanced snack between meals helps tremendously. I advise women to have lean protein at every snack and meal and to keep carbohydrate intake to 16 grams per meal and 7 per snack.
What you eat counts!
Keeping good choices close at hand is the key! When you’re hungry and tired our natural response is to reach for what’s close at hand. Sugar laden foods, caffeine and carbohydrate heavy foods may fill your need in the moment, but not in the long term. When in this healing phase it’s important to avoid processed foods, alcohol, caffeine and refined and processed sugars. Many of my patients are gluten sensitive and notice good, positive changes when it is removed from the diet.
Keeping the foods you need handy may take a little more time, but the end result is worth it. Lean proteins can be cooked ahead of time, vegetables can be purchased peeled and cut, and nut butters on an apple are quick and easy. And remember…you are worth every effort!
- Breathe deeply. One of the best things you can do when you feel stress building is to pause, take in three very deep breaths through your nose, exhaling mindfully through your mouth…and feel your heart rate decrease. You can do this anywhere and no one will even guess what you are doing!
- Disrupted or poor quality sleep can also affect your ability to lose weight! When your circadian rhythm is disrupted your cortisol cycle will follow! Create a goal to get at least 7 hours sleep per night. Follow good sleep hygiene – including turning off all electronics one hour before bed!
- Exercise mindfully. Keep our heart rate under 90 beats per minute if you are currently exercising. You may want to consider easing up for a few months while you are healing. If you don’t exercise, try walking 15 minutes once or twice a day – outside if possible.
- Find time to enjoy something every day – whatever that means to you! Is it meeting a friend for a meal? Skyping with a family member? Reading? A bubble bath? Taking your dog to a dog park? Taking a class once a week? One woman I know loves to take classes – she does everything from craft classes to wine tasting. These classes define what she needs for fun – connection, learning, new environments and a feeling of moving forward in her life. What’s fun for you?
Stress related weight gain does not have to be a part of your life!