by Marcelle Pick, OB/GYN NP
Nearly all of my patients ask me when we first meet, “How can I lose this weight?” A full third of these women have been on one diet or another for as long as they can remember. This habitual dieting generally keeps women at a manageable weight until they enter perimenopause and menopause.
I hear stories all the time about weight gain that suddenly appears at this time (especially around the stomach) and simply refuses to come off, no matter what my patients eat or how much they exercise. This personal history of dieting and a feeling of being out of control sends them running to the latest trendy diet, only to be disappointed again and again.
And they are not alone. At Women to Women we see patients of all ages who struggle with weight as their central health concern. In most cases, they feel guilty or angry at themselves about the way they look. They are anxious to “fix” themselves with dieting and often are willing to overlook their long-term health in trying the latest diet craze or products advertised in the media. Many of these programs just set you up for failure because they are deprivation-based and lack a maintenance program.
From Dean Ornish to Jenny Craig to Atkins to South Beach, there have been scores of new diets promising universally quick results. There is now a “low-carb” version of our favorite snacks to take the place of the “fat-free” foods that used to be fashionable. Women are inundated daily with conflicting information about what, how much, and when to eat. Multiply that by the very real hunger signals our bodies send us, and by the comfort and enjoyment inherent in the act of eating, and who wouldn’t feel confused?
I feel that this is the perfect time to give you my thoughts on what I have come to call the “diet culture.” For I think we all are aware that just as advertisers aim product at the “youth culture” in America, there are many companies right now marketing product to those of us who are anxious to lose weight. What they won’t tell you is that only three to four percent of dieters will succeed in keeping that weight off after a year. It’s no wonder the diet industry can sell us something new every year!
There are many reasons why yo-yo and fad dieting don’t work — and may even do more harm than good. Let’s talk about them and then turn to how you can lose weight in a healthy way and keep it off permanently.
At Women to Women we consider excess weight gain to be one of many symptoms that indicate an underlying biochemical imbalance in our patients. Although fad diets address this symptom in the short term (meaning that if a person follows the plan, they will initially lose some weight), they do not address the root cause, which is often some kind of metabolic dysfunction or hormonal imbalance.
Over the years, I have seen repeatedly that dieting is not the key to long-term weight loss — the real key is a healthy metabolism supported by a balanced hormonal state.
How does a woman’s body get out of balance? The reasons are as varied and unique as each woman. Each one of us gains, loses, and maintains weight at certain points in our lives for a variety of reasons, physiological, cultural or emotional.
This simple fact is something the diet professionals aren’t anxious to reveal because it is simpler to sell us a one-size-fits-all plan. These diets may work to a degree in some people, but for a lot of women fad dieting without an understanding of their underlying biochemistry only leads to a yo-yo cycle and more weight gain.
Why is weight gain different for women?
We’ve all had the frustrating dieting experience of watching the pounds peel off our husband or mate while we struggle to lose even a few. Why do men seem to lose weight more quickly than women? Men’s bodies are trained by evolution to have strength and speed. They have a different muscle-to-fat ratio in their bodies, which makes it easier for them to speed up their metabolism and burn fat. Women, on the other hand, are hard-wired to reproduce. They keep an insulating layer of fat on their bodies that men don’t have. (Women also live longer!) In addition, fat is essential for the production and storage of reproductive hormones. Progesterone production begins with an adequate level of cholesterol in the blood. Women don’t lose weight rapidly because they are genetically programmed that way — it has nothing to do with willpower!
Additionally, the erratic hormonal fluctuations that can occur in perimenopause and menopause may cause weight gain and a change in body shape in some women. This is due to vacillating levels of estrogens and progesterone. For more detailed information on these changes, please visit our library of articles – there are many that further explain this phenomenon. Some women report experiencing strong food cravings at this time, which can be a symptom of declining progesterone levels. Once hormone levels reach a new equilibrium it becomes easier to lose extra weight.
What if you’ve tried everything and still can’t lose weight?
In my years of experience, I have seen a few underlying conditions in my patients that make losing weight on a popular diet plan particularly difficult. Here is a summary of these problems.
Adrenal fatigue: We touch on the intricate link between weight and the adrenal glands in our article “Natural Weight Loss,” but because adrenal depletion is so widespread, and because adrenal health so critical to losing stubborn pounds, I want to include at the top of this list. The adrenals release an important hormone called cortisol, which is often described as the stress hormone and is related to adrenaline, the more familiar adrenal hormone, and to your serotonin levels (see below). Too-high or too-low levels of cortisol in the blood can be a major cause of weight gain and the inability to lose that unwanted weight. For more information on adrenal function and adrenal exhaustion, see our extensive list of articles in our Adrenal Health section.
Carbohydrate sensitivity: While carbohydrates are an absolutely necessary component of a balanced diet, many of us become increasingly sensitive to them as we grow older. Over consumption of simple carbohydrates (like those found in white bread, candy, soda, white rice, and many breakfast cereals) creates a rollercoaster effect on your appetite: you feel energized and sated for a little while as your insulin spikes, only to crash a few hours later when your blood sugar drops precipitously. This low blood sugar triggers the brain to send out hunger signals again, which can cause you to overeat and gain weight. For some of us, this rollercoaster feels like a gentle ride. Others who are more sensitive experience steeper crests and valleys. If this sensitivity is not treated with a diet lower in carbohydrates and sugar, it can evolve into excessive weight gain and a larger metabolic concern called insulin resistance, a pre-diabetic condition in which cells becomes inured to insulin and the pancreas is triggered to produce ever-increasing levels. For more information, see our articles on insulin resistance.
Depleted serotonin: Serotonin is just one of a host of neurotransmitters secreted by the brain that regulate mood, attention, and energy levels. Ongoing stress can deplete our serotonin reserves, leading to intense food cravings — particularly for the refined carbohydrates that when eaten mimic the sense of well-being created by serotonin. In some women, this state of serotonin depletion becomes chronic. Persistent low serotonin levels lead to plummeting energy levels — particularly in the late afternoon — bouts of depression, and compulsive eating. Low serotonin levels can be detected through testing. To learn more about raising serotonin levels naturally, read our article on Antidepressants.
Yeast or intestinal parasites: Colonies of excessive Candida (yeast), bacteria, or intestinal parasites in the digestive tract can make it very difficult to lose weight. Many doctors do not test for these organisms. There are several tests you can order to determine whether you have parasites. For women who have yeast overgrowth, eliminating yeast and sugars for a period of time can restore balance to the digestive tract, allowing weight loss to occur naturally. Women often need to use supplements or probiotics to eradicate the yeast or parasites, but once this is accomplished they begin to lose the unwanted weight.
Food allergies: Similarly, allergies and sensitivities to certain foods can create a dysfunctional metabolism. Frequently these sensitivities crop up in adulthood and manifest themselves in easily overlooked ways, for example, stomach and intestinal upset, headaches, insomnia, lethargy, joint aches, and rashes. If we suspect a patient has a food sensitivity, we recommend an elimination diet. We eliminate potential allergens for two weeks, then reintroduce them for a day and test for reactions. If reactions do occur we recommend staying away from the offending food for at least four months and then cautiously reintroducing it.
Sometimes a patient will present with only one of these nagging weight gain factors; more often women will have a combination. Most of my patients had no idea that their bodies were out of balance until they began to feel symptoms of perimenopause and menopause. In many of my patients, I find that their metabolism is frozen from years of fad dieting. Once they modify their diets and get further treatment customized to their particular issues, their metabolism heals and they are able to lose weight — gradually, safely and permanently.
My concern with fad diets
Popular diets do work for some people. However, I remind my patients that studies show the average weight loss after one year on some of these diets is just five pounds — and that includes men! Still, we keep trying. At any point in time, 44% of the women in this country are on some kind of aggressive diet.
And still more information keeps coming. There is increasing evidence that weight loss is linked with having a ready supply of calcium and vitamin D in our systems. There is also a controversial connection promoting human growth hormone (hGH) and the ability to put on lean muscle mass. Much needs to be learned before we can say for sure how these elements factor into our own biology, but it is interesting to note how rapidly our knowledge is growing.
So what does work? I have found through years of my patients’ — and my own — trials and tribulations that paying attention to a woman’s individual body chemistry and her emotional history leads to successful, long-term health and weight loss.
Still, there are many women out there who may not have immediate access to alternative healthcare professionals and are unsuccessfully trying to lose weight. For those women experimenting with over-the-counter diets, I’ve provided an overview of what I see as pros and cons of the most popular choices available.
In general, I prefer those diets that encourage a balanced ratio of protein, fat and carbohydrates in every meal. I am more inclined to suggest the Schwarzbein Principle I and II or the Metabolic Typing diets because, along with their balanced food plan, they advance the concept that each person has different factors that contribute to their ability to lose weight.
Putting it all into perspective
My point of view results from 27 years of experience with women and weight, and it is rooted in the belief that eating well and often is a necessary, enjoyable, and healthful act. Over the years we have adapted our Lifestyle and Nutritional Guidelines to reflect the healthful eating and lifestyle habits that lead a majority of women to hormonal balance, sustained weight loss, and overall well-being.
Learn to accept yourself for who you are and ultimately love yourself, because the body you have is the most valuable house you’ll ever own. Your personal blueprint is a treasure map to natural weight loss and lifelong health that no popular or radical diet can ever replicate. Whenever you are at odds with your own best interests on dieting, I hope you will revisit our article on natural weight loss and the nutrition and lifestyle guidelines for a refresher.
A time of Thanksgiving and peace
At Women to Women we try to keep the ideas of moderation and mindfulness in focus when we approach any choice, be it food, exercise, commitments, or work. While we do recommend watching what you eat, we think it is more important to encourage you to listen to your body. Get to know yourself. Learn what triggers your cravings. For many women, outgrowing a few bad habits (like drinking soda pop) or starting to exercise can be the catalyst for positive change in the rest of their lives. We want you to first and foremost get nutrition and enjoyment out of every meal, then to concern yourself with any extra pounds.
As the holidays approach, I encourage you to enjoy your turkey and vegetables and leave the guilt behind. Have your piece of pie (remember to eat some protein with it), then take a nice walk around the block with a friend or relative and share a laugh or a memory. Balance is something we can create in all aspects of our lives, and in the process, guess what? We can lose weight, gain perspective and, certainly, look ahead to many years of good health.