Dr. Suzanne Steinbaum

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The Truth About Menopausal Weight Gain: Why Diet Matters

I think the hardest part of going through the process of menopause is that you just don’t feel like yourself. Maybe that’s why they used to call it “the change.” One day you are one person, and then you start changing, not by choice, not in a controlled manner, and certainly not because you felt ready to change. Up until perimenopause sweeps into your life, you probably felt like you were in control. Like you had choices. If you wanted to lose weight, you went on a diet. If you wanted to get into better shape, you exercised. If you wanted to have blond highlights in your hair, you colored it.

Now, all of a sudden, your normal go-to strategies are no longer working and you have menopausal weight gain.

The old tricks you used to rely on no longer have the same quick results. You go on a diet, but you keep gaining weight. You exercise, and you still feel swollen and bloated. Your once-cheerful demeanor seems elusive, and the slightest insult can set you off on a tirade or send you straight into blues land. And, adding insult to injury, your hair is turning gray. And I mean you are finding stray grays everywhere, from your eyebrows to down under. Worst of all, it seems you can’t do anything to stop it. Why can’t you drop those pounds, or run as far as you used to run, or coast over those little road bumps in life? Well, I guess you could still do your roots. But what about the rest of you? Your weight? Your fitness? Your mood? Sometimes it may seem like your very personality has changed. One patient explained to me that even her feet started looking different. If you can’t even recognize your own feet, how can you possibly feel okay? You may be looking in the mirror and saying to your reflection: “Who are you?

When women are young, they are, biologically speaking, outfitted to procreate.

We have the bodies to carry, birth, and nurse children, and we have the estrogen that makes it all happen. This is, of course, necessary to propagate our species. But whether you decided to participate in the whole child-bearing thing or not, at some point, even if you are CEO of a Fortune 500 company, this particular evolutionary goal expires. Biologically speaking, it doesn’t really matter if, after you are past those childbearing years, you get fat, out of shape, and can’t even recognize your own feet. But what does biology know about you personally? What does evolution understand about how much you want to fit into that strappy black dress? You and I both know your purpose and impact in this life is far from over, and you want to feel strong and good and energized and sane in order to keep doing the amazing things that you do every day.

Sit down, because I’m going to hit you with some harsh truths. When this hormonal shift happens, your metabolism is going to slow down—maybe a little and maybe a lot—and that means most women are going to gain weight. Unfortunately, you can’t drink enough coffee or take a magic pill to speed up your metabolism. There are only two things you can do to keep from gaining weight: diet and exercise. And I’m not talking about the diet and exercise you used to do in your 20s, as in “I will cut back on the French fries a bit and hit the gym once or twice” diet-and-exercise plan. No, this is the “I will count my calories and make sure that I choose nutrient-dense choices, slash the sugars and cut back on the simple carbohydrates and exercise every day” plan.

We will get to the exercise part, but the first and most powerful thing you can do to combat not just menopausal weight gain, but low energy, mood swings, and that feeling of not being yourself, is making a commitment to eat a diet that is rich in complex carbohydrates (like fiber-rich whole grains), vegetables (especially the green ones), low-sugar fruits (think apples, pears and berries), lean proteins (tofu, legumes, fish, chicken—whatever you are most likely to eat) and little doses of luscious healthy fats (almonds, avocados, olive oil). Does that sound so bad? But wait, it also means that your daily calorie allowance simply cannot be the same as when you were on the track or soccer team in high school, even if you exercise regularly. When your metabolism slows, you must keep your caloric intake lower. Depending on your activity level and size, that could mean cutting back to 1,500 calories per day, or even 1,100-1,200. (A dietitian or nutritionist can advise you more specifically on your individual calorie needs.)

But more is happening beyond the external and visible accumulation of body fat with this menopausal weight gain you may be noticing. Inside, your level of the protective HDL (“good”) cholesterol you enjoyed in your good ol’ estrogen-rich days will probably start to decrease and your LDL (“bad”) cholesterol will probably start to increase. This invisible phenomenon is what causes the increased risk of heart disease. As the LDL cholesterol goes up and the HDL goes down, it creates the perfect environment for damage to the lining of your increasingly less-elastic arterial walls. Damage here can lead to plaque in the arteries and, consequently, heart disease and stroke.

You may also have noticed that you aren’t just adding padding to your hips and thighs.

Your once-flat stomach may have developed a new and unwelcome roundness. This belly fat, so common for women as their hormones shift, actually interferes with your metabolism. Suddenly, the sugars and carbohydrates that you processed so efficiently when you were younger are sticking around in your bloodstream, causing the release of more insulin, which leads to more belly fat in a vicious circle of carb consumption and an expanding waistline. This cycle also makes it more difficult to lose weight. Sigh.

Don’t get too frustrated with this menopausal weight gain, because dietary changes really will make a serious impact on this situation. You are not condemned to menopausal obesity, but avoiding it may require that commitment I mentioned earlier. If you cut out the sugars, change your diet, and train yourself to look at food a little bit differently, you can master this process. You can put yourself back in charge of your body and moods. Stop being negative, telling yourself the good days are over, that you can’t do it, or some silly story about how you are destined to get fat and decline. You’ve got stuff to do! So get up and get serious. Make the commitment to take control of your diet, not just on weekends, not just three days a week, but every day.

You’ve got this. Are you ready to master your menopause?