I have heard it hundreds of times. My menopausal clients, sitting in front of me, sometimes in tears, “I don’t understand. I’m not doing anything different. Why am I putting on weight? I’m hardly eating, I’m exercising more than ever. I’ve tried everything. Keto, paleo, fasting, but all I do is put on weight.
‘Despair’ is the word that most of these women will use. The bad news is that for most menopausal women no amount of diet chasing or exercising harder will help them lose weight. In fact, certain diets and exercise regimes could contribute to weight gain. The good news is that there are reasons why you are putting on weight at this stage in your life.
Exploring the causes will not only help to achieve your optimal weight but it will put you on track to address any other underlying health issues at the same time. Addressing menopausal weight gain is not just about looking good in your favourite outfit. There are real health implications for women as they get older if they are overweight. These include higher risk of cardiovascular events, diabetes, musculoskeletal conditions such as osteoarthritis and certain cancers. Let’s not forget the emotional toll that weight gain can take at this time in life when, psychologically, you are going through enough already.
In this article I will give you a number of reasons why this is the case. These reasons are backed by recent scientific research into healthy ageing for women which I will be referencing at the end of the article. It is important to understand that menopause is not just about a decline in sex hormones affecting your organs of reproduction. A woman’s body has estrogen receptors and target tissues for estrogen and progesterone all around the body. Therefore, every organ and tissue is affected by the decline in these hormones.
These hormones don’t just regulate reproduction. They do a whole lot more. As we enter into this new phase in our life, there is changes to our heart, liver, gut, blood vessels, brain and whole nervous system. For this reason, dietary changes, exercise protocols, nutritional and herbal medicines need to be specific to your changing body and also specific to you. Otherwise menopausal women are left vulnerable to chronic health issues as they age.
If you are not sleeping you will not lose weight
In fact, during menopause, not sleeping will cause you to gain weight, and for many women lots of it. Many menopausal women land themselves in a place where they are exhausted, yet pushing themselves to do extreme exercise. If you are not sleeping, extreme exercise can actually contribute to your weight gain due the affect it has on your cortisol levels. The trouble with lack of sleep at this time in your life is that it can often be the night sweats, hot flushes, painful joints, burning feet or anxiety that keep you up.
This in itself can become a vicious cycle. 2 to 4am is a precious time for sleep as it is when the brain rests and heals. This is often the time that women are awake. So, with lack of sleep comes high insulin and high cortisol. This causes disruption to your melatonin and adenosine levels which are both responsible for getting and keeping you asleep. High insulin and high chronic cortisol levels will markedly contribute to weight gain. I emphasize the regulation of your circadian rhythm and melatonin production in our treatment plan, especially if you are not sleeping and gaining weight.
You are Inflammaging
Have you heard of the term, Inflammaging? Every health condition that we suffer from has an underlying inflammatory process behind it. It just depends on the extent of the inflammation. Inflammaging is a term that describes a form of low-grade, chronic and systemic inflammation.
Natural estrogen and progesterone have immune enhancing and anti-inflammatory effects. Imagine what happens to this low-grade inflammation when these hormones go into chaos or drop? Full blown inflammation. This is the reason why auto-immune conditions, and their flare-ups are so prevalent in menopausal women and also why musculoskeletal issues arise at this time. The reality is that inflammation is a major causative factor in menopausal weight gain and needs to be addressed in a wholistic and individualized manner.
Your Changing Liver & Digestion
There is too much to mention in regards to what goes on with our liver and digestion during our menopausal transition. As mentioned already, estrogen and progesterone receptors reside all through-out our body, including in our digestion and our cardiovascular system. With declining protection from these hormones our blood flow to each cell, tissue and organ is decreased and our liver function capacity can decrease by up to 40%.
Our gut flora (microbiome) is affected along with our ability to digest and assimilate our nutrients. This all leads to the perfect storm that contributes to weight gain. The road to digestive and liver recovery is different for every woman as it depends on so many individual factors but no amount of exercise and ‘eating less’ will result in weight loss if the liver and digestion are not working optimally.
The Adrenal/Weight Gain Connect
The short of a very long story is that women seem to be under increasing physical, emotional and psychological stress. During our menopausal journey, not only do our adrenals have to work harder but they also become more sensitive to stress which increases our cortisol levels. Increased cortisol levels not only increase the inflammatory responses in our body but also contribute to insulin resistance and poor sugar metabolism. These factors, in turn, contributes to weight gain. Throw in cortisol’s ability to decrease melatonin levels and therefore contribute to poor sleep compounds the potential weight gain. Furthermore, if the adrenals are under stress, so will the thyroid be as they are intimately connected via feedback loop. Nourishing our adrenal health and nervous system is vital.
Estrogen dominance & Modern Day Toxic Load
We live in a world which is inundated with endocrine/hormonal disruptors. And not all estrogens are the same. As our normal estrogen levels go into chaos, our fat cells will store excess estrogen for a number of reasons. One reason is because during menopause, the ability of our liver to clear excess estrogens diminishes. If we don’t change our diet and lifestyle to suit our new internal environment, the proliferative affects of estrogen will cause us to gain weight. The accumulation of xeno or environmental estrogens from many different sources including plastics, pesticides, the pill, other toxic waist and animal products put a load on our liver, in turn decreasing our ability to metabolize our fats. Lowered progesterone levels also means that there is less opposition to the prolierative affects of excess estrogen. Diet and lifestyle changes to support proper estrogen metabolism, glucosee metabolism and liver health is vital during your menopausal journey.
Muscle Loss
It is important during menopause to realise that, as part of the normal ageing process, we will lose muscle mass. How much and how fast we lose it will depend on a number of factors such as the type and duration of exercise, our digestive health, our ability to assimilate our muscle building nutrients and how well we metabolize our glucose via the liver. Muscle loss will cause our metabolism to drop and poor sleep will exacerbate this. The result of muscle loss is a drop in mitochondria. These are the fat burning and powerhouse of each cell, responsible for making our energy so its important to support our mitochondrial function and to make sure that you are doing exercise that is appropriate for you and that your nutrition supports muscle growth and repair..
Nutritional Deficiencies
Studies have shown that there is a direct and clear link between certain nutrient deficiencies and weight gain. This is more prevalent during menopause as our declining estrogen levels affect the function of our liver and digestion, intern decreasing assimilation of nutrients. We also require higher amounts of nutrients due to oxidative stress. Amongst these nutrients are iron, zinc, magnesium, potassium, selenium, Vit A, C, E & D. Low vitamin D levels (which is actually a hormone) can contribute to fat storage. Vitamin D is produced in the skin with the help of estrogen. It is very important to check vitamin D levels as it has an influence on many aspects of our menopausal health, including the muscles, the nervous system and brain, health of our joints and bones. It is also involved in melatonin production so therefore is vital for a good nights sleep. As you know, without sleep, you won’t lose weight. And without sleep, your feel-good hormone serotonin maybe low which can contribute to all kinds of mood disorders.
Conclusion:
Menopausal weight gain is multi-faceted and therefore needs to be addressed taking into consideration all aspects of your health. The first goal with weight loss is to stop gaining. It is best to take small and sustainable steps to healing and change. Also to understand that there are many myths out there regarding the best diets that simply do not suit the changing body and mind of the menopausal woman.
References:
S.R. Davis, C. Castelo-Branco, P. Chedraui, M. A. Lumsden, R. E. Nappi, D. Shah. Understanding Weight Gain At Menopause. Climacteric, Vol.15, 2012, Issue 15, 419-429.
National Institute Of Aging. Research explores the impact of menopause on women’s health and aging. May 6, 2022.
Furman D, Campsis J et al. Chronic inflammation in the etiology of disease across the life span. Nat Med.25(12), 2019,1822-1832.
A Fenton. Weight, Shape and Body Composition Changes At Menopause. Journal Of Mid-Life Health. 2021 Jul-Sep; 12(3): 187–192.
C.W. Brady. Liver Disease In Menopause. World Journal Of Gastroenterology. 2015 Jul 7; 21(25): 7613–7620.
M. McCarthy, A.P. Raval. The peri-menopause in a woman’s life: a systemic inflammatory phase that enables later neurodegenerative disease. Journal of Neuroinflammation, vol. 17, Article number: 317 (2020)
T.R. Silva, K. Oppermann, F. M. Reis, P.M Spritzer, L.M. Redman. Nutrition in Menopausal Women: A Narrative Review. National Library Of Medicine. 2021 Jul; 13(7): 2149.
Miranda Sweeney