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The Science of Weight Gain

We get asked a lot about weight gain in menopause. What causes it? Is estrogen responsible? Will HRT make me gain weight? Is it just bloating? And, what the heck can I do about it? Weight seems simple, but as we age, weight actually DOES get more complex, hormones DO play a role, and you do need to be more considerate of a variety of factors....

Let's not keep you weighting... read on!

What Causes Weight Gain (and how is it different from bloat or water weight?!)

Several factors are responsible for weight gain, namely diet, exercise, environmental factors, and genetics. Diet is the key element for most people, as well as exercise and general movement. Environmental factors refers to medications, hormone disruptions, and social factors, and genetics refers to our baseline metabolic rate, how we build muscle, and thyroid function.

Bloat is a more temporary situation; Bloating is usually a digestive issue, though hormones and stress also play a part. Sometimes there is an underlying medical condition. Generally, when we are bloated, the stomach feels hard and full, and the abdomen may be distended.

Water weight is a bit of a misnomer; when we start a diet, the weight we lose initially is typically just "water weight"; Your body burns through the calories, then dips into your glycogen supply for energy. Glycogen is bound to the body by water, and the process results in the water being released and your pants fitting a bit better. You can read more about it here. However, a more accurate term for what we might suffer from is water retention. Water retention can have causes that aren't due to underlying disease, such as hormone level. Examples include eating large amounts of salt, sitting or standing for prolonged periods, and medication side effects.

Can My Metabolism Change?

...And what is 'metabolism'? Well, your metabolism constantly provides your body with energy for essential body functions like breathing and digestion. Your body needs a minimum number of calories (the basal metabolic rate, or BSR) to sustain these functions. Factors such as age, sex, and physical activity affect metabolism or BMR.

Body composition changes drives changes in metabolism; as we age, we lose muscle mass, and in turn, burn less calories when at rest. Even if we are still exercising, building muscle mass becomes harder as we age (and we may not do muscle building exercise anyway), and we can easily end up losing muscle weight and gaining fat weight. Furthermore, our metabolism does slow as we age in general, so this will have some degree of effect.

To answer the original question - can metabolism change? Yes, your metabolic rate can change. As noted by Harvard Research, HIIT training, eating protein, lifting weights, and green tea are all factors that can improve metabolic rate, BUT those same researchers note that diet plays more of a role than metabolic rate.


What Role do androgens - DHEA and Testosterone - play in Weight?

Our DHEA levels drop and that means our testosterone levels also drop. Both of these hormones are important for building muscle, especially testosterone. As DHEA levels decline, so does our energy and enthusiasm for setting and keeping to exercise goals. Without these important hormones mood can change - it is hard to motivate yourself to exercise when you are feeling down in the dumps most of the time.

Adding a small amount of DHEA can help give you the boost you need to get into the gym - and live a healthier life post menopause! You can read more about DHEA here.

What Role Does Estrogen Play in Weight?

This is such a tricky question, so let’s look at some facts:

  • High estrogen and low progesterone levels can lead to water retention and bloating.
  • Estrogen often acts as a fluid retaining hormone, while progesterone is a natural diuretic. Therefore, when these hormones are thrown off balance, you may notice bloating.
  • Estrogen doesn’t just play a role in water retention; it also aids in bile production. This means that low estrogen may lead to a reduction in bile, which may lead to symptoms that cause menopausal bloating.
  • Estrogen promotes the storage of fat for healthy reproductive years. When estrogen is balanced, the right amount of fat helps carry out female reproductive functions. However, when there's too little or too much estrogen, weight gain often results.

There is no one clear answer on how estrogen interacts in YOUR unique hormone make-up. We know what messages each hormone sends out, and we know its function, but some people are more or less sensitive to estrogen and will have different outcomes when supplementing with it. However, as we have mentioned before, Silky Peach (and the estriol in it) is unlikely to cause any significant weight gain. The amount of estriol in the cream is very low and does not have the same cell growing impact that the more powerful estradiol has. Additionally, as a localized topical supplement, it has minimal proliferative effects.

Emotions & How We Eat

Since diet is often the key factor in weight gain, it is important to make note of two key areas that affect it that often get missed: education and psychological adjustment. Education and awareness are tricky, since food labeling is deliberately misleading, and studies found we typically underestimate calorie content of foods. Education about our diet, then, becomes a lot trickier when we think we are eating less junk, but actually we are eating chemicals that affect our health and weight!

Some great books about health and wellness we would recommend are:

  • The Blue Zones by Dan Buettner
  • How Not to Die by Michael Greger
  • This Is Not Normal by Deborah Mathew, MD
  • Women’s bodies Women’s Wisdom - Christian Northrup MD

Psychological adjustment refers to our emotional relationship to food. When we “eat our feelings”, it’s way more likely to be a tub of ice cream than a pound of broccoli. While the thinking part of our brain says “oooh broccoli - good for so many things”, the emotional part of the brain screams “I DESERVE COOKIES, ICE CREAM, A FOURTH GLASS OF WINE, FEED ME NOW, I DON’T CARE.” The emotional part of the brain is often looking for two key things - satiety and reward.

Satiety comes from foods that make us feel full and heavy, often things like pastas and breads, and reward typically comes from foods that hit our dopamine receptors (think sugars!). Whilst whole foods and plants make us feel good, those feelings are less immediate, so if we are emotional, sugars and simple carbs often win out.

Ten Factors That Impact Weight:

  1. Nutrition Choices - Any simple carbohydrate like breads, cakes, crackers, white rice, potatoes, candy, alcohol will be broken down quickly, spike blood sugar and force insulin to rise. Over time, especially with post menopausal women, insulin loses its effectiveness at getting glucose into the cells to provide energy. The glucose molecules group together to make triglycerides (fat molecules) and get stored as fat. And women then have less energy to exercise. Moral of the story - don't eat the 4 whites: flour, sugar, rice, potatoes. Just don't.
  2. Timing of eating - When you eat matters - If you eat after 7pm and don't burn it off then the food will be digested, converted to fat molecules and stored. The evidence suggests that our bodies may do best when we eat more in the morning than at night, a pattern that’s vastly different from how most Americans eat. Timing our meals this way may lead to better body weight, hormone regulation, blood sugar and cholesterol levels, sleep patterns and other metabolic improvements.
  3. Exercise & loss of muscle - Many, many older women exercise - BUT, as we age, it is easy to do two things - lose the intensity and ditch the weights. The issue with that, is that high intensity exercise is key for metabolic rate, as is muscle mass, and muscle mass is linked to weight based exercise. The bottom line? Both intensity AND weights need to be incorporated into your exercise routine! Studies have shown that elderly patients do better overall with weight based exercise and higher protein intake.
  4. General Movement - have you heard of the Blue Zones? These are the areas of the world that have some of the best overall health and longevity. One of the cited reasons, that has a lot of scientific support, is general movement. Not a one hour blast in the gym and 17 hours of sitting, but a lifestyle that incorporates movement. Our society is set up for sitting, (sadly), and this sedentary lifestyle does not bode well for metabolic rate or your waistline. Standing desks, yoga breaks, gardening, weekend strolls, just move more!
  5. Specific exercises for belly fat - critical because belly fat can drive hormone imbalances, it is not all about crunches, in fact, they can be harmful to your spine unless done right. There are a range of other activities important for all the muscles around the belly, AND the pelvic floor. Making sure you use all the muscles that hold organs in place AND allow you strength and flexibility in the middle of your body will inevitably whittle down belly fat. You do need to do them regularly though, if you start, make great progress and then stop, those muscles will get smaller again.

How to Flatten Your Belly

The Most Effective Abdominal Exercises (Get Abs Fast)

6. Stress levels & Cortisol - Elevated levels of cortisol can increase insulin levels and, as these two hormones rise, fat deposits increase around the middle. Stomach fat has many cortisol receptors and is very sensitive to the effects of cortisol and insulin. It becomes a vicious circle - the fat cells around the tummy have lots of receptors that end up attracting more fat. Stress management is a key factor in a lot of areas of our lives, from sleep, to mood, and yes - weight gain.

7. Sleep quantity/quality - Did you know that women need more sleep to maintain metabolism? Well, we do, and loss of sleep plagues women in menopause… There are two parts to this - the role of melatonin, and why women need more sleep. The production of melatonin does not start until after lights out. Melatonin is critical for the production of a hormone called prolactin. One of prolactin’s effects is to suppress appetite. When we stay up late, with the lights on, less and less melatonin is made and so we feel hungry, and that can lead to night time nibbling; with no activity to burn off those nibbled calories, they are stored as fat. Now, for women, hormones, brain function, and organ function all require more sleep, something noted by the Sleep Foundation

8. Food Chemicals/hidden calories (weird ingredients that affect hormones) - Sugar can mess up your hormones, and processed foods can wreak havoc on your body. Between Xenoestrogens and additives, hidden calories are the lesser of two evils.

So, let’s deal with hidden calories first. Hidden calories is a vague term, and can mean anything from foods that you don’t think have a high calorie count (think smoothies), to foods that have hidden sugars (think corn syrup, fructose, etc.), to consuming things without thinking (coffee with creamer, juice, salad dressings). Many of these can be easily eliminated by understanding food labels and being more aware of what you are eating/drinking. Aside from hidden sugars, which is a hornets nest, and covered in much more depth here.

Now, food chemicals are a different ball game. Again, there are several categories: secret (weird) sugars, as mentioned, chemicals that make you addicted to the food, and chemicals that are obesogenic. We won’t get into cancer causing chemicals in this blog… but stay tuned.

Obesogenic means ‘tending to cause obesity’ and can be attributed to several food chemicals, often preservatives. The preservatives BHA and methyl and butyl paraben are likely obesogenic and can be found in everything from vegetable oils to processed meat and chewing gum to potato chips. These foods can do everything from increase how much you eat in a sitting, to disrupt your hormones and your gut microbiome. This blog goes into more detail on the main obesogens and which foods they are found in!

Additives like sugar, caffeine, and alcohol have addictive capabilities, but Initial studies suggest that foods with two or more key ingredients linked to palatability — specifically, sugar, salt, fat or carbohydrates — can activate brain-reward neurocircuits similarly to drugs like cocaine or opioids. This study looked at ultra processed foods that often add all these elements (and a lot of sugar) to help keep you hooked.

9. Water Consumption - whilst this is SUCH a tired line for weight loss, there is actually more going on here that is often missed in lieu of ‘water fills you up’. Firstly, water helps flush the liver and the kidneys, which helps with overall organ function, as well as decreases water retention. It reduces bloating from things like excess salt, and it helps with hot flashes (yes, really! Dehydration increases core body temp, so dehydration can increase frequency and severity of hot flashes). However, whilst water might fill you up, it is important for weight management as it actually helps increase your base metabolic rate. Lastly, water levels have been linked to fatigue and concentration, so when you aren’t drinking enough, you’re more likely to feel crappy… leading to… skipping the gym AND making worse food choices. You can read more about each study here.

10. Awareness (tracking) - many of these elements are outside our sphere of awareness, which is where tracking comes in. Many of us DON’T track, and we rely on guesswork, which often leads to miscalculations about why, what, and when we are eating. Tracking can do several things: help identify what you’re eating, when you’re eating, what precipitates eating, emotional states, as well as things like other symptoms you may be suffering from. We wrote about this at more length in this blog on which symptoms affect what, but many women suffer from symptoms in clusters that can often be traced back to specific hormone imbalances.

SO, What Next?

When it comes to dealing with unwanted menopause weight gain, you can see there are a lot of factors to consider. No one thing is likely responsible. One of the things we want to stress is that hormone balancing is KEY and this comes in several ways:

  1. Avoiding xenoestrogens in food and beauty products.
  2. Avoiding sugars and ultra processed foods that can disrupt hormones.
  3. Making lifestyle adjustments to support hormone balance.
  4. Being mindful of the hormone therapies you are using; consider hormone testing to gain more insight into your hormone picture.

Managing your hormones can be the first step towards better health in menopause in so many ways, and can give you great insights into living a happier, healthier life!