Excerpt from “Hot Flash Kitchen” by Wendy Wesley, RDN
“It’s like the perfect storm for weight gain.” -- Amy’s story
“Now that I look at the last 15 years from a 1000-yard view I can see the weight gain clearly and because I see how and why it happened and I feel like I’m ready to correct it. It started slowly and I was ignoring it. Truth is I was having too much fun with life and I didn’t want to change anything. I think I knew that my life was the reason. The restaurants, going to friends’ houses, grazing all the time, travel and wine. So much wine.
“Another thing happened during this time is my kids grew up. I wasn’t chasing them around anymore. I had free time available to me as my kids became teenagers and gained independence. I still drove them places but I wasn’t chasing them and worrying if they were hurt. It’s a different kind of worry.
“I remember eating but never really feeling hungry or ever full. Just always grazing. I’d wake up at 6 am and eat a yogurt with granola and never realizing that was around 40 grams of pure sugar. I wasn’t eating doughnuts and Danish so I thought I was making good choices. But I craved sugar all day. I didn’t make a mental connection between sugar in cookies and sugar in yogurt. It’s the same sugar but I believed it was different. When you said that breakfast in America is dessert, that clicked. I have been thinking about this for a long time.
The other thing I realized is that I have more money today than I ever have. And more time. I believe I worked hard so I deserved wine. A lot of wine. You’re told that you have a hard life with all these kids and a challenging career and you deserve to drink wine because life is hard. I bought into all of that. So eating and drinking and tons of sugar and 10 years later and I’m carrying around 35 extra pounds. I’d do some things differently like exercise and a few pounds would come off but I couldn’t keep that going. So that weight would come back on and bring a few extra with it.
So that’s where I am and I need a fresh set of eyes on me because I am unhappy with the way I feel and look.” - Amy D. , 55 years old
Weight loss is the number one reason women ask for my help before, during and after menopause. Aesthetically, the sudden and often rapid increase in weight is incredibly distressing. It seems to come out of nowhere and catches women by surprise.
Healthwise, excess body fat increases a woman’s risk for heart disease, type 2 diabetes and cancer. It can also exacerbate hot flashes. Excess weight can also increase joint and back pain and cause sleeping issues.
For some women, this is the first time their weight has bothered them. Discussions around weight are delicate and should not be framed as moral issues. In fact, obesity is identified as a disease with medical professionals and researchers beginning to better understand and recognize different types of obesity through genetic testing. Someday, we may be able to prescribe specific drugs to treat obesity just we do with chemotherapy and cancer.
Research shows that most of us, on average, will gain 1.5 pounds per year in our 40s and 50s. This average is completely independent of race or initial weight. Some women go through menopause without gaining any additional pounds but, as peri-menopause starts to emerge, even women who have been thin their entire lives may notice extra padding around the but, hips and belly.
Janelle, 54, complained to me that she can no longer wear her size 2 shorts.
“Nothing has changed with food and exercise,” she complained. “But I cannot easily wear my favorite clothes. What’s going on?!”
This is the same repeated story I hear from my clients who all have the same complaint: What I used to do is not working for me anymore.
“That’s Not Going to Work for Me After Menopause” – Joyce’s Story
“I remember logging my food for the first time and it threw me a bit. Seeing what I ate on paper was jarring and I knew it would be. I think that’s why I always said that tracking wouldn’t work for me. I really didn’t want to do it. I had a big bakery bagel on my log and you asked how many times each month I eat bagels. I answered just a few times. It’s no big deal. Then you asked what else do you have a few times each month. That’s when I started to see that when some foods are eaten a few times a month that’s not the whole story. I also ate pizza, lasagna, candy, chips, fast food, fries, ice cream and soda a few times each month. Over a month, “a few times” of different foods really adds up. I can have these things but not at this frequency. That’s not going to work for me anymore after menopause.” – Joyce C., 49 years old
THE “WHY” OF WEIGHT GAIN DURING MENOPAUSE
Menopause weight gain is a common experience caused by a combination of hormonal changes, the natural aging process or sarcopenia and lifestyle factors like poor sleep and reduced physical activity. Weight gain typically begins during peri-menopause and often settles around the abdomen, a type of fat called visceral fat, which poses increased health risks.
Hormonal Shifts:
The decline in estrogen and progesterone levels change how the body stores fat typically promoting the accumulation of visceral fat around the midsection rather than the hips and thighs. Lower levels of these hormones slow down a women’s basal metabolic rate while increasing her appetite.
These hormone shifts can promote insulin resistance leading to more fat storage and fewer calories burned. Additionally, sleep may be interrupted by these hormonal shifts causing a woman to have an increased appetite to fuel a tired brain.
Age-related Muscle Loss or Sarcopenia:
Sarcopenia is the natural loss of muscle as we age and it if accelerated during menopause due to declining estrogen, progesterone and testosterone. This process leads to increased systemic inflammation, weakness and overall risk of falls. Effective management requires resistance training, adequate protein intake and for some, hormone therapy.
As women age, we naturally lose muscle mass which burns more calories than fat, slowing down our metabolism. If calorie intake isn't adjusted, weight gain is the likely result.
Lifestyle Factors:
Poor Sleep: Hot flashes and night sweats can disrupt sleep, leading to increased levels of the stress hormone cortisol, which encourages fat storage and can trigger cravings for high-calorie foods.
Decreased Activity: Many people become less active as they age, burning fewer calories daily.
Genetics: A family history of carrying weight around the abdomen may increase your likelihood of doing so during menopause.
A NUTRITION PROGRAM FOR MENOPAUSE WEIGHT LOSS
This book contains the nutrition program I use to help peri-menopausal and menopausal and post-menopausal women feel better, lose weight, and avoid chronic disease as they transition through this time in their lives.
In my university nutrition training, menopause nutrition was never discussed. A broad category of “women’s health” was but the topics centered around conception, pregnancy and lactation but, menopause, specifically weight gain, was not. The menopause nutrition program I have created in this book is the product of experimentation, trial and error.
I began my nutrition counseling career a decade ago in an acute care hospital where calories ruled. Every patient was assessed for caloric, fluid and protein needs based on their disease or condition. When counseling a patient on weight management, I preached calorie counting and restriction.
You likely already know this, but calorie restriction diets don’t work for the long haul. You may have set your resolve to finally get on track and lose weight. You likely researched a diet plan or bought a new book. Maybe you paid for an online course.
You may have joined a gym or an exercise program. Then you went shopping for workout equipment or clothing. After that, you may have purchased supplements, protein powders or all vegan or non-GMO foods and spent a fortune at the grocery store for all organic vegetables, fruits and frozen dinners to eventually give up after the restriction and intensity became too difficult.
You may have repeated this routine many times over the course of menopause. I know that I have. We think that if our willpower and resolve are powerful enough, we can lose weight. Many of us did lose weight but the intensity was too much and the expectations were too unrealistic to maintain.
Maintaining weight loss must be about consistency and never about intensity. This is why an intense focus on calorie counting is doomed to fail.