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Written by Dr. Sooji Rugh, Medical Provider

Do you ever long for that youthful and elusive hour-glass waistline?

Women in your 40’s, watch out! As we enter into the transitional time of perimenopause, our waistlines are not the only thing at risk. As we gain weight during this time in our lives, we also increase our risk for both heart disease and cancer, the top two causes of death for women. 

The average woman can gain between 5-17lbs during the transitional time of menopause. The average waist can also grow by 1-3″. These changes are believed to be caused by both menopause and aging. In animal studies, estrogen appears to help regulate body weight. With lower estrogen levels, lab animals tend to eat more and be less physically active. Reduced estrogen may also lower metabolic rate, the rate at which the body converts stored energy into working energy. The same process may happen with women when estrogen levels decrease after menopause and might explain why menopausal women have been found to exercise less than younger women, and gain weight.

The weight gain associated with menopause has a predilection for the abdomen, rather than hip or thighs. The trouble with belly fat is that it’s not just skin deep, it also includes the fat underneath, or abdominal visceral fat (AVF)— which lies deep inside your abdomen, surrounding your internal organs and pushing outside to create that muffin top or spare tire appearance. Not only is it unwanted for its appearance, but also for its dangerous health consequences. Abdominal fat doesn’t just sit there, it’s quite active and produces hormones and other inflammatory factors that can raise blood pressure, negatively alter good and bad cholesterol levels and impair the body’s ability to use insulin (insulin resistance). All of this can increase the risk of serious health problems, including hypertension, diabetes, and cancer. In fact, increased belly fat may be a better indicator than weight when it comes to increased risk of premature death. In the Iowa Women’s Health Study, women with a normal weight but with a large waistline were noted to have increased their risk of dying of cardiovascular disease, cancer and other causes.

Is weight gain during menopause inevitable?

There is hope!  You can prevent or reverse the course by paying attention and adjusting to healthy eating habits and leading an active lifestyle. Data from the Women’s Healthy Lifestyle Project  provides clear evidence that weight gain and increased waist circumference, along with elevations in lipid levels and other cardiovascular risk factors, are preventable through use of lifestyle intervention in healthy menopausal-aged women.

Stick to the basics:

Move more. 

Muscle mass diminishes with age in both men and women and if you don’t do anything to preserve the lean muscle by exercising and by eating proper macronutrients to main your muscle mass, your body composition will shift to more fat and less muscle — which slows down the rate at which you burn calories. If you continue to eat as you always have, you’re likely to gain weight.

Your aerobic capacity also declines. This is the rate at which you can use up energy during exercise. To use the same energy as in the past and achieve weight loss, you may need to increase the amount of time and intensity you’re exercising, no matter what your past activity levels were.

A National Institutes of Health review showed that people who participated in aerobic activities every day for 10 or more minutes had 6 fewer inches around the waistline compared to people who did not exercise.

Eat less.

To maintain your current weight — let alone lose excess pounds — you may need about 200 fewer calories a day during your 50′s than you did during your 30′s and 40′s. To reduce calories without skimping on nutrition, pay attention to what you’re eating and drinking. If you are actively losing weight, be sure to have enough lean protein so you don’t risk losing more lean muscle mass. Choose more fruits and vegetables. Don’t skip meals, which may lead you to overeat later.

Consider Estrogen replacement.

You may want to have a discussion with your gynecologist or primary care provider about whether estrogen replacement treatment (ERT) may be for you.

Although ERT use is widely believed to cause weight gain, data from the PEPI trial does not support this belief. Moreover, ERT may have a protective effect in reducing central adiposity.

There have been various studies that suggest postmenopausal women on ERT had lower values for AVF waist circumference, a more favorable cholesterol, and a slightly reduced risk of Metabolic Syndrome when compared with women not on ERT. These benefits may be more evident when started in the early years of menopause.

Seek support. 

Surround yourself with friends and loved ones who’ll support your efforts to eat a healthy diet and increase your physical activity. Better yet, team up and make the lifestyle changes together. We can also help at GreenLite with the weight loss and the support to make that change in lifestyle. Successful weight loss at any stage of life requires permanent changes in diet and exercise habits. Commit to the changes and enjoy a healthier you!

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