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Menopause, Midlife & Weight Gain: What This Integrative MD Wants You To Know

Kyrin Dunston, M.D.
Author:
January 08, 2022
Kyrin Dunston, M.D.
Board Certified OBGYN
By Kyrin Dunston, M.D.
Board Certified OBGYN
Dr. Dunston is a board certified OBGYN and functional medicine specialist.
An older woman in her 40s or 50s out in nature
Image by ROB AND JULIA CAMPBELL / Stocksy
January 08, 2022

A majority of women believe that weight gain during menopause is inevitable. That's probably because the data appears to support this conclusion. Almost two-thirds of women qualify as either overweight or obese by the age of 50. This percentage only increases for women in their 60s.

If you're approaching menopause, you may dread the loss of control over your weight and body. If you're in menopause and have already gained weight, you may blame menopause for the unwanted addition to your midsection. You may feel like a victim in your own body and believe that losing weight is beyond your grasp.

As a board-certified OB/GYN and functional medicine specialist, I'm here to tell you that's not the case.

Why menopause isn't to blame.

Thankfully, the research clearly states that menopause is not responsible for midlife weight gain.

A study completed in Australia and reported in the journal Climacteric, which studied weight gain as it relates to menopausal status, found there was no significant difference in weight gain1 as women progressed through menopause.

Most studies that point to menopause as a cause of weight gain do not use lifestyle as a control. If they did, they would see that older women often exercise less frequently and intensely, consume more alcohol, and eat a less well-balanced diet—all the factors that go into determining rates of weight gain2.

The truth is that women tend to gain weight with age, regardless of their menopausal status3. This is good news because it means that weight gain is entirely under our control. We simply have to address the factors that lead to it.

Of course, changing what and when you eat and increasing physical activity are part of the answer. But food and exercise aren't the only factors that cause weight gain.

How to find (and mitigate) the cause of midlife weight gain.

In reality, excess fat is just a symptom of an underlying problem and not the problem itself.

Trying to lose weight with a straight "calories in minus calories out" approach is akin to coming home each day to find water on the bathroom floor, then cleaning it up day after day after day without ever looking for the source of the puddle. Is the sink leaking? Did the tub overflow? Is the toilet stopped up? Is the dog peeing while you're out?

You might laugh to think that someone would clean that water up day after day and never look for the source of the problem. But we go about trying to lose weight in the same manner. By addressing only diet and exercise, we set ourselves up to fail.

You probably view fat as an unwanted decoration, but it has a purpose. Fat is our energy storage tank. To successfully get to your healthy weight and maintain it, you need to figure out why your body is storing fat instead of burning it. Your body sends signals to store calories as fat when hormones are out of balance, the nutritional value of your diet is limited, and when you feel uncertain of your place in the world.

Let's look at each of these in detail:

Hormonal balance 

The seven main metabolic hormones include insulin, thyroid, cortisol, DHEA, estrogen, progesterone, and testosterone. Hormones signal when the body should burn fat for fuel to create energy and when it should store fat in case of an emergency. All seven hormones need to be in balance for our stored fat to receive the proper signals.

Your thyroid is a great place to start. Thyroid hormones determine the rate at which fuel is burned in your body. Not enough and your body will retain fat, too much and you will unexpectedly lose weight.

Insulin's job is to turn sugar into energy. It either uses the energy right away or stores the sugar in the body for later use. If you have an overabundance of sugar in your diet, your body will store it as fat. You can combat this by either reducing the amount of sugar you eat (including simple carbohydrates and processed sugars) or by using more energy.

Cortisol, DHEA, and our sex hormones are all produced in our adrenal glands. Our adrenals respond to stress and are triggered by our "fight or flight" response. In a life-threatening situation, stress provides us with a rush of energy. However, once the stressful situation has passed, we are left feeling tired, hungry, and possibly even more stressed than before. This prompts us to reach for a quick fix, most likely a sugary snack or bowl of carbohydrates.

Estrogen, progesterone, and testosterone come second to the more essential insulin and cortisol hormones. If the body's hormones are out of balance, these "secondary" hormones will not produce at healthy rates. Low estrogen can affect your mood; low progesterone can result in a heavy period and increased appetite; low testosterone can increase your fat retention, directly causing weight gain.

Getting in touch with what your body is telling you can be complicated, but balanced hormones are vital for a healthy weight. Look closely at your eating habits, mood, stress levels, and sex life for clues about which hormone may be out of balance for you.

Balancing your hormones will look different for everyone. Some hormone imbalances are easy to see from the outside. Other hormonal imbalances require blood tests and medication to treat properly. Regardless, if you think something is off, consult with your medical practitioner.

Nutritional deficiency

Nutrients create energy, regulate our mood, burn fat, and build muscle. So, what happens if we do not get enough nutrients from our diet?

If our body does not have all of the essential vitamins and minerals that it needs, our metabolism begins to slow down. A slow metabolism means less energy, erratic moods, more fat storage, and less muscle.

The solution to this one is simple: a well-rounded diet of whole foods, including grass-fed proteins, healthy fats, and complex carbohydrates. Choosing nutrient-dense meals over processed snack foods provides our body with everything it needs to keep us energized, content, and fit.

Energetic balance

Lastly, we need to address the "intangibles" of energetic imbalance. Our mental health plays a key role in our physical health. The reasons for energetic imbalance are as varied as the number of people on this earth. You could be unhappy in a relationship or dissatisfied with a job; whatever the case, that crucial balance between mind, body, and soul is lost.

The only way to address an energetic imbalance is to look inside.

Meditation and breathing techniques provide us with the alone time we need to do this essential inner work. Finding balance in our mind and soul is a daunting prospect. The solution will look different for everyone, but sometimes seeking outside help is the push we need to get ourselves back on track.

The bottom line.

Instead of blaming midsection weight gain on menopause, we need to learn to examine the root causes. Solutions may vary from person to person, but these factors will give you some guidance on where to start.

The menopausal midsection is a myth founded on only half a story. Diet and exercise are only part of the solution.

You can learn to control your weight by reading your body's signals. Hormone balance, nutritional deficiency, and energetic balance all have different symptoms and unique solutions. However, once addressed, each will bring you one step closer to debunking the belief that weight gain has to happen as you age.

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