Weight gain or difficulty maintaining a set weight is a multifaceted problem. Let's review the causes of weight struggle in perimenopause and what you can do about it.
Hormone Imbalance
Here's putting it mildly: hormones affect your weight!
Figuring out which specific hormone is out of whack can be tricky. Also, hormones work together, so it's normal for more than one to be off balance. Things usually get tougher after menopause.
WHAT CAN YOU DO?
Check your hormone levels (estrogen, cortisol, thyroid, and DHEA levels).
Estrogen decline
The decline in this key sex hormone is one of the main reasons for weight gain in menopause. Estrogen helps regulate metabolism and signal fat breakdown.
WHAT CAN YOU DO?
Hormone therapy - Some research suggests that hormones can help women improve muscle mass, increase metabolism, and lose weight.
Cortisol - the stress hormone
Do you frequently feel stressed? If that's the case, you'll need to discover methods to lower cortisol, also known as the stress hormone.
Despite common misconceptions, cortisol isn't inherently "bad." It aids in promoting alertness in the morning and activates your fight-or-flight response when you need to be vigilant.
That said, if your cortisol levels remain consistently high over time — whether that’s a few days to a few years — everything from poor sleep and fatigue to skin breakouts and digestive distress can kick into high gear.
If these symptoms sound familiar, perhaps it’s time to take supplements to regulate your cortisol.
WHAT CAN YOU DO?
Ashwagandha -Native to India, Africa, and certain regions in the Middle East, Ashwagandha is one of the best adaptogens for stress.
Rhodiola Rosea - Another adaptogen, with evidence supporting its ability to minimize stress.
Adrenal imbalance
Adrenal hormone imbalance may also be responsible for weight gain.
WHAT CAN YOU DO?
You may be a candidate for DHEA supplementation.
Thyroid dysfunction
Hypothyroidism can slow down metabolic processes, making it easier to gain weight.
WHAT CAN YOU DO?
Check your thyroid level. You may need medication to correct a low thyroid level.
Slower Metabolism
As we age, our metabolism slows, making it harder to lose weight.
WHAT CAN YOU DO?
Practice portion control and calorie counting; Replacing high-calorie foods with lower calorie choices and cutting your portion sizes can help improve weight control..
Add more whole fruits, vegetables, and grains to your diet, and reduce the amount of processed foods and refined grains, such as white bread and white rice.
Try the Mediterranean diet.
Hydration is also critical to maintaining weight as we age.
Certain medications (GLP-1 Agonists, Phentermine, Orlistat) can help overcome a slower metabolism.
Intermittent Fasting
One strategy to eating less is to not eat or “fast” for certain periods. According to a Harvard review article, intermittent fasting can change body composition through the loss of fat mass and weight.
Three ways to do this:
Alternate day fasting — Alternating between days of no food restriction with days where you eat only one meal a day at 25% of daily calorie needs. Example: Mon-Wed-Fri consists of fasting or 400-500 calories a day, while alternate days have no food restrictions. This, to me, sounds sadistic and preposterous. So, no…
Whole-day fasting — 1-2 days per week of complete fasting or up to 25% of daily calorie needs, with no food restriction on the other days. Example: The 5:2 diet approach means no food restriction five days of the week, cycled with a 400-500 calorie diet the other two days of the week.
Time-restricted feeding — This was my choice. Eating only during a designated window of time and technically fasting all the other hours of the day.
Get Moving
You don’t need hours of exercise to get the benefits. That is, you don’t need to do it all at once. The Centers for Disease Control and Prevention (CDC) recommends 150 minutes a week of aerobic exercise for adults. That means you can spread your activity out during the week. You can break it up into smaller chunks of time during the day.
Strength training can help you build and maintain muscle and bone mass, which is especially important since you lose them as you age. The more muscle mass you have, the more calories your body uses even at rest.
Get support Find a sport, exercise, or physical activity that you enjoy doing and recruit a friend to join you, and you’ll be more likely to do it. If losing weight by eating healthier is your goal, you can find support for that too. Joining a weight-loss program, such as Weight Watchers or Noom Weight, can help with accountability and learning behavioral changes and healthy habits.
Mount Sinai has many weight management centers.
Muscle Mass Decline
As people age, they lose muscle and gain body fat. Women see a 3-8% decrease in muscle mass every decade after turning 30.
Muscle loss results in a slower metabolism since muscle is the body's most metabolically active tissue. Therefore, reduced muscle mass during menopause can create additional challenges.
WHAT CAN YOU DO?
Prioritize proteins: You need to have 30 grams of protein per meal.
Lift weights and build muscle! Prioritize strength training over other training.
Hydration and getting enough sleep are critical to maintaining muscle mass.
THE TAKEAWAY
You do have to reduce calories.
You do have to choose a nutrition plan you can stick to.
You do have to hydrate.
You do have to exercise.
You do have to balance your hormones
You do have to sleep 8 hours a night.