A question about menopause and specific weight gain around waist

[Speckydots]

Hi,

So, I had a body composition scan done in January - shows you all your measurements (waist, hips etc) plus lean/fat composition etc. It's very detailed. I was active and did a lot of exercise, but felt the toll of post-menopause and wanted to get a handle on where I was.

I had the scan done today again (didn't have to pay for various reasons) and I've been lifting heavier weights and being more purposeful.

Overall, it was encouraging. Lost weight, fat mass and increased lean mass. Take off my hips.

BUT, I've put on 2 inches on my waist which shocked me. What's that about? Is that water rention? Is that estrogen drop? I'm not a big eater etc.

I'd like to lose it but not sure how.

What are you eating? Sounds like you’re gaining visceral fat. There are a number of things that could cause that, but in general, lots of women do gain around the middle during and post menopause due to hormonal changes leading to changes in weight distribution.

Also, what is your waist measurement? Is it in the healthy range (less than 31”), or outside that? Is it mostly your health you’re concerned about, or your appearance, or a bit of both?

Sorry, no idea why the previous post is so bold and enlarged.

It's 33inches.

It doesn't look big, to be honest. But obviously it's bigger than it was.

I'm a healthy eater, I think. 2 x meals a day. Lots and lots of protein, no weight carbs, a square or two of 90% choc a day for a treat, tons of vegetables, nuts/seeds, greek yoghurt etc. No white stuff, few carbs. Try to minimise snacks in between the two meals.

I like almond milk. I have a large mug of that with cacao each day. I wondered if stuff like that was piling on the fat?

I don't know.

What am I doing that is increasing visceral fat?

I'm more concerned about my appearance tbh, I'm vain! But also, I don't want to have to buy new clothes.

Yeah, that was scary!!😂

Your diet sounds pretty okay, on the face of it? Are you eating lean proteins, or fatty ones? If you’re eating a high fat diet, that can be associated with visceral fat gain? So can large amounts of sugar, but that wouldn’t seem to apply to you. Time restricted eating can help target visceral fat, but sounds like you might already be doing that, if you only have two meals a day. Do you drink alcohol? That’s a common cause of weight gain around the middle.

Look, I’m not an expert, just interested in diet and nutrition. Sounds like you’re doing well if you’ve lost fat overall and gained lean tissue and it might well be that your waist measurement might reduce anyway if you just carry on doing what you’re doing. But my guess is that you’re eating too much fat (you didn’t mention alcohol, so I assume it’s not that).

I think you're right. I don't drink so it's not that. I think I eat healthy, but even within that, there might be high fat content.

God, it's boring. But I'm just going to keep going.

Also, if you get time, look up the DIETFITS study. There’s nothing magical about reducing carbs in itself.

Or there’s this metabolic ward study - the gold standard for dietary/nutritional research; “Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity”. Kevin D Hall et al. Cell Metab. 2015. Sorry, not sure how to link on my phone, but if you google he link you should find it.

Thanks so much @coronabeer, that's really helpful. I think that's what's happening. I'll give that article a read.

Sounds like you’ve done really well, I’m sure you’ll get to where you want to be with maybe a little tweak of your diet, nothing major.

What is your height & what is your weight.

the menop hormone changes mean that more of your body fat shifts to your waist. The only way to reduce this is to reduce total body fat %. Before you maybe had 25% body fat & it went to your boobs & bum, now some of it shifts to your middle.

What was your body fat % in January & what is it now?

Last question, how much did that cost you, to get a total body composition scan, where did you get it done?

I'm 5 ft 3 - I'm 57Kg. I was 59 in Jan. I've lost 3kg in fat mass, gained 2 in muscle.

Interestingly, I went back on HRT in Feb. My boobs are several cm bigger too!

I think I just need to keep doing what I'm doing

I just did a search for a local company who did it and there was one pretty close. https://www.fit3d.com/

The fact your breasts have grown makes me pretty certain your HRT dosage isn't right. It might be time to get the dosage checked and modified.

Well done with the weight loss, fat loss and muscle gains! I did a weight lifting body composition to shift my perimenopause weight, enjoyed it enormously and still lift weights regularly now I'm post menopause. I got my waist back too!

I don't know if I imagined it but I'm sure I read when you hit the slide into menopause and your hormones go a bit wonky. Your body makes estrogen making fat cells it likes to store around your middle to try make up the shortfall and they're a bugger to shift

No idea if it's true or I dreamed it or something like

No, this is correct.

As your bodies start to notice a decline in oestrogen from your ovaries, it can try and obtain it from different sources. Fat cells produce a weak type of oestrogen. You can therefore start to develop cravings for carbohydrate rich and sugary foods which will then turn into abdominal fat in a bid to increase oestrogen levels in our body. Because of this, some women start to develop a “spare tyre” around their middle.

More here:

https://www.themenopausecharity.org/2021/04/24/weight-change/

Why does increase in boob suggest the HRT is wrong dosage? And wrong in what way? It's a pretty standard amount

It's really simple. HRT should not make you gain weight or increase breast size. If it's doing either or both of these things, the balance of hormones isn't correct. That said, it might not even be your oestrogen dosage is incorrect. It might be you need more or less progesterone or even some testosterone. Prescribing HRT is an art, and most GPs are not great at it. Even seeing a specialist can take a few goes to get the balance correct.

And what is a standard amount? We're all individuals, what works for me might not work for you.

Using myself as an example, in addition to 200mg progesterone (taken daily) and 1mg of testosterone (taken every other day), I take 0.5mg of both estriol and estradiol and every other day. Originally, my dose of estriol and estradiol was 1mg of each daily, and pretty much within a week, my breasts grew and within a month, I had gained weight. Once reduced, my weight went back down, as did my breasts. However, it did take a while to work out the correct dosage for me. (Which takes me back to my point that prescribing HRT is an art, and this is further complicated by the fact that we're all individuals and there's no one-size fits all HRT).

Oh, interesting. I've never heard of estriol and estradiol being prescribed in this way (daily, 1mg etc). Are you in the UK? Is this a private doctor and is this regular body identical HRT?

I think I could probably do with testosterone, but for that to be effective, I needed to build up the estrogen.

I don't need 200mg progesterone a day, that would be too much.

Am I right in thinking you are in the US, and you take non FDA approved HRT?