Why we put on weight during menopause

[Gabrielleohare]

Informative post from Dr Louise Newson on Instagram this morning. I can't copy and paste the text so I've attached the screenshot instead.

It explains what's causing weight gain, how it can affect appetite and also underlines the importance of a health diet, whilst recognising that it's often hard to eat well consistently.

I'm still perimenopausal but noticed a huge change in cravings over the past few years which made it extremely hard to eat the things I knew I should be doing.

It's really helpful to know there is a reason we feel like this and it's not just us being weak willed or unmotivated.

Apparently it’s more to do with the blood sugar spikes driven by our perimenopausal oestrogen levels

Going on HRT causes one stone of weight gain without changing a thing. I’d love to know why that happened.

Not for me. I was consistently gaining weight, and finding it impossible to control during peri, until I went on HRT and then it stabilised within a fortnight. Have kept my weight steady since. Dreading coming off it.

Processed food usually means things that have 5+ ingredients and are mass produced in a factory. It includes bread, pizza, chicken nuggets, flavoured yoghurts, biscuits, crisps and tons of other stuff - most of what's on the shelves of supermarkets. The problem is that is low in nutrition and often protein compared to fresh/unprocessed foods and it's now known that this can cause us to overeat.

We don't just need a certain amount of calories each day, we need a certain amount of nutrition for our bodies to repair and function properly. So when we are eating low-nutrient foods we eat more of them to get what we need. Unfortunately these foods have got plenty of calories and we have to eat more calories than we can use, which gets stored as fat.

The other problem is that processed foods generally contain more carbohydrates than we can use. Our bodies can only store a small amount, so when we eat too many they get stored as fat.

Post menopause women become more carb sensitive, which means we turn more of the carbs we eat into fat.

So this is why the recommendation is to eat more natural unprocessed foods. Which means more work for us all, and often bigger shopping bills.

And have you any evidence for these arbitrary measures? Why 5, and not 6 ingredients for example?

5 is just given as a rough guide because of the wide range of processed foods and its designed to be a simple metric to make it easier for people to recognise mass produced foods. A good book to read which has links to all the trials about the effect of processed foods on appetite and fat storage is the Fast Keto diet. (Btw The data isn't about justifying keto, which isn't for everybody)

It’s a struggle and I have come to the conclusion that I have to accept some weight gain as I age but not too much.
I used to be a size 8/10 and am now a size 12.
I am short as well, so weight really shows on me.
I can only lose weight if I cut out everything I enjoy and end up miserably thinking about food all day, chastising myself if I give in to the temptation and have a biscuit with my tea!
It’s no way to live!
I weighed myself this morning and after almost three weeks of cutting calories, no alcohol, bread, intermittent fasting, active every day, weights, yoga, etc….I’ve lost nothing!
Depressing.
So I’m going to stop all this cruel self sacrificing without going overboard and accept the weight.
Life is for enjoying and I love bread!!

I weighed myself this morning and after almost three weeks of cutting calories, no alcohol, bread, intermittent fasting, active every day, weights, yoga, etc….I’ve lost nothing!

Weight doesn’t the whole story, particularly if you have upped your activity levels. I have noticed on the regular “How much do you weigh?” threads on MN that I am usually at least one dress size down from other posters with the same weight and height. I think the reason for that may be that my exercise levels are higher so my body is leaner and more dense. If you see what I mean.

Not to mention HRT down regulates thyroid function. Given the woeful nhs approach to thyroid Illness ( ignoring autoimmune underlying most thyroid illness & prescribing only levothyroxine when a lot of us need t3 which I pay for at a rate of £150 a month),
people need to self test thyroid and look at that element of it, I’ve seen big fluctuations in my thyroid since hitting peri menopause

To the poster who said - when you age people have got to accept you need to eat less and move more - don't you wonder why that is? Are you not curious? Let's say as you age you maintain the same calorie intake and energy expenditure but you start to gain weight, don't you want to know why?

Restricting your calories and increasing your energy expenditure might not be sustainable. I do think weight loss and gain is poorly understood. For example do we understand why sleeplessness contributes to weight gain when in theory you would imagine if you are awake for longer you are expending more energy.

Hormones are clearly a factor but I don't fully understand why and as you can see on this thread some people lost weight and others gained weight on hrt.

@Jewel1968 - lack of sleep, insomnia etc can subsequently cause disruptions in the hormones that control our appetite and satiety. Leptin and ghrelin. They’re mentioned upthread.

I know (and accept) that when I’ve had a bad night, I eat more the next day. I just go to bed earlier the next night. (Also gets me out of the kitchen)

@Ohyeahwaitaminute exactly! It's way more complex than eat less, move more. Not sure if experts even fully understand it all and I guess if moving more and eating less for you works then why not. Trouble is it won't work for everyone and it's hard to sustain.

Intellectually I know for example my exercise regime helps with weight management not because I am expending energy but more because when I am in the pool I am not eating and when I come out of pool I am in a better frame of mind so don't reach for food.

I suspect hormones play a big role but I don't know what role exactly.

Am pretty sure that most ppl don't maintain same energy expenditure as they get older. That is crux of problem. Look at how many threads on MN where people talk about being worn out by age mid 50s, slower reactions, fearful of falls & injuries already. It's madness to me but makes sense to them.

Just running same numbers thru a TDEE calculator, where only variable is age, from 25 to 50 to 75yo, female, mass = 60kg, "moderate exercise", calorie needs....
25yo .... 2017 kcal
50yo .... 1833 kcal
75yo .... 1650 kcal

allowing that what gets perceived as 'moderate exercise' changes over time anyway, I don't think that 50 year change is enormous. Only an 18% decline from the 25yo value.

@lljkk so am I right in reading that as - a woman with same energy expenditure will need to consume different clarories to maintain weight. What is the reason for that assuming the expenditure is exactly the same? That to me is key to understanding

You may be right about energy expenditure reducing but for me not having demands of younger kids means my energy expenditure is probably higher.

@Summerhillsquare there's a book by Andrew Jenkinson called Why we eat (too much). It's about hunger, weight gain, hormones, appetite etc and explains very well why ultra processed foods are unhealthy and why whole foods are generally healthy.
There are loads of threads on here about the book. The first thread started off interesting but unfortunately soon developed into post after post of people reporting their weight loss (good for them!) rather than discussion of ideas in the book.
I much preferred Jenkinson's book to any of Spector's self-promoting reads.

What is the reason for that ... That to me is key to understanding

I think it's because our max heart rate reduces as we age regardless of what we do to keep cardio health brilliant, and don't ask me why, I'm not a physiologist. But our calorie expenditure is a function of (long formulae that includes sex, age, mass, VO2max and cardio effort = heart rate). Vo2max also reduces with age, must be at least partly dependent on cardio decline too.

Our perceived effort can remain the same, but our actual power output goes down because of multiple aspects of the aging process. Suppose I feel like I'm working at 90% of my maximum capacity. At age 25 that means I might run a mile in < 8 minutes, at age 50 I'm pleased to do the same level of perceived effort & get a mile done in < 10 minutes (nb, I'm a naturally very slow runner). Assuming I run at 80% perceived effort for 40 minutes at age 25 & age 50: I will burn more calories at age 25 for those 40 minutes (and go further).

Sports science covers this topic well. Reduced calorie needs as function of age-related reduced heart rate/power output affects men as much as women, so you can't just say it's "due to menopause hormones".

of course people tend to actually be on their feet literally moving & doing more at younger ages, due to other commitments. I own up to some exceptionally lazy weekends now I'm in my 50s.

That's interesting @lljkk . I've long wondered about the "max heart rate" thing because my heart rate goes way above its alleged maximum when I run. It has declined over time, from the mid-180s a decade ago to mid-170s now. I'm late 50s so my "max" heart rate should be around 160. The rate I mentioned is during a 10k at a pace of around 6m/km, so a comfortable speed rather than any great exertion. From what you're saying, it seems I may be using calories at a higher rate than is typical for my age? Which could partly explain why I haven't put on any weight post-menopause. Thanks for helping me to understand!

I have put on a stubborn half a stone since being menopausal. I am now on HRT and I have noticed I am not craving sugar or as hungry as I was but the weight isn't shifting. Could be water retention as my breasts are tight in my bras.

Has anybody worked out what to do about it? I'm well over the healthy BMI now but eat pretty healthily. I don't want to be one of those women who never enjoy food and are permanently calorie watching. But I also know it's not good for you to have too much visceral fat. What's the solution?

@KittyBurrito have a read of the book Why We Eat (Too Much) as @PaulaVerlaine recommended yesterday. It’s a really interesting read.

Thanks @Peridot1 !

They usually mean ultra-processed.

Am I the only one who reads the reviews on Amazon (starting with lowest stars) & feels I get the main messages from that browse, no need to buy the book?

Like that "Why we Eat..." book, it's
by a bariatric surgeon, has no background in nutrition
he provides too many references & the science part is heavy going
he cherrypicks his advice section, and doesn't give references for it
he says to expect moderate results
his basic only actual advice is " avoid all processed foods and stick to a low GL diet"

Did I miss any other important headlines out of the book?

Wait, 1 more headline:

• each person has a unique set point their body doesn't want to lose weight from (yet seemingly they can easily gain from there)

We really are in a "pick your health guru" age, aren't we?

And what is 'ultra processed'? When i pick my carrots and top and scrub and chop AND cook them? Its meaningless as a term.

I need to say this, if you are in a calorie deficit you cannot gain weight

I have started HRT recently and been RAVENOUS, like I need to eat RIGHT NOW ...so if I wasn't carefully tracking I would easily be eating way more without realising. AS it is i am staying in my deficit and my weight is stable.