Middle Age Spread – Is It Really Inevitable?

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Ah, the menopause, such a mixed blessing for most of us. There exists the wonderful realisation that those pesky monthly bleeds are now the stuff of nostalgia and contraception never needs to be an issue ever again, but there can be a heavy price to pay in terms of the hot flushes, mood swings, short fuse and a general sense of being ‘past it’ (never believe this evil lie!), to name just a few.I meet countless menopausal women during my working life and spend a great deal of time listening to blow by blow accounts of nights of hot flushes and rows with the husband etc etc, and I can only sympathise – after all, my time is surely coming!! What does surprise me about these discussions is the passion with which so many women of a certain age will fight to the bitter end to conquer their flushes and irritability etc, yet in the next breath they will mention in passing the 20 pounds they have gained at the same time with a resigned acceptance.

So does the menopause have to involve that very 21st century phenomenon ‘fat acceptance’ and shopping trips for clothes a size or two larger, or is there another way? As with so many issues facing us these days, there is both good and bad news – the bad news is that once we are approaching the menopause there are various, fairly powerful factors that conspire to cause weight gain, in particular around our midsections, but the great news is that there is a lot that most women can do to prevent or even reverse this process. One fabulous example of triumph over adversity in this area is our very own Sue Prosser who claims to be in better shape now than she has been for most of her adult life, and I am sure that if you do what she has done you can achieve something comparable with her results!

Some physical changes are unavoidable during the menopause in terms of changing hormone levels, and these come with their own potential problems, in particular they do increase your chances of weight gain. As your ovaries produce less oestrogen your body tries to increase oestrogen supplies from elsewhere, and fat cells are an excellent source so your metabolism shifts in a general fat creating direction rather than the fat burning one that most of us hope for. Progesterone levels also fall which can be associated with water retention and bloating – not fat, admittedly but this doesn’t do much for the numbers on the scales or your dress size. And testosterone levels fall meaning loss of muscle mass and an associated lower metabolic rate while androgen levels send any fat that you do intend to store straight to your abdominal area instead of the hips and thighs that you have probably been used to. Add in a spot of insulin resistance and some stress hormones that commonly feature in many women’s experience of this delightful process and it is easy to see why great numbers of ladies surrender to these apparently insurmountable odds.

Now for the good news:For a long time we were led to believe that this was the full story, however experts now largely agree that weight gain around the time of the menopause is much more likely to be related to changes in lifestyle rather than hormones because women of menopausal age generally do less exercise and have lower metabolic rates than younger women. And there is a great deal of scope for comfort eating at this stage of life too, with life events including children maybe leaving home, divorce, or loss of elderly parents. The dreaded hormones can also be a cause of emotional munchies – depression, tiredness and being snappy most of the time are often associated with lower oestrogen and progesterone levels, and are big causes of disordered eating in themselves.

In summary, weight gain is more likely around the time of the menopause than it is earlier in life, but it is by no means inevitable. And the solution will come as no surprise to most, it’s not exactly groundbreaking stuff – eat less, move more! On average you need to consume 200 fewer calories per day during your 50s than in previous decades, and if you do not make that change then you can expect to gain 1-2 pounds per month on top of all the hormone related gains. And good resistance exercise will help to reverse the loss of muscle that most of us experience as we get older so get into fitness in whichever form suits you best – weight bearing exercise is best as this also helps to combat osteoporosis.

As for all the other issues, take whatever practical steps you can to improve your sleep patterns, ask your loved ones to bear with you through this hormonal phase that won’t last forever and try to identify whether or not you have become an emotional eater. If you have then Sue’s book Stop Dieting Start Living contains some excellent suggestions about how to deal with these matters too.Lastly, a word on HRT. I get asked my opinion about this very frequently and I have a standard answer. HRT is known to be associated with a number of health risks and one of the most worrying of these is a slightly increased risk of breast cancer. So if your menopausal symptoms are inconvenient and irritating but you are basically coping then taking something that increases your cancer risk does not really make sense. However, if your whole life is falling apart and popping a pill with what is essentially a very small associated increased risk makes it all better then it may not be a bad idea. But don’t forget alternative therapies such as black cohosh – there is a stack of evidence from reputable sources that suggests they have real benefits, particularly for hot flushes, and none of the serious side effects.

Wishing you a slim, trouble free menopause…

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