Navigating Menopause: A Guide to Preventing Weight Gain

What does a male doctor know about menopause? That is a valid question. I do not have first-hand experience with menopause myself. However, I have treated hundreds of patients, including women in their menopausal stages. My biggest takeaway...? Weight gain. It is one of the most obvious and uncomfortable symptoms of menopause. The good news is that there are remedies for menopausal weight gain.

Understanding Menopause

Menopause is a natural biological process marking the end of a woman's menstrual cycles and fertility. It typically occurs between the ages of 45 and 55. Menopause is officially diagnosed when a woman has gone 12 consecutive months without a period. During this stage, the ovaries stop producing the hormones estrogen and progesterone. This hormonal change leads to various physical and emotional shifts.

Common Symptoms Experienced During Menopause

Some common symptoms of menopause include:

• Weight gain

• Hot flashes

• Night sweats

• Mood changes (such as irritability or depression)

• Sleep disturbances

• Changes in skin and hair

  
  

While menopause is a natural part of aging, every woman's experience is unique. Some may experience minimal symptoms, while others face significant discomfort. Lifestyle changes can help manage symptoms effectively for many women.

The Major Causes of Weight Gain During Menopause

Weight gain occurs during menopause for several reasons. A decline in estrogen levels affects body fat distribution, leading to increased abdominal fat. This increase can also cause insulin resistance, making it easier for women to gain weight and harder to shed it.

Insulin resistance occurs when the body's cells become less responsive to insulin, leading to higher blood sugar levels and weight gain. When blood sugar is elevated, the excess glucose that organs can't use is sent to the liver and converted to fat. This fat accumulates around the body's midsection (visceral fat), leading to further weight gain.

Some of this additional fat may stay in the liver, causing a condition known as "fatty liver disease," further impacting weight.

An increase in insulin resistance is the major cause of weight gain associated with menopause. It makes sense that techniques that reduce insulin resistance are the best approach to reversing that weight gain. This is true for people seeking to lose weight during, shortly after, or well after the menopausal period.

Menopause also results in muscle mass loss. This reduction decreases metabolic rate, which means fewer calories are burned, whether at rest or during activity. As body fat percentage increases and lean muscle mass decreases, maintaining a healthy weight becomes more challenging. Stress, whether physical or emotional, also contributes to weight gain through increased cortisol levels.

Given these factors, maintaining a healthy weight during and after menopause can be difficult. The good news is that there are effective, medically safe approaches to inhibit weight gain and achieve weight loss, even during menopause. I have treated many women facing these challenges. This effective program reduces insulin resistance, leading to meaningful and lasting weight loss. Beyond weight loss, reducing insulin resistance also promotes better health, energy, and an improved sense of well-being.

Insulin resistance is a cycle that can cause weight gain

Effective Strategies to Prevent Weight Gain During Menopause

To reverse insulin resistance effectively, a solid plan includes:

• A low carb diet (best guided by a continuous glucose monitor, CGMs)

• Intermittent fasting

• Strength training

  
  

Low carb diets lower blood sugar and, consequently, insulin resistance. We guide patients in setting personalized carbohydrate intake targets. Continuous Glucose Monitors (CGMs) are excellent tools for understanding insulin resistance and guiding a low carb approach.

Intermittent fasting can supplement a low carb diet and lower insulin resistance. Patients often adapt well to fasting periods of 12, 14, or 16 hours. Strength training routines help build muscle mass, allowing the muscles to absorb insulin and blood glucose effectively, thereby reducing insulin resistance.

Many women start strength training routines at home, guided by health coaches. Using bands and five- or ten-pound dumbbells for 45 minutes three times a week has produced remarkable results.

Continuous Glucose Monitors are the Most Effective Tools for Weight Loss through Carb Tracking

Creating Your Personalized Plan

You can take steps today to implement a personalized plan that includes:

1. Improved Insulin Sensitivity: Reducing carbohydrate intake lowers insulin levels, helping with weight management.

2. Reduced Appetite: Low-carb diets can decrease hunger due to higher protein and fat consumption, which helps control calorie intake.

3. Fat Burning: Lowering carb intake prompts the body to burn fat for energy, promoting effective fat loss.

4. Improved Metabolic Health: Low-carb diets often lead to better metabolic markers, such as lower blood pressure and triglycerides.

5. Enhanced Energy and Mental Clarity: Stabilizing blood glucose levels reduces fatigue and "brain fog."

6. Improved Overall Health: Weight loss linked with low-carb diets, intermittent fasting, and strength training can alleviate conditions like GERD, sleep apnea, and fatty liver disease.

   
   

Counting calories is the old-fashioned way to lose weight. We don't focus on calories, we focus on carbs and sugar

Are Weight Loss Medications the Solution?

First, we do not consider weight loss medications to be a magical solution for metabolic health. In fact, numerous studies reveal their long-term side effects can be detrimental. While we can assist with short-term, low dosages of GLP-1 medications as part of a personalized weight loss plan, we advise against long-term dependency.

Weight loss medications are not magical...In fact, they can cause more harm than good long-term.

Occasional use of GLP-1 medications may be added for some patients. However, we believe that medication should only follow the establishment of healthy habits like low-carb diets, intermittent fasting, and strength training. When using GLP-1s, lower dosages and limited treatment courses (months—not years) are considered most suitable. Failure to adopt these lifestyle changes can lead to muscle mass loss and dependency on medications.

Low carb diets will vary from person to person, this is an example of potential low carb meal options. Work with a health coach and health practitioner to determine the best plan for you

Final Thoughts: Embrace Control During Menopause

Many articles on the internet suggest that gaining weight during and after menopause is inevitable. This perspective is incorrect. With simple lifestyle changes, you can prevent weight gain and reduce the risk of long-term metabolic health challenges.

Get started with a health coach and a continuous glucose monitor to establish a baseline for your overall metabolic health today.

Thank you to *MetabolicMDs and The Metabolic MD podcast for providing additional information