Menopause and Weight Loss

Many women associate menopause or the use of hormone replacement therapy with weight gain. But what are the facts? And what can you do about it?

In both women and men, there is an increase in Body Mass Index (BMI) with age, with the peak BMI occurring between 50 and 59 years of age (1). Many women claim that this weight gain is caused by menopause, however research doesn't support these claims. Women gain total body weight at a linear rate from age 35 - 65, a trend that is not related to loss of ovarian hormones or their subsequent replacement (2).

Menopause results in body composition changes that could indirectly lead to weight gain. During the menopausal years there is a shift in the distribution of fat from the traditional hourglass figure of the younger woman to a more central deposition in the abdomen.

These changes in fat distribution are independently associated with an increased risk of developing hypertension, abnormal lipid profiles, Type II Diabetes and cardiovascular disease (3). In addition to the change in the distribution of body fat, there is more body fat and less muscle mass. This may decrease resting metabolic rate, which in turn results in weight gain (4).

What's the best advice for women dealing with weight gain in their menopausal years?

Exercise. Try walking at a moderate intensity for at least 30 minutes a day (in 10 - 30 minute bouts) and partake in bi-weekly resistance training sessions. This prescription is supported by a study that demonstrated numerous health benefits for exercise in menopausal women, including loss of abdominal fat and overall body fat (5).

References:
1. Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL. 1994, 'Increasing prevalence of overweight among US adults, A National Health and Nutrition Examination Survey 1960-1991' Journal of the Americal Medical Association, 272:205-11

2. Davies KM, Heaney RP, Recker RR, Barger-Lux MJ and Lappe JM. 2001, 'Hormones, Weight Change and Menopause' International Journal of Obesity, 25:874-879

3. Sturdee D, MacLennan A. 2007, 'The weight problem', Climacteric, 10:2

4. Smith K. 2005, 'Exercise Can Help Control Body Changes During Menopause', Healthcare, Food and Nutrition, 22(10)10-11

5. Asikainen T, Kukkonen-Harjula K, Miilunpalo S. 2004, 'Exercise for Health for Early Postmenopausal Women', Sports Medicine, 34:753-778

Find Your Motivation to Exercise: 10 Tips

Struggling to get out the door for your afternoon walk? Or finding that extra hour of sleep more appealing than hitting the pavement for your morning stroll?

Despite being well aware of the benefits of exercise - and knowing how great you will feel after exercising - you may find yourself struggling with motivation. Read on for some tips:

1. Adopt an Exercise Buddy

Exercise buddies keep you accountable - there's nothing like the commitment of knowing that someone is waiting for you. Walking groups or cycling bunch rides are a great way to meet people, and as your fitness improves, other people who have greater fitness will spur you on!

2. Walk to a Beat

Listening to music can motivate you during exercise, resulting in longer, more enjoyable sessions. If music isn't your thing, try listening to books on CD or podcasts.

3. Try Something New

Try cycling, aqua aerobics, water running, walking, swimming or even dancing. There is a form of exercise that you will love out there - you just may not have found it yet!

4. Just Do It

Sometimes overanalysing can be detrimental - you just need to get out there and exercise!

5. Enter Fun Runs and Walks

You don't have to be a serious runner or athlete to enter races, most have 'walker' divisions. Aim to do a fun run or walk to sustain interest and give yourself a goal to work towards.

6. Schedule It

Book an appointment with yourself and prioritise exercise just like you would any other appointment.

7. Exercise Early

If you want to get something done, do it before other tasks and responsibilities accumulate. If you exercise early you will benefit from an elevated metabolic rate for the remainder of the day, which means you are likely to burn more calories. If you can't fit exercise in early, try to do it before you get home. Once you get home, it can be difficult to go back outside!

8. Be Prepared

Keep a bag of exercise clothes at your work or in your car - you never know when you may be able to fit in an exercise session. If you are going to exercise in the morning, organise the gear you need the night before.

9. Keep Track

Keep an exercise diary, or use a heart rate monitor to measure your exercise intensity, duration and calories burned. When you meet your exercise goals, treat yourself to a non food-related reward. When you are pressed for time, a pedometer is a great way of measuring your incidental exercise.

10. Be Flexible

Don't worry too much about missed exercise days, but try to identify the barriers that prevent you from exercising and address them.

How to Increase Your Metabolic Rate

To increase your metabolic rate, or the rate at which your body burns energy, you need to exercise at a moderate intensity (a level where your breathing rate is elevated, but you can still carry out a conversation) for at least 250 minutes a week. You also need to eat small meals every three hours. 

Metabolism Explained

Your metabolism is important in determining how much body fat you burn. Every person's metabolic rate is different, but in theory, raising your metabolic rate by 10% can decrease your body weight by up to 7.5 kilograms! Your metabolic rate comprises of three factors, two of which you have the power to change:

1. Resting metabolic rate the amount of energy expended when you are sleeping or sedentary (60 - 70% of the average person's daily energy use)
2. Physical activity (20 - 25% of the average person's daily energy use)
3. Thermogenesis an increase in your resting metabolic rate in response to stimuli such as food digestion (10% of the average person's daily energy use)

The two factors that you have the power to change are the physical activity (engage in regular exercise) and thermogenesis (eat every 2-3 hours).

Don't Slow Your Metabolism

One of the fastest ways to slow your metabolsim is to 'crash diet', or try fast diets and fasting. When you lose weight quickly, your body responds to perceived starvation by slowing your metabolic rate to conserve energy. Hence when you start eating normally again, your body stores fat because its metabolism has slowed!

Yo-yo dieting has a similar effect. The more weight you lose, regain and lose again; the more muscle tissue you will shed. Unlike fat, muscle tissue is metabolically active.

So by maintaining a healthy metabolism with exercise and regular eating, you'll enjoy a healthy metabolism - and a healthy weight.

Fast Weight Loss: Why it Doesn't Work

Fasting diets generate fast but false results. Here's why:

You lose fluid, not fat And any fluid lost will return as soon as the fast is completed, in other words you'll re-gain any weight that you lost.

Lowered metabolism During fasting your metabolism slows by up to 40% to prepare for starvation, so when you eat normally again your body burns fewer calories and you gain weight.

Hunger and lethargy Fasting leads to hunger and cravings - not what you need when you are trying to lose weight! And when you drastically cut your calorie intake you will feel weak, making it even more difficult to maintain your resolve to lose weight.

Yo yo dieting Fasting often leads to cycles of weight loss and weight gain called 'yo yo' dieting. 95% of people who go on fast weight loss diets regain any weight lost - plus more - within two years (1).

Abstinence leads to binging When your food intake is restricted you experience physical and emotional deprivation. This compels you to eat, which commonly leads to overeating or binging. As a result, you are likely to feel sensations of guilt and failure. This often becomes a cycle which is difficult to break and has devastating effects on your self esteem (1).

Nutritional deficiencies Prolonged fasting may lead to nutritional deficiencies. For example, if you don't consume enough calcium you may be at risk of osteoporosis, or if you don't consume enough fibre you may experience constipation.

Poor Health Fast weight loss is bad for your health because it:
- Increases your risk of medical complications such as gallstones, gout and constipation (2)
- Lowers your immunity
- Leaves you deficient in important vitamins and minerals.

Impracticalities Fast weight loss involves restricting food intake to the point where you are constantly hungry and lack the nutrients you need to maintain physical health and energy levels. This situation can't be sustained in the long term. Plus fasting makes it difficult to carry out normal social interactions - people who are dieting often avoid social situations and family mealtimes, leading to feelings of isolation and loneliness.

Some people claim that fasting can help rid your body of 'toxins' (i.e. the food you eat). 'Toxins' occur naturally in your body, and your body has fantastic systems to cleanse itself (your kidneys and liver).

Healthy Weight Loss

A sensible weight loss goal is 0.5 - 1kg per week, and the best way to achieve this is to make healthy changes to your eating and exercise habits. These changes should always be sustainable - that way you will lose weight and keep it off. 

References:
1. Why Diets Don't Work, Eating Disorders Foundation of Victoria
2. Rapid Weight Loss Linked to Gallstones, Flinders Medical Centre