Have you noticed as women age (usually around 45-55 years), our body shape starts to change? Our favorite pants begin to feel snug around the middle, and losing weight becomes more challenging! I want to address this because many of my clients ask about weight loss and wonder why it is so much more difficult as they get older.
Many factors can contribute to this midlife weight gain, but one of the biggest is the change in hormones, specifically lower estrogen, higher cortisol, and insulin response. We all know that estrogen levels decrease dramatically post-menopause. However, the relationship between how low estrogen and high cortisol play a significant role in weight gain in post-menopausal women doesn't often get enough attention.
Here’s a breakdown to explain how these hormonal changes contribute to body composition and weight gain:
Low Estrogen Levels
1. Fat Distribution
Abdominal Fat: Estrogen helps regulate fat distribution in the body. With lower estrogen levels post-menopause, women tend to accumulate more abdominal fat, which is associated with a higher risk of metabolic disorders.
Subcutaneous to Visceral Fat: There is a shift from subcutaneous fat (under the skin) to visceral fat (around internal organs). Visceral fat is more metabolically active and can lead to increased inflammation and insulin resistance.
2. Metabolism
Slower Metabolism: Estrogen plays a role in maintaining metabolic rate. Lower estrogen levels can lead to a decrease in metabolism, making it easier to gain weight even if caloric intake remains the same.
Muscle Mass: Estrogen helps in maintaining muscle mass, which is important for a higher metabolic rate. Loss of estrogen can lead to a decline in muscle mass, further slowing metabolism.
High Cortisol Levels & Insulin Response
* Small rises in cortisol levels in response to stressors are normal and have many important functions in the body, such as helping reduce inflammation, regulate metabolism, and help the body wake naturally. However, chronically elevated cortisol is when problems arise and can result in high blood pressure, fatigue, Irritability, thinning skin, and difficulty concentrating.
1. Stress Response
Stress and Eating Habits: Elevated cortisol levels, often a result of chronic stress, can lead to increased appetite and cravings, particularly for high-fat and high-sugar foods, which contribute to weight gain.
Emotional Eating: Stress can also cause emotional eating, where individuals eat more as a response to stress, further contributing to weight gain.
2. Fat Storage
Abdominal Fat: High cortisol levels are associated with increased storage of fat in the abdominal area, similar to the effects of low estrogen. This type of fat is more dangerous as it is linked to cardiovascular diseases and diabetes.
Lipogenesis: Cortisol can enhance lipogenesis (fat creation) and decrease lipolysis (fat breakdown), leading to increased fat accumulation.
3. Insulin Resistance
Blood Sugar Levels: Cortisol can increase blood sugar levels by promoting gluconeogenesis (production of glucose from non-carbohydrate sources) in the liver. Persistent high blood sugar levels can lead to insulin resistance (the body's cells don't respond normally to insulin, resulting in glucose build-up in the blood), which is associated with weight gain and difficulty losing weight.
Metabolic Syndrome: High cortisol can contribute to the development of metabolic syndrome, which includes symptoms such as high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels.
Combined Effects on Weight Gain
The combined effect of low estrogen and high cortisol can create a challenging environment for maintaining a healthy weight.
Increased Appetite and Fat Storage: These hormonal changes can lead to an increase in appetite and fat storage, particularly around the abdomen. Estrogen can help the body respond to insulin more effectively, which helps lower blood sugar. When estrogen levels are low, body cells may not be as sensitive to insulin, which can cause blood sugar levels to increase. An increase in cortisol (your stress hormone) causes the body to release glucose (the main type of sugar in the blood) for energy. If this energy is not used, it is laid down as fat.
*Double Wammy: Some studies show that the hunger hormone ghrelin also increases during perimenopause, leading to more hunger and cravings.
Reduced Metabolism: Lower estrogen levels slow down metabolism, while high cortisol levels can lead to insulin resistance, further promoting weight gain. Decreased estrogen leads to loss of muscle mass, reducing the overall metabolic rate. Lower estrogen levels can also often contribute to muscle and joint stiffness, which may deter some women from physical activity, thus leading to lower muscle mass.
How to Mitigate Weight Gain Post-Menopause
Before you lose all hope of figuring this out and ever feeling good in your body again, know there are strategies to help your body combat these hormone level changes, offset, and even reverse, the metabolic slowdown associated with aging. You can lose fat, gain muscle, and improve your overall well-being.
This is where we talk about exercise – how it relates to cortisol and insulin levels, how to use exercise to burn fat without over-training, how to help increase muscle mass to protect our bones and improve metabolism, and improve recovery. For post-menopausal women aiming to lose fat, gain muscle, and improve mobility without spiking cortisol levels, focusing on low-impact, moderate-intensity exercises is ideal.
1. Cardio
30 minutes of walking or using the elliptical after meals can help regulate blood sugar levels.
Short sessions (10-20 minutes) of intense interval cardio workouts stimulate less cortisol production than long, endurance workouts.
Aim for 150 minutes of light-to-moderate aerobic activity each week.
Avoid: Long durations of high-intensity exercise such as long-distance running.
2. Strength Training
Efficient Strength Workouts that incorporate compound, whole-body exercises that involve more muscles will burn more calories.
An effective weight training routine to improve muscle mass can be done in about 30 minutes 2-4 times per week and with or without equipment.
Avoid: Hours of weight training in the gym every day or high-intensity lifting classes (such as daily CrossFit-style) which can put too much stress on the body and not allow for enough rest.
3. Mobility and Flexibility Training
Exercises that enhance mobility, flexibility, and balance should be included in your weekly routine to help you maintain range of motion and stability.
Some great options that can also help reduce stress and enhance well-being include restorative yoga and tai chi.
Other Strategies
Consume a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Avoid high-sugar and high-fat foods that can contribute to weight gain.
Practice stress-reducing techniques such as mindfulness, meditation, journaling, or deep-breathing exercises to lower cortisol levels.
Ensure adequate sleep, as poor sleep can elevate cortisol levels and contribute to weight gain. Aim for 7-9 hours of rest each night. (read this blog post to help)
Consult with your doctor or healthcare provider about hormone replacement therapy (HRT) if appropriate, to manage symptoms of low estrogen.
Incorporating exercise into your lifestyle is a powerful tool to combat the hormonal changes that contribute to weight gain post-menopause. By engaging in regular physical activity, you not only help to manage your weight but also improve your overall health and well-being. Exercise can enhance your metabolism, maintain muscle mass, and boost your mood, all of which are crucial during this stage of life.
Remember, the key is consistency and finding activities you enjoy. Whether it's brisk walking, strength training, yoga, or dancing, the most important step is to get moving and make exercise a permanent part of your routine. Incorporate changes that fit seamlessly into your lifestyle. Exercise should be fun and rewarding. Embrace this opportunity to prioritize your health and enjoy the benefits of an active lifestyle.
And please, be patient. Understand that progress takes time. Celebrate small victories along the way and be patient with yourself. By starting small, setting realistic goals, and creating a routine that works for you, you can gradually incorporate these beneficial changes in fitness and nutrition into your life without feeling overwhelmed. This will help you stay committed in the long run to see results.
Stay positive, stay consistent, and most importantly, enjoy the process!
Resources
Khalafi, M., Habibi Maleki, A., Sakhaei, M. H., Rosenkranz, S. K., Pourvaghar, M. J., Ehsanifar, M., Bayat, H., Korivi, M., & Liu, Y. (2023). The effects of exercise training on body composition in postmenopausal women: a systematic review and meta-analysis. Frontiers in endocrinology, 14, 1183765. https://doi.org/10.3389/fendo.2023.1183765
Kodoth, V., Scaccia, S., & Aggarwal, B. (2022). Adverse Changes in Body Composition During the Menopausal Transition and Relation to Cardiovascular Risk: A Contemporary Review. Women's health reports (New Rochelle, N.Y.), 3(1), 573–581. https://doi.org/10.1089/whr.2021.0119
The Science of Health. "The Connection Between Menopause and Belly Fat." August, 24, 2023. https://www.uhhospitals.org/blog/articles/2023/08/the-connection-between-menopause-and-belly-fat. Accessed 22, June 2024.
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