It’s summer — and you’re going to the beach in your bathing suit… or wearing shorts and tank tops… or at least thinking about it. At this time of year more than any other, you’re more aware of your body.
Or it’s the holidays — and you want to look fabulous for those parties you’re invited to. Or it’s just any day, and you want to look and feel wonderful.
But you step on the scale, and the little arrow is higher. Or you look in the mirror and don’t think you look as good as you used to. You feel heavier. You feel like you look different.
It’s a common problem for women like us going through early menopause.
Confronting The Reality Of Weight Gain & Menopause
You’ve gained a few pounds and perhaps your body looks different. You’re noticing a new, very annoying, roundness to your tummy. Your waistline seems to have disappeared. The scale is becoming your enemy… yet you’re not doing anything differently than you used to. You might find yourself asking: What is going on?!
Let’s start with something that drives me — and many other women in early or premature menopause — crazy: Many books and articles insist that women put on weight during menopause because they’re older.
It’s not a function of menopause, they argue. It’s a function of aging. Your metabolic rate drops as you age, which accounts for the weight gain. In addition, older women are often more inactive.
Well, maybe this applies to the average woman in menopause who is in her 50s. But what if you’re in your 20s or 30s — and you start noticing the creeping weight gain and new thicker body contours? I know I did….and dozens of prematurely menopausal women I’ve spoken with have seen it happen to them as well.
We’re not middle-aged. We’re still young. So, regardless of what the books say, it can’t be age that causes these changes. And it isn’t. It’s your hormones, plain and simple.
If you’re going through an early menopause there’s a good chance you’ve noticed your weight going up — even though there’s been no change in your diet or exercise habits.
You might notice your body shape changing as well — shifting from a “pear” shape to an “apple” — as weight starts to accumulate more around your waist and abdomen instead of your hips, thighs and buttocks. You might notice your waistline disappearing, as your body becomes thicker through the middle.
And, finally, you might notice the development of the dreaded “belly” — a new rounder tummy, especially below your belly button, that just doesn’t want to go away.
Okay, so these changes aren’t life-threatening, but they do affect your self-confidence at a time when you least need it. They also affect older women in menopause, of course. But, in truth, it’s often worse for women in premature menopause.
The biggest difference? When you’re going through this in your 20s or 30s, the changes in your appearance are often more apparent than the changes an older woman in menopause goes through (especially to you), simply because most other women your age aren’t experiencing the same thing.
Other women in their 20s and 30s aren’t getting the so-called “middle-aged spread” that women in their 50s experience, but you may be.
Why is this happening?
As I said before, most of this is due to your hormone levels. Lower levels of estrogen may cause a variety of physical side effects.
Low Estrogen And Weight Gain
#1 First, because estrogen is stored in fat, many researchers believe that, when you enter menopause — whether naturally or through surgery, your body responds by holding on to fat cells in an effort to boost the lagging estrogen levels.
The result? It’s tougher to lose fat and much easier to keep the pounds on.
#2 Second, as estrogen levels drop, your level of androgens — the so-called “male” sex hormone — increases in relation to the estrogen.
Unopposed by the higher levels of estrogen your body used to have, the androgens may produce male characteristics — in this case, the shift in body fat from your hips, thighs and buttocks to your midsection, resulting in the “apple” shape that is more common in men and in postmenopausal women (which, incidentally, may also be linked with an increased risk of heart disease).
#3 Third, low estrogen levels affect the production of collagen — which results in drier, thinner skin. It may also lead to a saggy appearance, and lack of muscle tone — all of which contributes to a change in your body shape.
Low progesterone levels in relation to estrogen (which is popularly called “estrogen dominance”) also causes a number of side effects. Among the more common ones: increased bloating and water retention — which may not be actual fat, but makes you look heavier, and blood sugar fluctuations — which can increase your appetite and slow your metabolism.
Finally, there’s the mood connection. As you know, fluctuating or declining hormone levels can cause mood swings, depression and anxiety. This is because the levels of serotonin and endorphins in your brain apparently drop in the face of fluctuating hormones (source).
What raises serotonin levels in your brain? Certain foods, like chocolates. Often, when you go through premature menopause, you notice you have food cravings — much like you did when you had premenstrual syndrome (PMS).
But unlike PMS, your hormones don’t bounce back to regular levels, so you may have food cravings longer than in the past… and, unfortunately, cave in and eat more of the foods you shouldn’t, like calorie-dense treats, salty snacks and sweets.
Regardless of what some people have claimed, there does appear to be a biological basis for the changes you’ve noticed in your body and your weight. It’s not in your mind. It’s related to your hormones.
So that’s the bad news. But all is most definitely not lost! There are three very basic things you can do to help fight the changes in your body brought on by changing hormone levels:
• Eat correctly.
• Exercise regularly.
It’s a simple prescription without doubt — but it’s one that can make a big difference!
Next, we’ll take a quick look at how replacing hormones can help (and when it doesn’t), as well as some tips on how to eat right to help you lose the weight you might have gained, and keep it off!
Hormone Replacement Therapy: Will it Make Me Fatter… Or Fitter?
Since we often put weight on because our estrogen levels are low, usually we can keep that weight off — or, at least, gain less — by replacing estrogen. It makes sense, right? But then why do so many women say that they gain weight on HRT?
That’s the million-dollar question — but there’s actually a simple and logical answer.
First, let’s look at the facts about HRT and weight: A widespread look at HRT, the PEPI trial — as well as other smaller studies — found that while women on HRT did often put on a few pounds, those women who weren’t on HRT gained more weight. In fact, some studies have shown that many women actually lose weight on HRT (specifically fat tissue) (1, 2).
One possible reason: When you’re in premature menopause, your estrogen levels drop — so your body may try to up its fat content to store and produce as much estrogen as possible.
When you go on HRT during early menopause you’re getting the estrogen your body would otherwise have had if you’d entered menopause at the “normal” age. The replacement of estrogen appears to reduce the body’s inclination to accumulate and store fat.
In addition, when your estrogen levels are low, you tend to put on weight in your middle — more like a man. This accounts for the “disappearing waistline” that so many women in premature menopause experience.
When you replace estrogen, your body may revert to a more normal pre-menopausal weight-distribution, which for most women means putting weight on in their hips, thighs and lower abdomen instead of the middle.
So why do some women say they think they’ve gained weight on HRT? To some degree, this might depend on the type you’re taking. Progestins tend to make you retain water and bloat more.
Even if you haven’t actually gained fat, you may feel (and look) as though you have — especially if you’re on cyclical progesterone, that is, taking it for only part of the month.
Natural progesterone doesn’t seem to have this side effect as much; and often works as a diuretic instead, helping you lose water weight.
Other women have found that lowering their dosage of estrogen or progesterone helps keep bloating down. Finally, others have reported better outcomes with patches instead of pills. You can read more about this in the discussion about the different forms of HRT.
For many women, experimenting with different forms of HRT helps them identify the one that works best for them. However, this is something you should always do in conjunction with and under the supervision of your doctor.
But, all in all, the evidence shows that weight gain isn’t something you should worry about when you consider going on HRT. Indeed, HRT may help you keep your weight in line — and may help to reverse many of the changes you’ve have noticed in your body.
What if you can’t — or won’t — take hormones?
Well, there are still ways to boost your estrogen levels and help reverse that weight gain.
Phytoestrogens — which are high in foods and supplements like soy and flaxseed — can help you raise your estrogen levels the natural way. No, they’re not as potent as replacing hormones. But they still can make a difference.
You might consider adding soy foods to your diet, putting ground flaxseed in salad — or taking the dietary supplement route and getting flaxseed or red clover capsules from your health food store.
We examine many of these natural alternatives (and the scientific evidence behind them) in our helpsheet: What Does The Science Say About Natural Remedies?
Evidence from studies suggest that women on HRT tend to gain less weight on average than those women who don’t take it. In some cases, women on hormone therapy are able to lose weight. The type of HRT you’re taking might have an impact too. Progestins, for example, have been linked with water retention and bloating.
Eating Right for Early Menopause
Now on to something that’s talked about widely, but not always in a menopausal context: How we eat. Since weight gain is so prevalent when you go through early menopause, it’s vital to be sure you’re eating the best foods given this change in your body. And, happily, it’s really not that difficult.
Here are a few very simple tips that can help — many of which are really obvious, but they definitely bear repeating!
• Keep a balanced diet — to keep your weight down and to cut down on the risk of disease.
This is clearly one of the best things you can do for the overall health of your body. First, as you know, premature menopause increases your risk of heart disease. By consuming whole foods and keeping processed foods to a minimum, you can help shift the odds in your favor and help prevent heart disease.
For a long time saturated fats have taken the brunt of the criticism in dietary guidelines. They are believed to raise your blood cholesterol level — so a low-fat diet has long been recommended to help you keep your cholesterol levels down. However, newer evidence suggests that saturated fat might not actually be the great driver of heart disease it was once thought to be.
In fact, a more useful rule of thumb for eating might be to avoid processed foods, rather than to obsessively eliminate fats. The former method doesn’t rule out foods like nuts, seeds and fatty fish, all of which are known to be highly beneficial to heart health (3).
It’s not just your heart health that can benefit from focusing on a whole food, plant-based diet. If you’re on hormone replacement therapy (HRT) and concerned about breast cancer, eating right and staying trim is likely to lower your risk of developing the disease.
As for weight control, both low-carb and low-fat meal plans have been shown to be effective. More often than not, high fat foods are also high calorie foods — which certainly doesn’t help you keep your weight down. One gram of fat has over twice the calories as a gram of protein.
However, processed foods high in carbohydrates are notorious for their “binge potential” and recent reviews of the evidence have actually shown superior effectiveness for low-carb meal plans over low-fat in both heart disease prevention and weight loss (4).
If you do choose to follow a low-fat diet, don’t assume that you have to obsessively eliminate all fats from your diet. Low-carb is also a valid eating plan for weight control and heart disease risk reduction. However, your best course of action? Base your meals around whole foods and incorporate treats only on occasion.
• Keep your fiber intake up.
Fiber is your friend when it comes to eating properly. It fills you up, keeps your digestive tract healthy, and helps maintain a healthy heart. In addition, it has a protective effect against certain types of cancer.
You need both insoluble and soluble fiber. Insoluble fiber helps keep your bowel movements regular and helps protect against cancers of your intestinal tract. Foods high in this include: whole grains; fruits and vegetables.
Although debate has surrounded carbs and their impact on health, whole grains are nevertheless a better choice than highly refined grains. They are higher fiber and generally more nutritious than their more processed cousins.
The fiber in whole grains may help you keep your weight down too. It fills you up quickly and keeps you feeling satisfied for a longer amount of time than other carbohydrate-dense foods — which is a definite plus when you’re trying to avoid overeating.
As for fruits and vegetables, they too can fill you up and provide a rich source of fiber. Not only that but the nutrients they provide (and perhaps, their antioxidants) may help your heart and help fight cancer risks.
Soluble fiber keeps your blood sugar levels stable, and is metabolized slowly — a real help in keeping you from overeating. Foods high in soluble fiber include: apples, barley; beans; flax seed; prunes; rolled oats, oat bran.
Fiber has been shown to help prevent overeating, improve digestive health, and boost heart health. All of these benefits are particularly valuable to women in early menopause who may already be tackling weight gain and an elevated heart disease risk. Great sources include fruits, seeds and whole grains.
• Don’t forget protein — for overall health and (a nice plus) weight loss.
Protein can help you maintain lean muscle mass, which in itself burns calories — quite an effective one-two punch! But all too often, especially recently, people tend to overlook the benefits of protein, especially as a way of keeping weight in check.
Around the turn of the century, the emphasis was heavily focused on whole grains. In effect then, books and doctors were extolling the virtues of high-carbohydrate, low-fat eating.
But the pendulum is shifting back in more ways than one, and more support has emerged asserting that a higher balance of protein might be beneficial in weight control and all around health.
Regardless of whom you believe in this debate, there is no question that protein is a necessity in your diet. Amino acids are vital “building blocks” in your body, some of which your body makes — and others of which you can only get by eating protein-rich foods.
It is, in one form or another, present in every cell of your body. It makes, maintains and repairs cells — from muscle to other tissues. It is a crucial ingredient in everything from your bones to your hair; and makes up such vital substances as hormones (such as insulin) and disease-fighting antibodies.
It’s clear, then, that protein is a must in anyone’s diet. But it’s especially important if you’re tackling the fallout of premature menopause — and here’s the big reason why:
Protein’s thermic effect is higher than that of carbohydrates or fats. In other words, you burn more calories simply in the process of digesting the food you ate with a high protein meal than one high in fats or carbs. So you’re getting more bang for your buck when you eat protein.
One other big plus: protein may help to keep blood sugar levels stable — a big plus when it comes to preventing both mood swings and food cravings.
Protein has vital functions in your body, but it may also contribute to satiety — that feeling of “fullness” that can help prevent overeating. By keeping blood sugar levels low and stable, high-protein meals might also tackle the mood swings and cravings so common in menopause.
• Because it may be easier to add or keep weight on due to premature menopause, remember to keep an eye on calories.
For a while there, it seemed as though everyone forgot about calories! Articles, books, and nutrition experts were focusing on low-fat eating as a way of keeping your weight down.
But is calorie-counting really the most effective (or the most pleasant) way to lose weight?
It’s a simple scenario: Calories are, in effect, energy units. They’re what your body burns as fuel. But if you take in more calories than you burn, you gain weight.
However, not all calories are “equal” in the sense that like-for-like, calories from some food sources lead to greater satiety or a superior intake of nutrients.
Nevertheless, on the simplest level, if you’re trying not to gain weight, you have to burn the calories you eat — and, of course, be sure you don’t wind up with too many calories in the course of a day’s eating.
How much is too much? It really depends on the individual — your height and weight, your body build, your fitness level, and how active you are. But it’s good to keep in mind that only 3,500 calories add up to one pound of added fat — and those 3,500 calories can add up over time, especially if you’re not exercising.
So calories count, but (here’s the good news!) you don’t have to — and frankly, shouldn’t — count calories. If you follow the good eating guidelines included in this section, you’re well on your way to keeping your calorie intake in check painlessly.
More Useful Tips
Be sure to meet your calcium requirements. You already know that you’re at a greater risk for osteoporosis — so clearly calcium is a must in a good premature menopause diet. Low fat dairy products supply you with much needed protein too, and help keep your bones strong. Calcium-rich vegetables, like broccoli, are another good source.
Read more about your calcium intake in our ultimate guide on calcium and early menopause.
Try to eat more before 5:00 PM — and try not to eat anything after 8:00 PM. Intermittent fasting may be of significant help in keeping the added weight off.
Some have argued it makes no difference — that calories are calories, no matter when you eat. But other studies have shown you’re best off eating large meals earlier in the day, and potentially even fasting through the evening into the next day.
During the day you’re more active, so you can burn off some of the calories you’ve taken in. In fact, to put it more scientifically, it takes about four hours after eating for your blood-triglyceride levels to rise.
So, if you have a large dinner at 7:00pm or so, your triglycerides might hit their height around 11:00pm — right when you’re going to bed or lying on the couch watching television.
In general, it might be worth following that old saying: “Breakfast like a king, lunch like a prince, dinner like a peasant.”
Drink water whenever you can remember to — and definitely before meals. Water is not only good for your system, but by taking regular breaks to sip water you may increase that feeling of “fullness” and be less prone to overeating.
Try soup before meals. Studies have found that people who eat soup before a meal eat less. It’s even better than water, since you’re getting nutrients (5).
Finally, give in to your cravings, but only a little. Eating well and healthily doesn’t have to mean depriving yourself. You are going through premature menopause; you have a lot going on already; there’s no need to punish yourself. Often allowing yourself a little something you crave can help you keep eating properly.
For example, according to several surveys, chocolate is the number one food craved by women with PMS and women in menopause. A key reason? It increases the levels of serotonin and endorphins in your brain, making you feel better. So having a little chocolate may help lift your spirits and chase away the blues (in the short term at least), which might seem worth the small amount of fat and sugar you’re eating. Of course, you can’t overdo it, though!
Also remember that, if your dieting is too severe you’re more likely to resort to binge eating to compensate. Try to keep yourself satiated with quality whole food eating, and don’t buy into extreme fad diets that can cause compensatory eating.
And finally, just because you gave in to your cravings and “cheated” once, it’s nothing to get too anxious about. When this happens don’t let everything else you’ve worked for unravel — remind yourself that you’re only human and continue as before.