I remember when weight loss came so easily in my late twenties. I lost 80 pounds, thanks to diet and exercise (and if I am being overly honest, overexercise). Maintaining it was a matter of consistency, and as a creature of habit, this was easy for me. That is, until I hit my forties. What worked for me for more than a decade no longer worked. The simple math of calories in, calories out no longer applied. Working out longer and harder only caused my body to break down. The weight kept creeping back on. So, what gives? Weight loss and perimenopause: more than meets the eye.
Calorie Type
There are many factors that contribute to weight loss and perimenopause that we overlook. Yes, calories matter, but so do the type of calories. For example, if you’re consuming your goal of 1800 calories a day, but most of that is in the form of simple carbs, alcohol, and the common standard American diet, you won’t see the same effect as you would consuming complex carbs, higher protein, and moderate healthy fats with little to no alcohol.
This is because the decline in estrogen increases blood sugar fluctuations followed by insulin resistance. Meaning, the more simple or high glycemic carbohydrates you consume, the more likely you are to store this as fat. Where? In the abdominal area, buttocks, thighs… all of the places we are looking to tighten. What makes matters worse is when you start accumulating more weight around the abdomen, you increase insulin resistance. It becomes a vicious cycle.
While you don’t have to count every calorie in, you should be comfortable with what a balanced plate should look like. 1/2 a plate should be low glycemic vegetables, including cruciferous and complex carbohydrates, and fruit. 1/4 of your plate should reflect lean proteins, while the other 1/4 is comprised of healthy fats.
Fiber and the Gut Microbiome
The role of fiber and the gut microbiome are understated when it comes to weight loss and perimenopause. It is suggested that most adults only consume half of the requirements of fiber a day. This is problematic because fiber helps to control blood sugar, prevents the absorption of cholesterol and fats, aids in detoxification of fat soluble toxins, promotes bowel regularity, maintains digestive health, and improves satiety.
Fiber works to promote gut health by cleaning up the digestive tract of unwanted buildup. It absorbs fats, cholesterol, and toxins for excretion in your bowel movement. Thus, it reduces your risks of diabetes, heart disease, and some cancers, while improving blood sugar control and weight management.
Fiber is a type of carbohydrate found in vegetables, fruits, whole grains, and legumes. There are two types: soluble and insoluble fiber. Soluble fiber slows down digestion by forming a gel-like substance in your stomach when dissolved in water (like chia seeds soaked in water). This supports the control of blood sugar levels and cholesterol. You’ll find soluble fiber in avocados, apples, bananas, oats, peas, Brussels sprouts, and beans. Insoluble fiber remains whole as it passes through the stomach, and this is what helps promote bowel regularity and insulin sensitivity.
Prebiotics
Another way to look at gut microbiome is through the lens of prebiotics and probiotics. There’s a direct relationship between prebiotics, probiotics, weight loss and perimenopause.
Prebiotics are soluble fibers found in fruit, vegetables, nuts/seeds, whole grains, and legumes, in addition to herbs and spices such as black/cayenne pepper, cinnamon, ginger, oregano, rosemary, and turmeric. Prebiotics support weight loss by increasing satiety and reducing the amount of fat you absorb. They help the good bacteria in your microbiome thrive because they promote the production of short chain fatty acids (SCFAs) in the colon. SCFAs reduce the risk of obesity by regulating appetite (as well as colorectal cancer and IBD). According to a study published in Gut, the more prebiotics you consume, the less you crave the high caloric foods and the less the brain perceives those foods as a reward.
Generally speaking, you want to aim for 5-20 grams of prebiotic fiber a day. One way I ensure to hit my target is to supplement with Bio.me Daily Prebiotic Fiber. It offers 7 grams of prebiotic fiber from quality ingredients, is non-GMO verified, organic, and low FODMAP. I also aim for 5-7+ servings of vegetables and fruit a day.
Probiotics
Probiotics, found in fermented foods and supplements, are living microorganisms that influence health when consumed. Some benefits include modulating the immune system, cancer protection, and detoxification. Moreover, probiotics regulate metabolism, lipid (fat) regulation, and nutrient utilization. They manufacture vitamin K and some Bs, including biotin and break down the fibers you cannot digest, supporting their transition to the SCFAs. These SCFAs influence appetite and energy usage.
There are 2 main bacterial phyla we focus on in the gut: bacteriodetes and firmicutes. Research demonstrates a correlation between body weight and the balance of these bacteria. Those with higher levels of firmicutes and fewer bacteriodetes had obesity, and a less diverse gut microbiome. In essence, those who do not consume adequate prebiotic rich foods, along with probiotics, have higher levels of firmicutes versus bacteriodetes.
Probiotics may influence the release of GLP-1 hormone, associated with appetite reduction, as well as the peptide YY. Both influence calorie and fat burn. Certain strains also positively effect belly fat. According to a randomized, double-blind, placebo-controlled clinical trial published in Nutrition, Lactobacillus curvatus and Lactobacillus planatarum reduced waist circumference, visceral fat, and weight.
Stress
Stress almost inescapable, and it will wreak havoc on your ability to lose weight during perimenopause. Pushing through it is no longer the right response, as stress impacts every system of the body. One of the most influential systems to bear the burden is the endocrine system. The primary driver of the stress response is the hypothalamus-pituitary-adrenal axis, or HPA axis. It is responsible for increasing the production of of steroid hormones, called glucocorticoids, including the stress hormone cortisol.
Cortisol increases energy by mobilizing sugars and fatty acids in the liver, and is designed to be used by the body as its fuel source. It is initially anti-inflammatory; however, when we have chronic increases in cortisol it becomes inflammatory. The main job of cortisol is to increase blood sugar levels! Chronic stress means excessive cortisol production. This will increase belly fat and weight gain because the pancreas is going to release more insulin, and too much insulin also contributes to weight gain. This is where we start seeing insulin sensitivity issues as the body no longer responds appropriately and becomes diabetic.
Also part of the endocrine system, the thyroid gland is the master regulator of metabolism in your body. Every single cell has a receptor for thyroid hormone. The job of the thyroid is not only to regulate metabolism to help utilize energy and manage weight, but it regulates your heart rate, body temperature, growth and development, and bone metabolism. Chronic stress releases more cortisol, and this interferes with thyroid hormone regulation.
Inflammation
At the root of most chronic illness is inflammation. Yes, an inflammatory response to an injury promotes healing, but a new theory of disease suggests it is associated with a broad range of non-infectious diseases. Even more, inflammation impairs leptin, the key hormone in regulating metabolism and appetite. When there is chronic inflammation, leptin levels are low resulting in increased hunger and slower metabolism. Inflammation also increases insulin resistance, making the body more prone to weight gain, type 2 diabetes, and cardiovascular disease. One way to look at this is the more weight you have, the inflammation you have. This is a vicious cycle of inflammation and weight gain.
Another impact inflammation has is on hormones and the endocrine system. Thyroid hormones are the master regulators of metabolism, and in the face of chronic inflammation, they contribute to chronic inflammatory conditions including obesity. Estrogen has a complex relationship with inflammation. While it exhibits anti-inflammatory effects, it also inhibits the activation of immune cells which may exacerbate conditions like lupus and rheumatoid arthritis. Moreover, chronic inflammation results in low estrogen levels, which can lead to metabolic disorders such as type 2 diabetes and obesity, as well as elevated estrogen that results in weight gain, mood issues, fatigue and is often associated with conditions like PCOS and fibroids.
Cortisol increases in the face of chronic inflammation. Remember, it is designed to be anti-inflammatory but that changes when it is constantly released. This is when it becomes pro-inflammatory and we lose insulin sensitivity, leading to weight gain and increased belly fat.
Inflammation comes from leaky gut, food sensitivities, environmental toxins and exposures, overtraining at the gym and being sedentary, poor sleep, chronic stress, smoking, drinking, and more.
Fat vs weight loss
This should be a blog all on its own. Let’s start by talking about the difference between fat loss and weight loss. Fat loss refers specifically to losing body fat whereas weight loss regards losing overall weight that includes factors such as water, muscle, and fat. You do not want to burn muscle, because it improves metabolism. The scale does not discern what you are losing, and therefore isn’t the best tool to track your goals.
Now let’s discuss the ways in which your body burns calories.
- 5% of your total calorie burn comes from exercise, or exercise activity thermogenesis (EAT).
In a previous blog, I discussed how you cannot over exercise a bad diet, and that those longer workouts after indulging are not compensatory. - 10% of calories burned comes from nutrient digestion, or what’s called the thermic effect of food (TEF).
- 15% comes from simple, everyday movement also known as non-exercise activity thermogenesis (NEAT).
- The additional 75% comes from your basal metabolic rate, or BMR. This is what keeps you alive, and it’s the rate in which your body burns calories at rest.
The lower your BMR, the less calories you need to maintain your body’s functions. Unfortunately, this makes it harder to lose weight. This means you want to ensure your BMR is high, and the way in which to do that is to focus on building muscle mass. You can build muscle through strength training exercises such as lifting weights and high intensity interval training (HIIT), but also through your diet by adding more protein and eating enough calories, staying hydrated, getting enough sleep, not skipping meals, and reducing your stress. As a side note, low impact cardio and strength training during perimenopause not only improve muscle mass and bone density, but reduce symptoms like hot flashes and mood swings.
Weight loss and perimenopause
As you can see, weight loss, especially during perimenopause, is multifactorial. The old dogma of calories in, calories out is just that; old. The way in which our bodies adapt through this new phase in life requires consideration on many levels, including dietary and lifestyle changes.
If you’re struggling to lose weight during your menopause transition, schedule a free 15-minute strategy session with me. Let’s discuss factors that may be impeding your progress, and design a plan that works best for you!