by Judith A. Norris, Ob-Gyn, RNP
I did not want to write this column on weight, but since it is of major concern for all of us, regardless of age, I gave in. Just seems to be a lot of misinformation out there about estrogen and weight gain, as we age. No, it isn't our imagination, it is easier to gain weight now that it was when we were in our 30's.
As we age we learn a few things about our bodies. For one, is it is unhealthy to be obese. The actuarial records have shown women who are obese have more heart disease, diabetes and cancer. However, being too thin is unhealthy too! Medical records have shown that middle-aged women who are underweight live shorter lives than those who are overweight. Under weight women are also more prone to osteoporosis. (I thought one could never be too thin or too rich, wrong again!).
It is important to have a realistic outlook and be aware that changes in body shape happen to all postmenopausal women. In our 40's , body fat proportions change. The ratio of body fat to muscle increases, as muscle mass decreases. Due to the declining estrogens and the age factor, weight is being added to our thighs and buttocks. Our shoulders become more narrow, and our pelvis grows wider. Weight distribution in our 50's is increasing now into the inner thighs and waist. The 50 year old body is more fat prone - as fat contents peak in this decade. Average American women will put on an estimated 15 pounds between the ages of 30-65, most of it around our middle!! Thank goodness, for the elastic waistband! At age 60, we tend to lose fat and muscle tone.
The weight you gain during menopause is due to a slower metabolism. As estrogen levels decline, this affects the way that fat is distributed. Declining estrogen levels affect insulin levels in the blood stream. Excessive fad dieting is unhealthy, and it may mean that you fail to meet your nutritional requirement. Exercise is a better means of improving muscle tone and increasing metabolism.
Consider your body shape. Is your weight stored around your stomach and waist, or more around your hips and thighs? If it is around your stomach and waist you are more prone to heart disease. To obtain your hip -to -waist ratio, measure your waist at its narrowest point while you stand relaxed. Measure your hips at their widest point. Divide your waist measurement by your hip measurement to obtain your waist-to-hip ratio. Ratios that are above 0.8 are linked to a greater risk of diabetes, heart disease, high blood pressure, osteoporosis, and arthritis. If you fall into this range, talk with your health care provider about a plan for a sensible weight reduction program. If you do not fit into this high risk category, you have no serious medical problems, and your weight is within the recommended weight for your height and age, there is no health advantage to reducing your weight. Just let your body settle down to its natural weight. For those of us who are over the recommended weight for our height and age, losing weight is to our health advantage.
So, does estrogen replacement cause weight?
There's no clear cut answer to that question. It's like which came first the chicken or the egg. Some women will gain weight with hormone replacement just as some did with birth control. However, the gain should not exceed 10 pounds. A weight gain of more than 10 pounds is not due to estrogen alone... We know that metabolism slows down as we approach menopause and this causes weight increase. Due to this slow down, food stays longer in the intestine and causes gas. Wonderful fifty and flatulent!!! Just the aging process alone causes weight gain as our body does not require as many calories as it did when we were in our 30's. In fact if you changed nothing, ate the same, and exercised the same as you did in your 30's, you will gain weight!
We need 120 fewer calories a day in our 50's in order to maintain the same weight. My endocrinologist informs me that as estrogen decreases insulin in the blood increases. This causes too much glucose to enter the cells and be stored as fat! Great. Just what I need!
Hormone replacement therapy only adds a fraction of the estrogen the body made there by slightly increasing insulin levels in the blood. This imbalance can lead to hypoglycemia. This can increase feelings of drowsiness and fatigue . Decreasing our intake of white refined flour and sugar will help to control this imbalance and help to lose weight. Check with your health care provider.
The BEST way to lose weight is what we hear all the time eat less, and exercise more!!! The older you get, the tougher it is to lose weight, because by then, your body and your fat are really good friends... DO NOT PROMOTE THIS FRIENDSHIP.
courtesy of OBGYN.net