September 18, 2003

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Menopause, Estrogen, and Body Fat

I recently got a really good question. Pamela Merritt writes:

One question I have that I really haven't found an answer to yet, is that many sources, including Dr. Atkins, mention women having trouble losing weight once they reach menopause, and in fact my mother found her low fat diet/exercise program was crashing and burning at this time (while low carb works. Go Mom!)

However, these same sources emphasize that birth control pills, and estrogen in general, cause weight loss problems.

How, when menopause means you are getting LESS estrogen, do women have trouble with weight gain at menopause?

Excellent question, and I believe I've found a credible answer. However, please keep in mind that I am not a doctor, nor do I play one on television. That being said -

In her book Outsmarting the Midlife Fat Cell, Debra Waterhouse says that the stubbornness of fat in menopausal women does, indeed, have to do with dwindling estrogen levels. You see, it's not just that estrogen creates fat - fat also creates estrogen. You might call it a feedback loop. This ability of fat to create estrogen (and other hormones, as well) is why women who are a little overweight are far less likely to get osteoporosis than women who are underweight. It is also a reason why serious obesity is a risk factor for hormonal disorders.

Because fat is a source of hormones, when estrogen production by the ovaries starts to drop as we approach menopause, the body hoards fat to buffer the decrease in estrogen. Waterhouse claims that women who aren't painfully thin actually have fewer menopausal symptoms than really skinny women, for this very reason.

This means that our bodies are increasingly reluctant to give up their fat cells as we advance through perimenopause, and apparently supplemental estrogen doesn't encourage them to let go - it just increases fat deposition and holds water, just like it does during our menstrual cycles (or, for that matter, in farm animals fed synthetic estrogens to fatten them.)

Waterhouse doesn't have much of a solution for this, you understand; she just encourages women not to worry too much about it, and accept it as part of the aging process. This is probably good advice. That being said, she hasn't much looked at low carb dieting, and I certainly know women who have lost weight during the perimenopausal years by low carbing, even if they haven't become fashionably thin.

Waterhouse does recommend not dieting strenuously, which she says will diminish muscle mass. This is true of low calorie diets, but one of the great benefits of low carb diets is that they're muscle-sparing.

Waterhouse is actually strongly anti-diet, and states that there are no bad foods - I hope you're all clear on how I feel about that! For those of us who are carbohydrate intolerant, carbs, and especially high-impact carbs, are bad foods, on a purely physiological level. They make us ill, and just as importantly, they make us hungry. It's hard to understand how we're supposed to eat "normally" when we're eating food that is, for us, severely physically addictive. However, this book was written before low carb dieting gained much currency; I'm not surprised that Waterhouse was unaware of the problems that carbohydrates present for many of us.

Waterhouse also states that eating large quantities of anything, even dry salad, will trigger the body to store fat - that the physical fullness-to-the-stretching-point of the stomach tells the body that it needs to store fat. This may well be true; certainly there is some research backing the idea of eating frequent, small meals to lose weight. It couldn't hurt to try eating 5 or 6 low carb mini-meals per day, rather than 3 big meals.

Waterhouse also encourages exercise, and I don't know of a single health, fitness, or weight loss authority who would argue with that. Please keep in mind that adding some resistance exercise - most commonly spelled w-e-i-g-h-t-s - to your exercise program will not only help prevent the loss of muscle mass and the subsequent drop in metabolism, but will also help keep your bones strong. I have recently gone back to doing aerobic weightlifting videos from The Firm, and (one slightly achy elbow, and the occasional flare up of my bad leg not withstanding) am in increasingly good shape. There is simply nothing like resistance exercise.

Once you get past menopause you'll probably find weight control much easier. You'll notice that once menopause is well and truly over, the body seems to give up its hold on the fat cells; middle-aged women tend to be plump, but old women tend to be thin. Indeed, you may find, once menopause is over, that you need to keep your weight up; really skinny old ladies are more prone to osteoporosis, among other things, than women who are a little more substantial, although, of course, being seriously obese will always be dangerous.

So there you have it: Eat low carb, don't starve yourself, divide your food up into several mini-meals, never eating enough to feel really stuffed, get some exercise, particularly resistance exercise - and accept the fact that it's just gonna be tough to be really thin for a good decade or so.

Posted by HoldTheToast at September 18, 2003 04:27 PM