Sergio Jaziz Becerra/Agencia Reforma
Saturday, 13 May 2023 | 07:05
Monterrey.- When the middle-aged women who struggle with their weight come with Sylvia Gonsahn-bollie to her Silver Spring, Maryland, office, she says the truth: “No todo está en tu cabeza”.
And that the challenges are real. For both men and women, weight reaches its peak between 40 and 65 years old, as muscle mass is lost and metabolism slows down. However, in them the hormonal changes related to the transition to menopause make things worse, say doctors and researchers.
Hormone therapy, along with training and diet changes, can help.
Many women between 40 and 50 years old notice that their weight starts to rise, even if their routines are the same, and that it becomes more difficult to lose weight. From then on, women increase by an average of between 360 and 680 grams a year, says Daniela Hurtado, obesity specialist at the Mayo Clinic in Jacksonville, Florida.
Hormonal changes during the transition to menopause, which generally start at 40 years old when the menstrual cycle becomes irregular, are associated with an average weight gain of 27 kilos, says Kathleen Jordan, director of Midi Health, a health clinic virtual care for women over 40 years old.
The estrogen problem
One of the culprits is the decrease in estrogen that occurs with menopause. The reduction is related to changes in the way women’s bodies distribute fat, with greater accumulation in the abdominal region, instead of muscles and hips.
The decrease in estrogen levels is also associated with lower insulin sensitivity and high cholesterol levels, which makes it difficult for women to maintain a healthy weight and put them at risk of developing type 2 diabetes, says Jordan, from Midi Health .
The studies have highlighted the importance of estrogen in weight control. A study centered on women over 40 years old found that those who took medication to prevent their ovaries from producing estrogen for 24 weeks gained more than 1 kilo of fat.
Some research suggests that estrogen influences your motivation to exercise. It was found that women with estrogen had more vigorous physical activity than those who took drugs to suppress estrogen.
“This suggests that there is a biological factor behind the weight gain of women at the middle age and it is not just what they choose to do”, says Wendy Kohrt, professor at the University of Colorado in Aurora.
The decrease in estrogen aggravates the loss of muscle mass as you age. Calories are burned in the muscles, so as muscle is lost, fewer calories are burned at rest and until active, says Ekta Kapoor, professor at the Mayo Clinic in Rochester, Minnesota.
Risks for health
The changes in the metabolism and the body of women during the transition to menopause also pose a greater risk of suffering complications such as high blood pressure and cholesterol.
A study reviewed more than 600 women after eating a food rich in fats and carbohydrates and during two weeks. Perimenopausal and postmenopausal women have worse metabolic health than premenopausal women, including higher levels of cholesterol and blood pressure, as well as glucose and insulin resistance. Even among women of the same age, premenopausal women had better results than those who were in perimenopause or more, says Sarah Berry, professor at King’s College London.
What to do?
For women who fight against weight gain at the middle age, doctors say that hormonal therapy can help, a form of estrogen that is usually taken with progesterone and that is approved for symptoms such as “bochornos”.
There is evidence that this can reverse the redistribution of fat to the abdomen during menopause.
Hormonal therapy can also relieve symptoms such as trouble sleeping and the mood that contributes to weight gain. However, this therapy alone will not prevent weight gain. Women also need to stay active and add strength training. Weight lifting and other ways help fight muscle loss.
To combat accumulation in the abdominal area
– A workout at high intensity intervals. To lose but not recover, you should try to do 150 minutes of exercise a week, although most people need between 300 and 420 minutes, says the expert.
– The changes in the diet also help. Add proteins and reduce sugar. Eating more fiber will help raise cholesterol levels, as well as slow down digestion, which can make you feel fuller.
– Controlling stress is also part of weight control, according to Gonsahnbollie. Stress raises the hormones cortisol, which increases insulin resistance and makes weight loss more difficult.
