When we get honest about menopause, it’s not the hot flashes and the night sweats  that bother us the most. Not really. Not deep down. It’s the weight gain. Although to  say that it “bothers” us, is like saying bankruptcy is a tad annoying. Despite the body positive message from the last few years, weight gain is still more distressing to women than sleep deprivation, hot flashes, wrinkles, or hair loss. If that’s you, you’re not alone,  and it’s nothing to be ashamed of. 

I think, for many women, the ‘classic’ picture of menopause is more expected — we  know it’s coming. We grit our teeth and deal with the inexplicable waves of heat,  knowing that it’s a phase. Almost a rite of passage, however distressing and disruptive it can be to our daily lives. We know there are solutions for those things, whether it’s diet changes or great supplement formulations, or your grandmother’s witchy tea. There are things that ‘work’. Yes, some women have brutal symptoms — I’m not  minimizing that at all. But in my clinical experience, and in self-reporting studies, the  hardest blow seems to be the weight gain. Especially because it feels out of our control.  In the words of a patient, “I did not give my body permission to do this”. 

Isn’t some weight gain healthy? 

Yes. A year or two into menopause, your only estrogen will be from fat tissue and your  adrenals, in very small increments. This, plus regular physical activity, will help maintain good bone density, better cardiovascular health, and overall resilience. A gain of 10-15 lbs is expected, and healthy. 

When it becomes a problem  

Weight gain of more than 30lb during menopause becomes a health issue, especially if you are already overweight when perimenopause begins. On average, that’s around 40 years old for most women, give or take a few years. Younger than most women think. In fact, if you’re in your mid 30’s, and your diet is more than 10% junk food and treats,  and you don’t exercise very much, and you know you’re already carrying more weight  than you’d like, this is the time to make changes. Trust me, it’s a lot harder when your  hormones start going bonkers. 

Speaking of hormones  

This isn’t just about estrogen. That’s why it’s so hard. There are several hormones wrapped up in this menopausal ride: thyroxine and liothyronine (our two thyroid hormones), serotonin, cortisol, insulin, testosterone, melatonin, and, of  course, estrogen and progesterone. It’s a whole symphony where one out-of-tune  instrument starts throwing all the others out of rhythm. 

Perimenopause (the first hint of hormone change) is really the ideal time to get your  thyroid checked, pay closer attention to sleep hygiene and self-care, and talk to a nutritionist or naturopath about a good hormone-reset diet.  

The earlier the better, but don’t let that stop you. If you’re in the thick of it, or even out  the other side of menopause, it’s never too late to regain some balance, and get a little  control back.  

Nervous system overload..

Weight gain is especially likely if your nervous system is under fire. This is common for  many women 45-55. This keeps cortisol levels high,  making it harder to get glucose out of the blood and into our  cells where it’s used for metabolism. High cortisol is also correlated with lower thyroid  hormones, a big hit to our metabolic rate. Cortisol blocks the secretion of melatonin, so  we don’t sleep well — sleep deprivation messes with brain hormones that control  appetite, and so we constantly crave carbs and don’t get proper satiety signals. Plus we’re too tired to exercise, making it hard to burn calories. The extra weight, under  these circumstances, is not distributed evenly in our bodies — it goes primarily around  the belly (thanks, cortisol!), and starts to line our arteries and internal organs. If only menopause were just about the hot flashes……

So, what’s the solution?  

• prioritize a healthy diet — doesn’t need to be fancy, it just needs to be real ▪ I recommend a Mediterranean-style diet, full of good oils, fish, lots of fresh  veggies, high-fibre fruit, nuts & seeds, a small amount of whole grains, and  lots of herbs. 

▪ Go easy on the coffee — no need to stimulate more cortisol than necessary ▪ Eat smaller meals and leave lots of time between — I’m not a fan of  intermittent fasting, but I absolutely  recommend at least 4 hours between meals so that your body has to burn  stored fuel. Also, stop eating by 6pm if possible — if you need a nighttime  snack, have protein. 

• lower cortisol levels 

▪ one of the beautiful things about menopause for women is  the realization we come to about all the stuff we’ve put up with our whole  lives — the little things that we can now choose to let go of 

▪ better stress management, for all of the things we can’t let go of (like caring  for an elderly parent) — even just 15 minutes of deep breathing and  stretching a couple of times a day will go a long way to dropping cortisol • get active 

▪ whatever works: take a dance class, a Zumba class, a yoga class, go running,  swim, hike, kayak, walk, go to the gym… whatever it is, do something every day, for at least 15 minutes. Yup, that’s right — every day. 

▪ do NOT, under any circumstance, think of this as burning calories for weight  loss… this is about bringing your whole system back into balance, so stop  stepping on that scale every time you come back from a run!! You will make  yourself crazy. 

• lastly — see a naturopath, nutritionist, or herbalist — I would recommend a  combination of these 3 things, as your essentials: 

▪ liver support — there are metabolic pathways in the liver that modify excess  estrogen and testosterone, making them easier to excrete, lowering the  hormonal burden — and wow, what a difference that makes

▪ eliminate or significantly reduce coffee, sugar, refined carbs, and ultra processed foods (really, we should ALL be doing this)