Menopause without Weight Gain
The 5-step solution to manage your changing hormones
DEBRA WATERHOUSE, MPH, RD

Dedication

To my sister and best friend

Lori Waterhouse Erwin

who radiates beauty inside and out

Contents

Cover

Title Page

Dedication

Attention All 35- to 55-Year-Old Women: Why You Should Read This Book

Chapter 1: So That’s Why I’m Gaining Weight!

The Life Cycle of a Female Fat Cell

When Fat Cells Turn 35

When Fat Cells Turn 45

When Fat Cells Turn 55

Fat Cells Are Your Menopausal Helper

Taking the ‘Men’ Out of ‘Menopause’

Chapter 2: What Type of Midlife Fat Cells Have You Got?

Fat Cells Prematurely Forced into the Menopause

Postpartum Fat Cells Entering the Menopause while Breastfeeding

Genetically Overactive Fat Cells

Fat Cells on Hormones

Unfit Fat Cells Under Stress

Fat Cells with a Long History of Dieting

Chapter 3: The Meno-Positive Approach to a Trimmer Transition

Teaching 35- to 55-year-old Fat Cells New Tricks

The Seven Habits of Highly Successful Menopausal Women

Repeat After Me: I Am Not on a Diet

Throw Away Your Scales, But Not Your Common Sense

A Tale of Two Menopausal Women

Chapter 4: Acquiring Meno-Positive Attitudes

The Menopause Is Not a Disease to Be Treated; It’s a Transition to Be Experienced

The Placebo vs The Nocebo Effect

Managing Your Midlife Weight Crisis

Diet Humour: Gaining a Whole New Perspective

In Menopause We Trust

Chapter 5: Mastering Meno-Positive Fitness

Starting with a Clean Exercise Slate

Take a Break from Walking

It’s All in the Timing

Hustle to Build Muscle

Exercise Smarter, Not Harder

How About a Little Floor Play?

Chapter 6: Embracing Meno-Positive Eating Habits

Tap into Your Body of Knowledge

Neither Starve Nor Stuff

Downsize Your Meals, Upgrade Your Snacking

Emotional Eating vs Eating Emotionally

It s Mind Over Platter

Chapter 7: Maximizing Meno-Positive Food Choices

Do You Have a Fat-Free Chip on Your Shoulder?

Mind Your Menopausal Food Cravings

Eat Your Oestrogen

Wet Your Appetite

Eat Well for ‘A Change’

Chapter 8: Living A Meno-Positive Lifestyle

Live Today Less Stressed

Mindful Menopause: New Age Medicine for Middle Age

The Pursuit of Hormonal Happiness

Your Midlife Checkup

Lifestyles of the Relaxed and Fearless

Chapter 9: It’s Not Over til the Fat Cell Sings

What Does a Healthy Midlife Woman Look Like?

Patience, Perseverance, Perspective

When the Transition Is Over

Thank You, Fat Cells

Appendix A: Meno-Positive Eating Records

Appendix B: Additional Resources

Appendix C: Suggested Reading

Biblography

Index

Acknowledgements

About the Author

Also by the Author

Praise for Menopause without Weight Gain

Copyright

About the Publisher

The advice in this book is not intended for persons with chronic illnesses or other conditions that may be worsened by an unsupervised eating and/or exercise programme. The recommendations are not intended to replace or conflict with advice given to you by your doctor or other health professional, and we recommend that you do consult with your doctor. The author and publisher cannot be held responsible for any results arising from use or application of the information in this book.

Except for those who have given permission to appear in this book, all names in this book have been changed. In some cases, composite accounts have been created based on the author’s professional experience.

Attention All 35- to 55-Year-Old Women: Why You Should Read This Book

Menopausal weight gain – it’s real, it’s necessary and it’s the most stubborn weight gain you’ll ever experience. It’s more stubborn than the weight you gained during pregnancy, and it’s as essential as the weight you gained during puberty. It also starts when you’re younger than you’d ever imagine and lasts longer than you’d like.

You may be in your mid-thirties when the first few pounds mysteriously appear regardless of how little you’ve eaten or how much you’ve exercised, in your mid-forties when you come to the disheartening realization that your waist is 2 inches wider and your body is a full size larger, or in your mid-fifties as you wonder if and when it’s ever going to stop. Whether your midlife weight gain is just beginning or finally tapering off, you are among the millions of frustrated women who are crying out for help with their expanding waistlines and changing bodies.

This book is the answer to your universal cry for help – providing the knowledge, understanding and solutions necessary to manage this mysterious weight gain and outsmart your ‘midlife fat cells’.

If you are in your mid-thirties to early forties, your initial reaction may be one of shock and resistance: ‘But I still have my periods and I don’t have hot flushes! I can’t possibly be in midlife! I’m too young to be menopausal!’ The average woman lives to be about 80 years old, so the midway point is age 40 – marking midlife. And, although you are probably too young to be menopausal, you’re not too young to be just entering the transition to the menopause – or, as it is called now, the perimenopause. The menopause is the clinical term used to mark the end of your menstrual cycles, but the perimenopause refers to the years surrounding that event. Not just a couple of years, or a few years, but up to 20 years beforehand. Research is finding that this transition starts in the mid-to late thirties for most women and ends in their mid-fifties. That’s one quarter of our lives!

But most women still think that the menopause involves only a two-to four-year transition. While it’s true that the most intense part of our transition lasts a few years, the initial changes begin more than a decade earlier when ever-so-slight hormonal changes affect your periods, moods and weight. Your premenstrual symptoms begin to transform from moderate tension to ‘PMS from hell’, your mood swings start to become mood sweeps, and your body shape progressively changes from an hourglass to a beer glass. You may have struggled with your weight before, but now the pounds accumulate without any appreciable change in your eating or exercise habits. If you are experiencing a change in your body shape, then you are in the perimenopause and need to work with that reality.

The truth is: Your body changes before you technically enter ‘the change’, and your 30 billion female fat cells enter the menopausal transition before you do.

Each and every one of us has 30 billion fat cells, and a few years ago research finally validated what we had long suspected: fat cells have gender. A woman’s fat cells are physiologically different from a man’s. They are larger, more active and more resistant to dieting. And based on that long-awaited research, I wrote my first book, Outsmarting the Female Fat Cell, to provide a non-dieting solution to weight loss that works with a woman’s fat-storing physiology. At the end of Outsmarting the Female Fat Cell, I cautioned women that when they reach the perimenopause, they will most likely have to outsmart their fat cells again.

Well, now you’ve reached that transition, and once again research is starting to surface to provide a physiological explanation for why female fat cells grow even larger and more stubborn during midlife.

Here’s a brief explanation: As soon as your fat cells detect a slightly lower oestrogen level, they come to your aid to produce oestrogen for you. (Fat cells producing oestrogen? This may surprise you, but it’s one of their highly evolved functions.) They know that eventually your ovaries will stop producing oestrogen, so they start preparing to take over the ovaries’ job. They increase their size, number and ability to store fat. Interestingly enough, the fat cells in your waist grow the largest because they are better equipped to produce oestrogen than the fat cells in your buttocks, hips or thighs. The larger and more active your abdominal fat cells become, the more oestrogen will be produced, and the more benefits you will receive: fewer hot flushes, milder mood swings, less intense PMS, improved sleep, a reduced risk of osteoporosis and an overall easier transition. This is why larger women have always reported less menopausal stress, while leaner women have the most difficulty with the transition.

Ironically, the very weight gain we abhor is actually beneficial for us. While we are waging war against our fat cells, they are looking out for our menopausal well-being.

You deserve to know, understand and accept what’s happening to your body and why it has to happen. You also are entitled to learn how to work successfully with your fat-storing physiology to achieve a healthy weight and a fit body.

Why hasn’t anyone told you this before? Because most people, including health professionals, don’t know. Hundreds of books about the menopause line the shelves of the women’s health sections in bookshops, yet I couldn’t find one that explained midlife weight gain physiologically or offered the guidance to manage it effectively. Instead, menopausal weight gain has been viewed as a part of the ageing process and a result of eating too much and/or exercising too little. So the standard recommendation has been to eat less, exercise more, and diet harder to lose weight.

The harder you try to lose weight by dieting, the more powerful your menopausal fat cells will become, and the more weight you will gain. Diets don’t work for most women regardless of age, but for menopausal women diets have close to a 100 per cent failure rate. Even on an 800-calorie-a-day diet, your fat cells will refuse to shrink and will fight back by growing even larger. Fat cells have an important mission – to manufacture oestrogen and balance your body during the transition – and they will do everything possible to make sure that they don’t let you down.

If fat cells are invaluable for helping to ease the transition, then why are women reporting more menopausal discomfort, hot flushes and forgetfulness than ever before? The headlines have informed us that obesity is on the rise and that women weigh more than ever, so what’s going on? Are fat cells sleeping on the job? Have they lost their ability to produce oestrogen?

Our fat cells are not responsible; we are. We are preventing them from doing their job by interfering with their mission. Since puberty, we’ve dieted. We’ve skipped meals; skimped on carbos, fat and sugar; and subjected our bodies to fasting, fad diets, liquid diets and diet pills. Our fat cells have been so busy fighting our drastic weight-loss attempts that they don’t have the energy or resources left to manufacture oestrogen and bring our bodies back into balance. Our fat cells are stressed out, and as a result we’re experiencing what I call ‘megamenopause’.

Our transition is magnified compared to generations past. We are gaining 50 per cent more weight than our mothers did, and our transition is 500 per cent longer. We have more hot flushes, more memory loss, more insomnia, more everything. And most of the blame goes to dieting. Our mothers may have experimented with a few diets, but we declared dieting our lifelong career.

Most women who are in midlife today started dieting in their teens and have been on at least 15 diets, losing and regaining the same one, two or three stone. Each time we dieted, our oestrogen levels dropped and our Cortisol levels (one of the stress hormones) rose. After years of yo-yo dieting and yo-yoing hormones, our systems eventually wore out. The result: a longer transition, a more severe experience, and more weight gain.

Needless to say, this is not a book that outlines a ‘diet’ to lose weight, nor does it guarantee getting your 20-year-old body back. This is a book that guarantees a full understanding of your female body during this important transition in your life – and guarantees that you will not gain more weight than is necessary and healthy for you.

This ‘minimizing weight gain’ approach would not make it on the info-mercial circuit or the cover of a tabloid, but that’s not my goal. Instead, my goal is to help you find your new natural healthy weight, prevent too much weight gain, lose weight if you’ve already gained too much, and accept this important and fascinating stage of female passage. If you don’t accept it but choose to fight it through dieting, you’ll only gain more weight, negatively influence your health and have a more difficult transition.

As a registered dietitian in private practice, I have been counselling women for over 16 years, and no other group is more confused and frustrated with their weight as those in the perimenopause. I’ve witnessed the pain they are in, but I have also witnessed the relief they feel when they come to a full and uncomplicated understanding of why they are gaining weight and discover what they can do to manage it realistically.

In the following chapters I will share with you what has been instrumental in helping over 2,000 of my clients. Through years of analysis and research (and a little bit of trial and error) I have uncovered the attitudes and habits necessary to outsmart midlife fat cells. I call it ‘The Meno-Positive Approach to a Trimmer Transition’. As your body is changing during the transition, your attitudes, eating habits, exercise habits and lifestyle have to change along with it. By working with your new menopausal physiology, this plan highlights the positive actions you can take to keep midlife weight gain to a minimum (or lose weight if you’ve already gained too much), while at the same time allowing your fat cells to produce oestrogen and bring your body back into balance. To accomplish this goal, the Meno-Positive Approach targets five essential steps:

1 Acquiring meno-positive attitudes. Your feelings about the transition, your body and your weight affect your experience. Those women who have the most positive attitudes going into the transition have the least amount of weight gain and other potential problems by the time they come out of the transition. I’ll help you initiate a positive attitude for your change in life, embrace your body changes and manage your midlife weight crisis without dieting.

2 Mastering meno-positive fitness. Exercise is second only to attitudes in how you transition through the menopause. Those women who exercise regularly gain only one half the weight of those who are sedentary, but your exercise programme must be tailored to work specifically for the menopause. I’ll show you how to lose fat, gain muscle, increase your metabolism, strengthen your bones and make your midlife fat cells fit.

3 Embracing meno-positive eating habits. How you structure your eating, when you eat, how often you eat and how much you eat can either cause more fat storage or less. Because menopausal women are highly efficient fat-storers, we must modify our eating behaviour to match our new midlife metabolism.

4 Maximizing meno-positive food choices. What you eat can also affect your transition and how much weight you gain. The focus is not on reducing calories and fat, it’s on increasing phytoestrogens (plant sources of oestrogen), responding to your food cravings, and trusting your body’s food messages. You’ll learn how to eat well for ‘a change’ – for managing hot flushes, fatigue, sleep and mood swings.

5 Living a meno-positive lifestyle. In addition to eating and exercising, other lifestyle choices can positively affect your midlife years and your weight. Taking care of your body, managing stress, setting aside time for relaxation or meditation, and adding laughter and happiness to your life can all have a powerful effect on how you feel and function each day.

By focusing on fitness instead of thinness, you will minimize weight gain while maximizing well-being. With the Meno-Positive Approach, you will replace negative attitudes and habits with positive ones, and learn how to:

• boost your metabolism, recharge your battery and feel your best

• tame your fat cells, call a truce with food and triumph with fitness

• throw away your scales, but not your common sense

• give up dieting, but not your desire to be healthy, fit and strong

• let go of control, but not your commitment to taking care of yourself

After years of trying to control our female bodies – our emotions, weight, body shape, eating habits and food intake – many of us now strive to control our bodies during the menopause and remain unchanged during a time of immense change. We want to prevent the menopause like we want to prevent osteoporosis, heart disease or breast cancer. Well, it can’t be prevented; it can only be experienced.

When women are asked the rhetorical question, ‘If you had a choice, would you rather not go through the menopause?’ most answer ‘No.’ We’d have to worry about contraception, cramps, tampons, pads, PMS, water retention, childbearing and child-rearing for the rest of our lives. We instinctively know that the menopause keeps us healthy and alive. So let your body transition to the menopause and allow it to find it’s new natural weight. It’s only trying to help you find a healthy balance for the second half of your life. Give your body the freedom to find that balance and it will give you back so much more.

In this thin-worshipping, youth-orientated society, it may initially be difficult to take this positive, accepting approach. But if you don’t you will only gain more weight and become more weight-preoccupied.

Haven’t you spent enough of your life going on and off diets and feeling uncomfortable with your body? I always thought growth and maturity were supposed to free us from these superficial obsessions, but that’s not what’s happening. As we enter the transition to the menopause, we are becoming more weight-preoccupied and food-obsessed. Think about it: women are entering the perimenopause at an astronomical rate. Every day thousands of women embark on the journey, and millions are gaining an average of 12 pounds – that’s millions of pounds of cumulative weight gain and millions of pounds of weight-preoccupation holding us down. We’re already seeing the negative signs of this mass body dissatisfaction. Menopausal women represent one of the fastest growing segments of the population with eating disorders, and one of the fastest growing consumers of prescription diet pills. Here’s another telltale sign: Researchers were funded last year to study women who have a positive body image during the menopause and how that affects their transition, but they couldn’t find enough women even to start the study!

Negative attitudes towards our bodies during the menopause started in the 1950s, when some doctors actually treated midlife women with tranquillizers. Then in the 1960s, from the best-selling book Feminine Forever we learned from a gynaecologist that the menopause was an ominous marker of lost youth and a disease of oestrogen deficiency. Unfortunately, this way of thinking continues today. A recent survey found that 53 per cent of women consider the menopause a medical condition that requires treatment. If you are one of those 53 per cent, I hope that this introduction has triggered you to question your attitude and that the rest of this book will turn you completely around. The menopause is not a disease to be treated; it’s a natural transition to be experienced.

Is puberty a disease? No. Is pregnancy a disease? No. Puberty and pregnancy are healthy stages of female passage – and so is the menopause. Like puberty, the menopause is a shift in hormones, but in reverse. With the exception of hot flushes, the menopause is the mirror image of puberty – and, like puberty, the transition will end. Weight will stabilize, moods will even out, and thinking will clear. You got through puberty without the benefit of years of wisdom and maturity. You’ll get through the menopause more smoothly if you let your wisdom and maturity guide you.

We can take a more positive approach to the menopause and the weight-gain associated with it, and we can change the way society views the menopause. We’ve had a positive impact on society before, and we can do it again. As we moved through the previous stages of female passage, we changed them. We changed society’s view of menstruation and PMS. We altered the birth control and childbirth industry. Now, we have an even stronger collective voice to change society’s outlook on the menopause.

But how will we change it? Will we keep dieting, fighting our bodies and trying to defy biology? Or will we keep demanding research, going to conferences, surfing the Internet and reading books to gather knowledge about what our bodies need to do during this important time in our lives?

My guess (and I’d bet a million dollars that I’m right) is that we will be proactive information-gatherers rather than self-destructive fighters. It’s a part of who we are. When I shared with my husband that I thought I was entering the midlife transition with my mega-PMS and change in body shape, he jokingly said to me, ‘My advice, Deb, is to take it like a man. Just grin and bear it, and forget about it.’ Knowing he was trying to get a rise out of me, I immediately retorted, ‘No, I’ll take it like a woman. I’ll question it, research it, talk to my doctor about it, talk to my mother about it, talk to my friends about it, then talk about it some more to understand and manage it the best I can.’

This book will give you all the research, education, facts, understanding, guidance and solutions you’ll need – so that we can all manage midlife weight gain and take the menopause ‘like a woman’.

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