Doomed to Get Old and Fat?

Last Editorial Review: 10/19/2004

Exercise Plus Fewer Carbs - That's What Works After Menopause

By Jeanie Lerche Davis
WebMD Weight Loss Clinic - Feature

Reviewed By Kathleen Zelman, MPH, RD, LD

Sad to say, we all put on weight more easily as we get older. Women are especially prone to get a bigger waist. But it's not inevitable.

Exercise and estrogen seem especially key in winning the war against late-life obesity, says Lila E. Nachtigall, MD, a reproductive endocrinologist and director of the Women's Wellness program at New York University School of Medicine in New York.

Studies have shown that in their reproductive years, women put on weight in their hips and thighs, which helps keep their cardiovascular system healthy, Nachtigall tells WebMD.

Whether menopause causes weight gain or not or if it's merely a factor of aging is a hotly debated issue among medical experts. But what's not debated is that menopause changes where you put on the fat and can make it more difficult for you to lose it.

"At menopause, women begin to put it on in the abdomen, the waist, and that's not good for cardiovascular health," she says. "That leads to [high blood sugar or] insulin resistance [a sign of diabetes], and that leads to more of that type of weight gain." Weight gain after menopause is also associated with high cholesterol, high blood pressure, and breast cancer.

What women don't realize is just how poor our body's ability to burn fat becomes as we age. We tend to have less muscle that burns fat less efficiently for energy. Research suggests that some of the fat-consuming efficiency of muscle tissue further declines with the decrease in estrogen production following menopause.

So What's a Woman to Do?

Try hormones. An interesting finding: women taking estrogen tend to get more lean body fat, which is better for her health, says Nachtigall. One very recent study found that after taking a combination pill with estrogen and progestin for a year, 90% of the women were the exact same weight as when they started the replacement therapy. But most experts don't recommend taking HRT just to promote a healthy weight.

Pump iron. Beyond HRT, exercise is the best way to keep weight under control. In fact, experts believe it's probably more important than diet in curbing weight gain, Nachtigall tells WebMD. "The more the better," she says.

Experts recommend regular aerobic exercise such as walking briskly 30 minutes a day, five days a week. And, just as important, add weight training to increase muscle mass. The more muscle you have the more calories your body can consume.

Eat ... and drink right. "I think [a diet of] low-fat, low-process carbs -- what I call the white carbs -- a little higher in protein, fruits and vegetable kind of carbs [is best,]" says Natchigall. She advises against soy supplements advertised as weight-loss aides. "They're very high in fat. You can't get the fat out of the soy. You'll faint if you read about their fat content. Soy is an oil, and extracting it takes an oil." Soy milk is also very high in calories, she says. And, cut back on the alcohol. Drinking is more closely associated with weight gain than menopause itself.

Open the lines of communication. Talk to your doctor. He or she may be able to advise you on a weight loss/nutritional plan and evaluate you for other medical conditions such as a thyroid problem that may be leading to your weight gain.

Most importantly, be yourself. Recognize that you are no longer 20 or 30. Focus on maintaining a healthy weight rather than fitting into those old jeans.

Originally published Oct. 7, 2002.

©2002 WebMD Inc. All rights reserved.

Health Solutions From Our Sponsors