Calories in, and calories out are not enough to maintain or lose weight. There is some truth to this statement, however, when you reach the menopausal stage your hormone levels begin to change. These hormonal changes will alter your body in how you store fat, where you store fat, and how quickly you can lose fat. It is a stage of a woman’s life that we all have to go through.
Hi everybody my name is dr mary claire haver and i am the creator and founder of the galveston diet i am a board-certified medical physician medical doctor i am a board-certified obstetrician-gynecologist and i am also certified in culinary medicine from tulane university i am coming to you today to talk to you about hormones menopause and weight gain i get
This question a lot and i have actually it’s so complex and it’s so multi-dimensional i’ve been doing tons of research on this and it all kind of feeds together with what i already preached but you know i wanted to specifically today just touch on if those of you who are going through the menopause transition and feeling a little crazy that there’s something
Wrong with you and you don’t understand it and no one seems to be able to explain why i want to give you a little bit of clarity as to what is going on with our bodies at this age um i’m going to walk over here and let my dog out who’s crying all right rex there you go buddy good boy sorry real life here i’m at my house um okay so um so what’s happening so
If you i’m going to give you some stereo scary statistics first um this is coming from uh the it’s a menopause review it’s called obesity and menopause our negligence or an unfortunate inevitability so if you take a woman who is normal weight and considers herself to be pretty healthy and you you take her through that seven to ten year menopause transition
Process from you know stone cold normal to going through the process which takes seven years on average all the way to the end you spit her out at the end where her ovaries are shut down and she’s got nothing if she does not change the quality of her nutrition how how and where and when she’s moving her exercise if she keeps everything the same even though she was
Normal weight and completely healthy before here’s what’s going to happen at the end she will gain weight she will replace muscle with fat and it’s going to go into places she’s never had it before she’s going to take that peripheral fat and there will be a change from what’s on her hips and thighs and shifting to more of belly fat or the fat deposit and or the
Fat deposited around your visceral organs okay that fat is dangerous the the subcutaneous fat is cosmetically distressing but it’s not that dangerous other than it can be harmful to our third you know arthritis hurts your hips and knees if you have a lot of it but it doesn’t create an inflammatory environment like the visceral fat does so what what happens to us
You know so definitely you know there’s there’s newton’s law of thermodynamics calories in his calories out and that by and large has a lot of truth to it and actually it was what i was taught in medical school it’s all i was ever taught but modern obesity research is proving that that is just not actually the answer when you look at people who try as hard as they
Can all the willpower in the world they calorically restrict it is not enough for them to maintain weight or them to lose weight now when you’re younger actually calories in calories out works pretty well i did it for years and it was great um however when we start throwing in the gut hormone changes the visceral fat the hormone changes suddenly these hormones are
Playing more of a factor hormones determine where you store fat how you store fat when you break it down and it hormones also drive our hunger and our society that has nothing to do with calories nothing so i want everybody to understand that there’s a huge emotional physiological biochemical part of where and how and how much fat we store that is hormone driven
And when as women and i’m talking to specifically women here who are roughly my age i’m 52 years old when we go through these menopause changes those things get compounded so scary statistics time so this is um from a menopause journal obesity and menopause it’s a polish journal but it was translated in english and it’s phenomenal um so when you look at women in
The u.s okay menopause is defined as um okay the prevalence here we go the incidence of obesity in the united states among women from 40 to 65 years old is calculated as 65 of us that is a dramatic increase from pre-menopause then for women over the age of 65 it’s as high as 74 percent three-fourths of us are morbidly obese at the end of menopause and many many
Many many many of those women were normal weight before or close to normal weight we see an average weight gain of 15 pounds through the menopause transition that is not willpower that is not calories in calories out that is your body your metabolism your hormones are changing so one of the things i want to do is educate you you know through the galveston diet
My program and everything is you know what’s happening to your body so you understand you’re not crazy this is real what those changes mean to you and what you can do nutritionally to hack those things to try to get your best outcomes so you don’t end up as one of those statistics and it’s very very doable i’ve got 42 000 students enrolled in the program now and
They’re killing it okay um so we look at there’s two kind of two areas of hormones that you need to focus on one affects everybody at every age at all times but it does tend to ramp up as we age with the aging process alone that is insulin that is cortisol that is leptin that is ghrelin then some other hormones like cholecystokinin neuropeptide y there’s several
There’s about eight or nine that i do a deep dive into um in the in the hormone research that i’ve been doing so but the two biggest ones you need to think about are are the four are insulin cortisol um leptin and ghrelin so insulin is what drives the glucose to be shifted and stored as fat um it also helps control hunger it helps control satiety and the
Incidence of insulin resistance in this country is huge several of you i know out there have been diagnosed with borderline diabetes or insulin resistance and there’s definitely a huge nutritional component to that so instead of just counting calories in calories out in the galveston diet we set our calories at somewhere around 1500 a day so a little less some
Days we focus on the quality of the nutrition you’re eating we focus on macronutrients we focus on micronutrients we focus on the things that are going to improve our insulin resistance through nutrition we focus on the things that are going to lower our cortisol levels through nutrition and exercise and meditation and stress relief we also looked at you know
We do a really deep dive into leptin and ghrelin so leptin is created in fat cells and it is the hormone that tells your brain you’re full stop eating that system is broken in a lot of us and it gets way more broken as we gain weight and get more of this visceral fat um so you never get the signal to stop eating it drives you to eat no amount of willpower can
Overcome an evolutionary drive yeah you could starve yourself but you are you know being manipulated by these hormones and my job my goal is to make sure your calories are where they need to be of course you know so you’re not starving but really to educate you as to what what we’ve been missing all these years the quality of the food looking at a hard dive and
Macronutrients not all carbs are created equal you’ve got a you know complex carbohydrates legumes whole grains that’s the way to go getting rid of the simple sugars getting rid of the things that are so so so addictive and do nothing but dry fat to your viscera drive do to get more belly fat and make all of the things that aging is doing to us worse so you end up
In this vicious vicious cycle my job my goal is to break the cycle so i invite you to break up with calories think differently think about the quality of the food think that you are hacking your own hormones to make them work better for you because as women at our age we have the gut hormones what i talked about now we’re going to talk about estrogen and what’s
Going on with that so in the perimenopausal period and give me a thumbs up or a wave if you guys are there right now so um our it’s like mr toad’s wild ride we have dramatic fluctuations of estrogen and along with that with our androgens which are interesting diode and testosterone we have a little bit of that way more than oh thanks for the thumbs up everybody
Okay so through the perimenopuzzle period all of a sudden we kind of had a steady state we had little fluctuations throughout the month normal cycle stuff and then we go through perimenopause and it’s like and our brain is like whoa what’s going on it can’t figure out what’s happening so you start having hot flashes you start having lots of metabolic changes you
Start having more brain fog you know risks are going up so then as we end as the estrogen levels start really really dropping your brain is like whoa where’d the estrogen go we need more it’s programmed to do that so it creates a hormone in the hypothalamus called follicular stimulating hormone and luteinizing hormone these are the hormones that are supposed to
Tell the ovaries get busy but our ovaries die okay our ovaries have shut down they’re not doing anything so it goes those those fsh and lh follicular stamina hormone and luteinizing hormone say hey anybody else out there in the body we need estrogen so the adrenals get stimulated a little bit other parts of your body get stimulated and we have a relative rise in
Our androgens okay in our male hormones there it’s not a huge rise not like a man’s level but we have a relative rise and there’s no estrogen on board to counterbalance it so estrogen is or very little estrogen comparatively estrogen is what drives the fat deposition in our hips and thighs that is called gynoid fat distribution is what makes a woman kind of curvy
And look like a woman we shift some of that fat over to the viscera and to our abdomen inflammation levels start skyrocketing and you start getting into the vicious cycle the relative rise of androgens which is unopposed with estrogen so we have this this androstenedione testosterone abundance we’re not used to leads to lots of things increase that’s when a
Woman’s risk of cardiovascular disease approaches a man that’s when we see her starting getting visceral fat and belly fat where she never ever had it before um that that sorry i had a call i thought i had it on sleep but whatever um that is what is driving this so you end up in this male-like pattern of hypertension heart disease metabolic disease all of it
Which makes us really really ill so when they look at weight gain in a woman in perimenopause and menopause they can actually break down they put people through the densiometers and they can measure how much hip fat you know hip and thigh fat versus visceral fat so a woman who’s gaining this weight through menopause will gain some in her hips and thighs again
But will have a much greater gain and the visceral fat where she never had it before and that’s what i’m focusing on that’s what i’m trying to bring down to get you out of this vicious cycle to break the inflammation cycle because that visceral fat is inflammatory that visceral fat creates cytokines not the fat on your hips and thighs the fat in your abdomen
That visceral fat is linked to all the disease states hypertension heart disease relative risk of cancer increase all of it all of it all of it we can start to reverse some of this with good nutrition exercise and stress reduction it can happen it’s happening it’s happening with our students they’re going to the doctor their labs are amazing their weight’s down
They’re getting you know high fives and woohoo’s at the doctor’s office and like hey you must have had a major nutritional change they’re like actually i did and you know it’s it’s all very very very doable so whether or not a woman should go on hormone replacement therapy here’s some important news if you’re going to do it one it’s an individual discussion with
Your doctor okay it’s not a one size fits all you have your own genetics you have your own environmental factors you have your own health where you are right now it’s a risk benefit ratio but if you’re going to do it you need to do it sooner rather than later if you start hormone replacement therapy older once you’re already through menopause it’s not helpful and
It might even hurt so if you’re going to consider hormone replacement therapy because your ovaries have shut down or been surgically removed go talk to your doctor but you need to do it sooner like in your 40s don’t wait until you’re post-menopause because the sooner you get started you actually when they look at women who are on hrt hormone replacement therapy um
Through the perimenopause and then look at their visceral fat and look at their body fat they actually do better they don’t have as much inflammatory markers in their blood their weight is a lot more stable they don’t have the obesity levels so i’m not saying it’s for everyone there are women who absolutely should never take a hormone as long as they live but it’s
Something to think about so um anyway that combined and but don’t leave nutrition out of the nutrition and exercise you’ve got to be doing weight-bearing exercise to keep the musculoskeletal unit small because what else is going on we’re losing our muscle we’re losing our metabolism just with age a woman will lose five percent of her metabolic rate per decade
Guys it’s all working against us we really weren’t meant to live this long we’ve artificially extended our lifespans but so you gotta like you gotta go in big you gotta go big or go home if you wanna be if you want to age well if you want to be healthy as you age enjoy your life enjoy your grandchildren enjoy you know your relationships and not be feeling poorly
Not dragging this extra weight around not be on all this medication it’s doable it’s very very doable but you need a sound nutritional program and that is what i feel like my purpose in this world is at 52 years old is to educate people as to the best nutritional profile for us y’all are just like me a woman in midlife who’s just okay guys i’m getting multiple
Calls i gotta go um hopefully you guys enjoyed this and um you learned something take care
Transcribed from video
Weight Gain, Hormones and Menopause By Mary Claire Haver MD
