Weight Loss in Perimenopause

What can I do to lose the weight?

The short answer: eat more protein and go to the gym. Ok, that’s a bit simplistic but a good start.

Eat protein

I think women chronically undereat protein. Many still think that as we get older we need less protein, but the opposite is true. In fact, latest research shows that perimenopausal and post-menopausal women should aim for at least 1.8-2g of protein per kg of body weight – obviously substantially higher than the RDI of 0.8g (Sims et al, 2023). This means that you need to have at least 30-35g of protein per meal plus some additional snacks. That’s a lot of protein to eat and we can explore how to do that during an appointment.  

But why do we need to eat so much protein, especially when it comes to fat loss?

• It helps us build new muscle through muscle protein synthesis

• The amino acids that make up protein are needed for muscle tissue repair after exercise

• It helps us lose fat. When the body is in a calorie deficit, it breaks down either fat or muscle. When there is enough protein around, the body breaks down fat instead of muscle.

• Protein burns more calories through digestion (thermic effect of food)

• Protein increases satiety to prevent overeating

• Preserves muscle mass for a strong metabolism 

Build muscle mass

As mentioned in my blog on weight gain, muscle is the largest site of glucose uptake, so the more muscle we have, the more sugar is removed from our bloodstream after meals (Merz & Thurmond, 2020). This leads to better blood sugar control, lower insulin levels and reduced fat storage. Muscle is a metabolically active tissue, which means that it burns calories even when you are inactive. A strong metabolism leads to weight loss.

You might notice that the numbers on your scales don’t necessarily move much when you put on muscle, but you will notice that your clothes fit better, that your waist circumference reduces and that you look leaner and more toned. Throw out your scales, get a measuring tape instead and look for those changes!

And how do you build muscle?

• Resistance training – there is no way around it, you need to lift some weights (and not just light ones!). This has so many other benefits too, especially for bone health. More about this in another post!

• Pilates/yoga – both help to build some lean muscle and they are great for core strength and improving balance

• HIIT (high intensity interval training) – this helps build and maintain lean muscle too, plus it can help with improving insulin sensitivity and reducing visceral (tummy) fat

Nutrient-dense and regular meals

Another thing many of us do, especially when we want to lose weight, is skip meals or don’t eat enough when we do eat. I’m no exception although I have been actively trying to reverse this. What we need to realise though is that we need food to ensure that we get all the vitamins and minerals needed for energy production, fiber for satiety and gut health, and protein to support the afore mentioned muscle building process. When we undereat, we actually slow down our metabolism, which means we burn less calories (the body is holding on to the extra because it’s worried a famine is coming, so it’s preparing). We also build less muscle because we don’t have the nutrients coming in to support muscle building. Not only that, in a calorie deficit the body actually prioritises fat for storage, as body fat is our energy reserve, plus it breaks down muscle to free up amino acids (the building blocks of protein) to make hormones, enzymes and immune factors. 

Regular meals with adequate protein are therefore essential and will help with weight loss – don’t skip meals! It really is the mindset that needs changing, i.e. we need to understand that eating more doesn’t necessarily lead to weight gain. I say ‘not necessarily’ because eating too much of course can lead to weight gain, especially if what we eat are mostly refined carbohydrates and foods high in saturated fats or worse, trans fats. Stick to the Goldilocks principle – not too little, not too much!

 Balance blood sugar levels

I mentioned in my previous post how estrogen plays havoc with our blood sugar. So what can we do to control our blood sugar?

Ensure that every meal includes a mix of protein, carbohydrates/fiber and fat (the exact ratios of these will depend on individual circumstances). Research has shown that for blood sugar control it is best to start your meal with eating fibre/vegetables, followed by protein and fats and leaving the starchy carbohydrates to last (Nesti et al, 2019).

Ensuring adequate fiber intake is essential for blood glucose regulation. This is because fiber forms a gel-like substance in the gut, which slows down digestion and absorption of carbohydrates, which leads to stable blood sugar levels. Fiber-rich foods are also filling and therefore help with appetite control, which indirectly supports weight management. In addition, fibre lowers cholesterol and lowers inflammation, thus supporting heart health.  Aim for a daily fiber intake of about 30-35g (Reynolds et al., 2020).

 Fix your sleep

I discussed previously how bad sleep impacts weight gain. Getting consistently at least 7-8 hours of sleep is essential to regulate those hunger hormones and eliminate cravings for energy foods (aka sugar). I know, easier said than done! Start with creating a wind-down routine that actually starts late morning, as the first thing to do is to avoid caffeine after 12pm (or even earlier). In the evenings, don’t use really bright lights in your house and limit screen time, especially on your phone or computer. Have at least an hour break from screens before you try to go to sleep – read a book instead. You might want to do some yoga moves before bed or have a warm bath. Make sure your room is cool and dark – use an eye mask if you don’t have good curtains/shutters. There are lots of other helpful tips we can explore during an appointment, and I can also give you some herbs and nutrients that really help with sleep.

There is more that can be done, for example stress reduction and working on your gut health, but I think the above is enough for today.

Prioritise eating real food rather than counting macros or calories – incidentally, this is also better for your mental health. Despite of what many people think, healthy food is actually delicious – you just need to know how to cook it. I realise that this is easier said than done for many, but this is where a nutritionist can help with recipe suggestions and meal plans.

If you want to find out more about perimenopausal weight loss, book in for an appointment.

References

Merz, K. E., & Thurmond, D. C. (2020). Role of Skeletal Muscle in Insulin Resistance and Glucose Uptake. Comprehensive Physiology, 10(3), 785–809. https://doi.org/10.1002/cphy.c190029

Nesti, L., Mengozzi, A., & Tricò, D. (2019). Impact of Nutrient Type and Sequence on Glucose Tolerance: Physiological Insights and Therapeutic Implications. Frontiers in endocrinology, 10, 144. https://doi.org/10.3389/fendo.2019.00144

Reynolds, A. N., Akerman, A. P., & Mann, J. (2020). Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses. PLoS medicine, 17(3), e1003053. https://doi.org/10.1371/journal.pmed.1003053

Sims, S. T., Kerksick, C. M., Smith-Ryan, A. E., Janse de Jonge, X. A. K., Hirsch, K. R., Arent, S. M., Hewlings, S. J., Kleiner, S. M., Bustillo, E., Tartar, J. L., Starratt, V. G., Kreider, R. B., Greenwalt, C., Rentería, L. I., Ormsbee, M. J., VanDusseldorp, T. A., Campbell, B. I., Kalman, D. S., & Antonio, J. (2023). International society of sports nutrition position stand: nutritional concerns of the female athlete. Journal of the International Society of Sports Nutrition, 20(1), 2204066. https://doi.org/10.1080/15502783.2023.2204066