Weight Loss In Menopause: A Piece of Cake
- Geri Brin
- Sep 13, 2024
- 4 min read
Updated: Oct 8, 2024
As Long As You Understand Why You Gobbled So Many Cookies In The First Place!
Illustration by: Cé Marina
You effortlessly lost a dress size for your high school prom. Quickly shed almost 20 pounds for your wedding. Went back to your pre-pregnancy body in a jiffy. Now, in your mid-50s, the weight you’ve mysteriously gained has settled in your midsection, and even if you chomped on nothing but celery stalks, the scale wouldn’t budge.
Sure, you’d love to slip into a slim pair of jeans or fitted dress again, but really, your continued health began to worry you when your bad cholesterol numbers shot up.
Maybe you’ll ask your doctor about getting a prescription for one of the new weight loss drugs. The Weight Watchers approach never appealed to you. And, reading psychological articles on your cell phone about why you eat what you eat surely won’t motivate you to create what Noom calls “more sustainable eating habits.”
Stop right there. Before you contact your healthcare provider, ‘meet’ Dr. Celia Egan, a Menopause Master and head of true. Weight Journey, a comprehensive physician-supervised weight-focused program for women. Board certified by the American Boards of Obesity and Internal Medicine, Dr. Egan is on the cutting edge of weight management science and treatment options.
Her clear and concise explanations about complex weight issues can help you move ahead with confidence.
M.D. For You: Are weight loss drugs magic pills for everyone?
Dr. Egan: “Before these drugs, we’d be happy if a patient lost five percent of her weight, which was considered a really good clinical goal. But, if you were a 5’2” woman weighing 200 pounds, losing 10 pounds wouldn’t give you a tremendous benefit.
“Patients now taking the new FDA-approved drugs are experiencing weight loss of 20 and 30 percent weight. So, it’s far more advantageous to go from 200 to 160 pounds.
“Before recommending weight loss drugs, we need to assess why you gained weight in the first place, and learn what barriers are preventing you from losing it. If you’re a woman in your 50s who feels terrible, can’t sleep, and has hot flashes, you won’t be able to make the necessary changes to keep the weight off. Relying only on the medication won’t do it.
“You can’t possibly be mentally prepared to think about healthy eating and exercising when you’re exhausted and anxious.”
M.D. For You: Please explain the connection between menopause and weight in non-medical terms?
Dr. Egan: “We can’t ignore the fact that a woman’s hormone shifts as she moves into menopause increase her risk for weight gain and chronic disease, including diabetes and cardiovascular issues. The reasons are complex and different for each woman, depending on her distinct emotional, physical, and intellectual makeup.
“Weight fluctuations are common and not a result of anything you’re doing wrong. If we understand your unique situation and hormonal health, we can create the best plan for you to lose and safely keep off weight.
“Women’s biology hasn’t changed over the decades, but the ways modern medicine thinks about and deals with weight management have. Now we have better tools to control weight loss.
“While hormone therapy (HT) isn’t specifically prescribed for weight loss, it can be an essential ingredient to help you maintain a healthy weight and metabolic profile, even during perimenopause. We have a number of safe, FDA-approved HT options to help treat perimenopause symptoms—other than weight gain—that can be blocking your ability to actually control your weight.
“You need those hormones to get your body realigned so it understands what to do with the food it’s consuming.”
M.D. For You: Assuming a woman is ready to embrace healthy eating and exercising, how do weight loss medications work?
Dr. Egan: ”Your brain is wired so you want to eat. But, consuming foods that are biologically unhelpful for getting your energy flow in the right place simply encourages you to gobble up more.
“If you only have cookies for breakfast, you’ll wake up every day and want to have more cookies, which makes it very difficult to make good decisions moving forward.
“Interestingly, weight loss drugs help you perform important lifestyle activities. They get your system biologically realigned from the neck down so you’re able to burn more energy. They also work from the neck up on your brain cells so you don’t crave the cookies as much. ‘I can have a fruit plate or hard-boiled eggs instead,’ you think. The drugs are appetite suppressants, and they turn down the craving signal so it’s more manageable.”
M.D. For You: Do you have to take these drugs indefinitely?
Dr. Egan: ”We’re starting to find that some women who gained significant weight around menopause may successfully stop taking the drug, provided they’re sleeping well, exercising, and properly educated about healthy eating. If there’s an emotional hook to your eating, you also must learn how to process it. This critical piece is called ‘mindfulness,’ which can be challenging when you try to do it without support.
“Our program tries to embrace the three pillars of weight loss management—drugs, dietary recommendations, and mindfulness—because they work synergistically to help ensure long-term success.”
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