Someone wrote me a beautiful note the other day asking about menopausal weight gain and I felt compelled to respond to her—and many other women who have the same concerns.

“Two years ago, I underwent a bilateral oophorectomy (removal of my ovaries) at the age of 31 as a preventative measure for a history of precancerous ovarian cysts. All is good now but I am finding it extremely difficult to lose weight, despite personal training and spinning 3-5 x/week and a mindful diet.  I was wondering if there are any post-menopausal “tricks” or tips. 

Also, if there are generally any supplements that are recommended in cases like this. Unfortunately, my efforts to do self-guided research have come up quite empty-handed.”

OMG, girl, I feel ya. Women that transition to menopause (lack of periods for more than 1 year either by natural causes or “castration” via ovary removal for medical necessity) often experience weight gain, and it tends to occur mid-belly (the “mom pooch”).  Even animals that are spayed (same as a total hysterectomy with ovary removal) tend to gain weight as well. This weight gain most likely has something to do with hormone regulation and production and it SUPER FRUSTRATING. I totally get it.

Here’s my short, honest answer.  I don’t know what to do about it.

Now, don’t get discouraged, but the entire medical community has been studying the epidemic of obesity for years.  We just don’t understand all of the rules and regulations of the weight battle.  And menopause wasn’t even researched until the past 20 years…do you know why?  Because most gynecologists were MEN!  And the reason you can’t find much research on it?  Because the field is so new!  But as an OB-GYN, I consistently hear and feel for women who experience a big weight shift during these “hormone transitions.”

My first big tip is to optimize your male/female hormone balance if your doctors are ok with you taking hormones (some women can’t because of cancer risks, heart disease risks, etc.).  Restoring hormonal balance to your sweet body will help with weight gain, in fact, new research even points to HRT (hormone replacement therapy) preventing menopausal flab.  If you can’t take hormones, there are natural supplements and herbs that can help, especially wild yam cream and vitex (progesterone and estrogen analogues).

In addition, here’s my best advice for my patients that I’ve had luck with…

  1. Don’t overdo the exercise. Many studies now support that exercise—while it makes us feel good and helps support bone health and muscle strength (two very important things during menopause)—doesn’t do squat (pun intended) to help with weight loss.  Do it because you love it, but not to lose weight. Do it to tone, but not to lose weight.   I highly recommend yoga, pilates, acro/gymnastics, and dancing to support loving your exercise and toning simultaneously. I got nothing against Cross Fit or F45 or other modalities, but these can be a bit harsh for women.  And I respect the spin maven that you are!  But tuning it down a bit may help with weight management better.
  2. Write down everything you eat—every lick, bite, taste. Every drink. I know I’m personally an experienced “micro cheater,” where I take a spoonful of food while I’m cooking, or I’ll gnosh on something (usually the kids’ Chick Fil A leftover nuggets) while I’m cleaning the kitchen.  Just don’t do it.  When I wrote down every little thing I ate, it really showed me how I was “sneaking” calories into my day.
  3. Portion it—I mean, I hated this idea. Like really, really hate this idea. But I do it.  I take a travel digital scale with me to restaurants and other places and I weigh out my food. I have terrible “measuring eyes,” so I was shoving all kinds of extras into my face (that steak looks like 4 ounces…oh wait, it’s 8? Aye carumba).
  4. Plan it. I figure out what to eat the night before and I limit grains to breakfast only.  Two days a week, I skip breakfast and intermittent fast (I used to do 24-hour fasting but found that to make me really bitchy…so in the interest of my marriage, I stopped).
  5. Don’t panic. Never, ever panic.  Stop and look around.  What does your family look like? Some of this may be genetic.  (some of mine is) I have women that come in and are upset because they don’t weigh what they did in high school.  I refuse at this point in my life to try to match myself before work, before kids, before real tits.  Slow and steady wins the race.  Make sure you are sleeping well, taking care of yourself with good, wholesome foods and spirit-stirring activities.  Happiness is a natural appetite suppressant.

I struggle with this same problem.  I really do.  And these things have helped me.  I have tried it all (I won’t name any names).  It seems like you are doing everything “right.”  But it may not be completely right for your body.  For your health.  My heart bleeds for you because I can sense your frustration.  Please, my darling, try to avoid jumping from fad diet to fad diet looking for the “magic pill.”  Stick with these things for at least 6 months before you decide to try something else.

Dr. B

Here are some resources you can try that have helped me (for the record, I own no stock or gain anything financially from these groups) (low carb and intermittent fasting)

The Obesity Code, Dr. Jason Fung

Bright Line Eating, Susan Peirce Thompson, PhD