by Barbara Berkeley, MD
Whenever I see a new patient, I take a history of his or her weight gain. With rare exceptions, the story is almost always the same. At a certain point, the patient started to become susceptible to weight gain. Once this turning point occurred, weight escalated over time--reversing occassionally during periods of dieting---but quickly reaccumulating.
Yet, when I ask patients to tell me when their weight gain began, they usually will refer to a bookmark in their life. Common answers:
"It started after my first pregnancy."
"It began after I got married."
"It started when I changed to a sedentary job."
"It was that gosh darn menopause!!"
The truth is that the tendency to gain weight usually begins subtly and increases with age. Some people have been overweight since childhood, but for a great many the weight just comes on over time. At some point, it reaches a critical level and we become uncomfortable with it.
By far, the most searches to my blog involve weight and menopause. This tells me that we have been conditioned to believe that menopause CAUSES weight gain. It also tells me that there is a feeling of desperation out there because we believe that there is something irreversible and unique about weight gain after 50. I simply don't believe that desperation is warranted.
Both men and women become more susceptible to weight gain as they age. As I've written in my other posts about menopause, this is because of a simple bodily truth. The rate at whch we burn calories (our metabolism) is dependent upon our size, our sex, and our age. Calories are burned at rest by our muscle tissue, and (if we let it happen) muscles are replaced by fatty tissue as we get older. There is metabolic slowing with time.
Thus, men who were lean and athletic in their twenties now have big bellies that overhang their belts in their 50s. They don't blame this on menopause. If you ask them, they generally blame it on beer, nachos and inactivity. For women, the problem tends to run more toward wine, sweets, and inactivity. But lack of estrogen does not mean inevitable and permanent weight gain and we do ourselves a disservice when we believe that.
Regardless of age, I give the same advice to each person who wants to be permanently lean. Take on your goal as a serious, long term project. I also say this: learning to be healthy is a life's work.. What I mean by this is that short weight reduction diets are meaningless. If you truly want to work on getting to a good weight and staying there, health has to become a passionate interest for you. When you are working on a long term project, little set backs are nothing more than opportunities to reassess strategy and keep going. People who want to lose weight for a class reunion next month are not looking at longterm results...and they won't get them.
What's different about weight control after 50 is that the slowing of metabolism and the tendency of the body to lose muscle means that we have to be more devoted to our project than we might have needed to be in our 30s. But that just makes it a more fascinating exercise and a more rewarding one. The worst thing that any of us can do is to give in to the belief that we are doomed to a life of flab and ill health. We're not.
So how can you begin a serious project to reclaim your 50 plus body?
1. Start by cutting all carbs other than vegetables and low sugar fruits (non tropical fruits) from your diet. Remove all grains and things that come from grains and flour (that would be cereal, pasta, bread and baked goods) and also cut out potatoes. For more detailed information on the foods to avoid, you can view other posts on this site or check the diet in my book (Refuse to Regain:12 Tough Rules to Maintain the Body You've Earned). By the way, I'm fine with any permanent eating plan that works to keep you at a healthy weight. If you can get the same result with another eating style, by all means go ahead. I just find that this particular one, a variant of Primal eating, makes the most sense to me and has been most effective with those I counsel.
2. Spend time considering how you can become an athlete. I know. This always makes people cringe. But everyone has a path toward becoming physically adept. Everything that you do regarding your Reclamation Project shoud be goal oriented, challenging and interesting. What does it mean to be an athlete? For purposes of your life project, it means that you have established a real rythm with at least one particular sport or activity. Think of the analogy of becoming fluent in a foreign language. You shold aim for fluency is your particular activity. Becoming an athlete doesn't mean that you are a star. It doesn't even have to mean that you're great at what you do. It just means that you're fluent. Here's an example: I am fluent in aerobics and tennis. I'm better at aerobics than tennis (I'm no star at either!) but I'm very comfortable with both. I know the rules, I have set schedules to practice them, I have the right equipment and clothes and they are part of the identity that I have established.
(To digress: this is me in the picture. I'm about to turn 65 next month. I eat no bread, pasta, rice, potatoes or grains and very few sweets....or let's say, I eat those things extremely rarely. I am 90% Primarian, eating few processed foods and making only occasional exceptions. I exercise about 5 days/week. I'm here to tell you, I never feel deprived or that anything I do has made my life anything but more enjoyable.)
If people identify you as a daily walker, as someone who goes faithfully to Tai Chi, stretching class, chair yoga...whatever...you are an athlete. One other thing that I can not overstress is the imprtance of keeping physically fit as you pass 60. Loss of muscle and decrease in balance lead to the falls that are so common in people over 80. Twenty years ago, I was 45, the age of most of my current tennis friends. It was a MOMENT ago, so I'm not foolish enough to think that 85 is far off. I'm paying my dues now to stay active and strong. And fitness isn't just an investment in my future, it makes me feel wonderful today and every day.
3. Work on keeping records for six months to a year. I don't feel that it's necessary to document dietary components like grams of fat, protein or carbs. I don't even think it's important to track calories. What I would prefer that you do is keep detailed notes about the way your body (and the scale) responds to the addition of carbs and salt. As long as you keep both of these minimal, your body weight will be stable. But this is the biggest challenge, because we live in a world of carbs and salt and they will inevitably creep back into your diet. Make a vow right now that you will take note of what you are eating each day, whether it makes you hungry or makes you feel addicted, and whether the scale jumped up. In this way, you can figure out what Atkins called your CCL or Critical Carb Level. There will be a certain amount and type of these foods that you won't be able to exceed and that amount tends to vary. Explore this scientifically by watching and observing. And if you find weight coming back, remind yourself that your project is to achieve long term control. Quickly put the kabosh on those foods that have found their way into your brain and onto your hips.
4. There are some things that we have to accept about ourselves. But there are many things that we can actively work on changing. I would advise not falling prey to the "just accept yourself" movement, particularly as it applies to menopause. Creating change makes for a far more interesting life, so I suggest you start each day with a mantra that reminds you where you want to go with your life and why.
5. Finally, I can only offer my own beliefs about weight control and the modern world. For me, it boils down to this: there are multiple reasons why our current environment causes weight gain. They may include ingested chemicals and exposures, changes in our gut microbes, additives in food, and numerous other factors in addition to the usual suspects (eating too much and being too inactive). Having a hormonal change, like the menopause is just one more factor. However, and it'a a BIG however, the mechanism that causes weight gain and blocks weight loss runs through the insulin system. Decreasing the amount of insulin we make, by decreasing our starch and sugars to very minimal levels WORKS. Rather than trying to parse out every causative factor, go for the fix.
As always, feel free to let me know how it goes.
For more posts on menopause and weight click here.