Book Review: Outsmarting the Midlife Fat Cell—Winning Weight Control Strategies for Women Over 35 to Stay Fit Through Menopause by Debra Waterhouse, M.P.H., R.D.

We each are born with 30 Billion fat cells.  

Fat cells have an important mission of manufacturing estrogen and balancing our body during the transition into menopause—and they will do everything possible to make sure that they don’t let you down. It seems women today have transitions that are more magnified than generations past. We are gaining 50% more weight than our mothers did and the time it takes to travel through perimenopause and menopause is 500 times longer. We have more hot flashes, more memory loss, and more insomnia. 

Women’s bodies are different than men’s. A woman’s fat cells are five times larger than a man’s, have twice the amount of fat-storing enzymes and half the fat releasing enzymes. Plus, men have more muscle, and muscle uses up more calories, so men have an advantage over us—unless we are in a famine situation.  

Women’s fat cells produce estrogen which helps them maintain fat in certain areas of the body. Gaining up to ten pounds during perimenopause and menopause is normal. More weight gain than that can affect our health negatively.  

Estrogen surges during puberty and pregnancy help us to gain weight, but in the menopausal transition phase a decrease in estrogen causes a weight gain by influencing the fat cells to increase fat-storing enzymes. So any extra calories are retained as fat.  Women need this extra weight because the fat cells produce estrogen which helps to prevent bone loss after menopause is complete.  

Estrogen is also responsible for about 300 other functions having to do with activity in the brain, sleep, decreasing hot flashes, bones, skin, heart and other cells. Stress and malnourishment triggers menopause to come faster. Having babies slows the clock. Each baby gives us five more months to hold off menopause.  

Stress wreaks havoc on our bodies by over stimulating our hearts, weakening our immune systems, upsetting the hormonal balance, decreasing estrogen levels, aggravating menstrual dysfunction, and it is responsible for infertility, intense PMS, megamenopause and excess weight gain.  

Cravings for sugar, chocolate and fat in the transitional phase helps to increase serotonin in the brain which helps us to feel better about ourselves, gives us more energy and stabilizes mood swings.  

After age 45, women lose ½ pound of muscle per year and their caloric needs drop by about 400 calories per day. If you eat the same amount of food as before age 45, these extra calories go into fat storage in preparation for menopause.  

Positive changes associated with menopause include: increased sex drive, energy, productivity, creativity, greater confidence and self-esteem, enhanced communication skills, and a greater awareness of the body’s needs.  

From age 35-55, there is a dip in estrogen. During that time we lose about 65% of our estrogen. That dip in estrogen can cause hair to fall out. This hair loss is also noticeable after birthing and just before you menstruate as well as in the perimenopausal period.  

So, how do you outsmart the cells to keep extra weigh off during menopause? Debra stresses a four-point approach including: exercise, modified eating habits, managing stress and taking care of your body.  

1. Exercise. How much? 60 minutes of aerobic exercise four times a week at moderate intensity. It will limit the amount of abdominal weight gained caused by stress and stress eating. A variety of exercise is more effective than the same old stuff you’ve always done, so mix up the type of exercises you do.  

Exercise during the transition time will help fight fatigue, increase your body’s metabolism, make your brain perkier, help you sleep better, stabilize your mood, diminish food cravings, reduce hot flashes, increase your flexibility and help with balance, mobility and agility, strengthen your bones, reduce your risk of breast cancer and heart disease, stabilize your blood sugar and help you live longer.  

And don’t overdo it. Too much exercise increases your chances of injury, compromises your ability to burn fat, harms your immune system, compromises your sleep patterns, puts wear and tear on your skeletal system and cuts down your lifespan. Balance is the key.  

2. Modify Your Eating Habits:  

• Eat frequently. Eating five or more times a day provides a steady and dependable source of glucose for our brains, balances mood swings and boosts energy.

• Snack often. Don’t skip meals. It slows down the metabolism.

• Eat your largest meal at lunch. Eat your smallest meal at dinner. During midlife our metabolism slows WAY down after 6pm and our nighttime caloric needs are almost non-existent.

• Eat smaller amounts overall. Eat no more than the size of your fist because that’s how big your unstretched stomach is.

• Check in with your body. Eat ¼ of your meal. Ask, “Am I still hungry?” If so, eat another quarter of the meal. Ask the question again. When you are no longer hungry, stop eating. Listen to your body’s needs for food. When you are hungry, you can’t gain weight from eating—unless you overeat. Your body is asking for food and it will use it. Determine your body’s signs of hunger. Where does hunger originate? In your stomach, brain, or in your body manifested as lack of energy?

• Be present when you eat. Pause when you eat and take in the experience. Sit after you eat and make the experience last. Enjoy the foods you crave. Don’t deny yourself of them. Just eat less and enjoy it more.

• Follow your cravings. Food cravings are the only way for your brain to communicate exactly what it needs to function optimally. Eat full-fat foods (just smaller portions). Craving carbohydrates can mean you are low in serotonin (feeling stressed or depressed). Craving fats may mean you are low in endorphins (feeling moody), and craving protein may mean you are low in dopamine (can’t concentrate.)

• Enjoy your alcohol, but limit it to 2-3 drinks/week for optimal health benefits.

• Eat more protein, but not too much. Over 60 grams/day leaches minerals from the bones and increases the risk for osteoporosis. High-protein diets are not good for the bones OR the kidneys. Optimal amounts of protein enhance the immune system during transition into menopause.

• When taking calcium supplements, take them with food—calcium citrate seems to be the most absorbable calcium according to Debra. (Dr. Moffat’s note: I’ve found that taking your calcium with some fat helps the calcium absorb better.)

• Eat a wide variety of foods, especially fruits and vegetables.

3. Manage Stress: 

Take time for yourself, put up a “Do Not Disturb” sign, meditate, do deep breathing exercises, experiment with aroma therapy, buy a set of ear plugs, take mini mind vacations, get a massage, live in the moment and ask yourself, “is this going to matter a year from now?” 

4. Take Care Of Your Body: 

Get a complete physical and have the following checked: Blood pressure, cholesterol, skin and colon cancer screenings, bone density and thyroid screening.  

The thyroid gland activity diminishes during menopause which can lead to an overwhelming menopausal experience. Low thyroid can also increase the risk of osteoporosis.  

(Denice’s note: Have them do a full thyroid panel. It seems like thyroid antibody problems are on the rise and a routine thyroid test does not pick this up.)  

I thought Debra had lots of great information to share. I was a bit discouraged that she didn’t point out the hazards of carrying too much weight. It was almost like she didn’t want to address those issues because she didn’t want to hurt people’s feelings. Maybe she just wanted to focus on gathering a positive self-image and higher self-esteem. I don’t know. Debra does have a Master’s in Public Health. She is definitely against dieting in any form and she does make some great points. Debra also wrote a book on why women need chocolate.

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