Losing Weight After Fifty: Menopause and Other Issues
Posted Jan 06 2011 9:17am
by Barbara Berkeley, MD
Let's get the off-putting facts out of the way first. Your metabolism slows down with age, meaning that your body burns fewer calories than it used to. Prior to menopause, estrogen directs fat storage into the hips and thighs. Once estrogen is gone, storage starts occuring in the belly creating the famed "mena-pot".
While these things are true, they don't have to mean anything. Is it possible to lose weight and keep it off later in life? Absolutely.
Over the years, some of my most successful long term weight patients have been over 60. When new clients tell me that they are worried about their inability to lose because of age, I show them a picture of my mother who had a major weight loss in her mid 80s and continues to control her weight now at 92. Because of two bad knees, exercise was out. She also has an underactive thyroid. She's always had trouble losing weight. Nevertheless, she did it.
Weight control after fifty is only a challenge if you misunderstand the basics. If you believe that weight loss and maintenance is achieved by starving and running the marathon, you will be justified in seeing major impediments as you age. Many people give up on trying to stay at a healthy weight because of just such thinking.
So let's return to those basics, because the fundamentals become even more important when someone is older or post-menopausal.
Overweight occurs when your body stores fat (that's a normal physiologic function) but then is unable to burn it off again (that's not normal). If everything is going just right, your fat cells should be open at all times, able to store fat and then release it again freely when it is needed for moment to moment energy needs. If you are making alot of the hormone insulin, your calories will go into fat storage but they won't be able to get out. It's a one way valve. If you drop insulin levels, fat flows freely out of the fat cells. (And let me remind you once again that what starts insulin going is eating sugar, starches or grain).
One of the most important considerations for those over 50 is not lowered metabolism, but that fact that we become increasingly insulin resistant with age. Insulin resistance means that we make more insulin when we eat carbs than we used to and that insulin levels tend to stay higher throughout the day. Thus, more trapped fat. More difficulty losing.
For those with weight problems over 50, the adoption of a diet that eliminates carbohydrate (except for fruits and vegetables), is key. Understood this way, you can see that the number of calories burned a day (metabolism) is secondary to the way calories are utilized. Essentially, you cannot utilize calories properly is you are making alot of insulin. Similarly, the fact that excess fat in post menopausal women lands in the belly is unimportant. Our aim is to avoid storing excess fat in the first place. Thus, where is goes is immaterial.
Here's one piece of very good news. I have found that it is often more possible for my patients over 50 to make the necessary changes in their eating habits than it is for younger patients. If you have been eating bread, pasta, potatoes and sweets for a whole lifetime, it's often now possible to take a "been there, done that" attitude. At 50 plus, all of us become concerned about our longevity and more specifically, about living out the rest of our years in optimal health. With the greater knowledge we have, and with a lifetime of having accomplished things already behind us, it suddenly becomes ok to try something new. Then too, the more mature we are, the less interest we have in conforming. This makes it easier to tell friends and family that we simply don't eat certain foods any more.