Have you noticed you’ve been putting on weight and are struggling to understand why? Many women gain weight as they grow older. But how much is too much and how can you stop the middle age spread? Obesity specialist and consultant diabetologist Dr Harvineder Chahal from London Medical shares his advice.
Many women struggle with weight gain as they get older. Lifestyle, hormonal changes and genetic factors can all contribute to an expanding waistline. It can be particularly challenging to help women lose weight at the time of the menopause, but with individual support and treatment, women can take control of their weight and safeguard their health.
Why does the menopause cause weight gain?
Research hasn’t conclusively shown us why the scales can creep up during the menopause. It’s likely to be due to a number of different things working in combination. The hormonal changes are definitely a significant factor, levels of oestrogen and progesterone go down which means that the amount of the male hormone testosterone is proportionately higher. We’ve seen in studies that this can have an effect on the way fat is distributed in the body.
Change of life and change of shape
One thing is clear, body shape changes at the time of the menopause. Younger women tend to accumulate fat on the hips or thighs. Around the menopause, a lot of the excess weight settles around the abdominal area. This is problematic because abdominal fat can put people at risk of something called the metabolic syndrome. Metabolic syndrome is a cluster of conditions including hypertension, high blood sugar and abnormal lipid levels, which can increase your risk of heart disease, diabetes and stroke- so it’s something to be taken seriously.
Hormones alone are unlikely to account for all of the weight gain during the change of life. Lifestyle, genetic and environmental factors also play a part, as well as diet being a huge factor. The way we eat has changed significantly over the past hundred years. This means that the easy availability of high energy and snack foods can make staying slim a challenge. As we grow older, muscle mass and levels of activity often naturally decrease, which means that we burn less energy. If we keep eating the same food, weight will steadily increase.
Sleep can become disturbed during menopause and in later life. Too little sleep can slow the metabolism and has been linked to abdominal weight gain, so insomnia may be another factor. Additionally, genetics can also play a role. If members of your family have put on a few extra pounds around the abdomen as they’ve grown older, you may do the same. It has been estimated that the average woman may put on more than a stone between the ages of 45 and 60.
How much weight gain is too much?
In the UK, most of us are overweight. Nearly a third of us have a BMI over 25 and just under a quarter have BMIs over thirty, making them obese. So, it’s easy to see how a little extra fat gained at the time of the menopause can be tip people into to a weight range that could endanger their health.
Individuals who are overweight or obese have an increased risk of many health problems. Sleep apnoea, hypertension, cancer, cardiovascular disease, liver disease and type 2 diabetes are all linked to weight. But weight problems don’t just have an impact on physical health, they can also affect emotional and mental wellbeing. The sad truth is that many people who are obese face stigma, which can make it more difficult to get jobs and can lead to shame, depression and low self-esteem.
When should you see a specialist?
Anyone who is concerned about their weight should get advice from a healthcare professional, especially if conditions like diabetes or heart disease run in the family. Advice from an obesity specialist, like myself, is important for people with a BMI over 30 or an obesity related illness.
Sudden weight gain could have a medical cause. A doctor can provide assessment and advice and exclude hormonal disturbances and other conditions that can trigger weight gain, bloating or fluid retention.
How can a specialist help with weight loss?
Although many people lose weight on their own, embarking on a weight loss programme can seem daunting. A specialist working with an expert multidisciplinary team can support people to safely lose weight and improve their health. Diet can be an extremely powerful tool, our clients have had excellent results, and have been able to put their diabetes into remission, just by changing the way they eat.
Weight loss is just the first step, the big challenge is keeping it off. When you lose weight, levels of Ghrelin, the hunger hormone, increase. This drives your appetite and makes it difficult to stick to your diet. Frustratingly, many NHS dietary programmes have limited resources, and too often the support stops, which means the excess weight can often return.
Customised weight management
Private dietary programmes can provide ongoing support and customised care. I’m a lead clinician on the SmartWeight programme at London Medical. We develop an individual dietary plan according to your health, lifestyle and personal preferences. The programme is directed by a team with over 30 years’ experience in managing weight problems.
SmartWeight focuses on helping you lose weight and sustain a healthy weight forever. Taking a more holistic approach, it addresses your relationship with food as well as providing a comprehensive programme, customised to your specific requirements and targets.
As well as providing lifestyle, nutritional and psychological support, we use medication to successfully support weight loss. Currently Orlistat is the only drug available on the NHS, however it has limited effectiveness and unpleasant side effects. At London Medical we have used the drug Saxenda extensively in treating diabetes. It is now licenced as a highly effective treatment for obesity. It helps overweight people to feel satiated sooner, and to feel full for longer, achieving an average 7-8% weight loss. Mysimba is another medication that can make a difference, acting on the appetite centres to help the weight drop by around 5%.
For severe forms of obesity that could seriously endanger health, bariatric surgery can improve life expectancy, protect against the long-term complications of obesity and put diabetes into remission.
Why choose London Medical?
London Medical is one of the UK’s leading private medical centres and an award-winning healthcare provider. With twenty-eight years’ experience, the clinic offers expertise in weight management and the treatment of diabetes and hormonal disorders in a friendly and welcoming environment. All treatments are specifically tailored to the unique needs of each patient to ensure long-term, sustainable results. With leading physicians, the latest technology and an integrated approach to care, London Medical can help you invest in your health and wellbeing.
Dr Harvineder Chahal is an experienced endocrinologist, diabetologist and obesity specialist. He is consultant in endocrinology, diabetes, bariatric medicine and general internal medicine at Imperial College NHS Trust and consults privately at London Medical, where he is the clinical lead for the successful Smartweight weight loss programme.