Women's Weight Loss Goes Beyond Diet and Exercise

The unwelcome weight gain can become a frequent problem among women experiencing menopausal symptoms. The primary care physician has likely been told by patients that their attempts to shed excess weight don't work.

About three-quarters of women 60 years old and over across the United States are over weight. Many blame menopausal changes as the reason for this change. However, the actual life stage is not the cause of weight increase. The aging process can cause weight gain women gain around 1.5 pounds annually, ranging from about a decade before menopausal and continuing for about a decade after the end of their menstrual cycle according to studies.

"A lot of women are in tears because they have gained 10 or 15 pounds," said Stephanie Faubion, MD, medical director of The Menopause Society and director of the Mayo Clinic Center for Women's Health in Jacksonville, Florida.

The lack of specialists in menopausal and obesity implies that primary care doctors need to understand the interplay of weight management and how the body performs following menopausal change.

"The importance of weight management in midlife cannot be overemphasized," Faubion stated. "Excess weight around the middle increases the risk of diabetes and heart disease and that is directly related to the loss of estrogen."

The decrease in estrogen as a result of menopausal changes can also cause the transfer of fat around the hips, thighs and buttocks, to the midsection area, which can be harder to reduce. Also, women lose the muscle mass they have as they age due to the fact that the hormone plays a role in the functioning of muscles, says Maria Daniela Hurtado Andrade, MD PhD an medical assistant professor at the Mayo Clinic Alix School of Medicine in Jacksonville, Florida.

"Menopause compounds the changes associated with aging: It makes them worse," Hurtado Andrade stated.

Growing evidence has found a link between obesity-related systemic inflammation to an increased risk of developing cardiovascular diseases such as heart attacks and vascular damage.

Michael Knight, MD, medical associate professor as well as a specialist in weight loss at George Washington University in Washington, DC has estimated that more than half the patients he treats are postmenopausal.

He suggested that doctors look for signs of adipose tissues dysfunction that can lead to localized insulin resistance and impact the health of your metabolism. Research suggests that doctors can conduct an initial metabolic panel in addition to analyzing high-density lipoprotein (LDL), triglyceride and the levels of renal function. Several other recent studies have suggested using the waist circumference and insulin resistance or the presence of metabolic syndrome as indicators to determine an adipose-tissue dysfunction.

Beyond Diet and Exercise

Physicians should talk to their patients about their physical activities, the kind of food they consume as well as changes in daily activity, Knight advised.

The option of surgery or pharmacotherapy are options for certain patients, as per Karen Adams, MD, clinical professor of obstetrics and Gynecology and a specialist in lifestyle medicine in Stanford Medicine situated in Palo Alto, California. Women who are postmenopausal and want to lose more than 5-10 percent in body fat require another treatment along with eating a healthy diet and exercising.

"What's important is transitioning the patient from feeling like they've failed to a mindset of seeking help or seeking care for this condition," she explained. Adams who is a certified menopausal specialist, employs the concept that they are "good enough" with her patients. She suggests that they consider the process of losing weight as a journey that may require a variety of techniques at different times.

Glucagon-like peptide-1 receptor agonists like tirzepatide or semaglutide are among the most effective medications for obesity, as per Knight.

Alongside these medications hormone replacement therapy conjunction with the weight-loss drug semaglutide can help in weight loss and decrease the risk of cardiometabolic disease for women who are postmenopausal compared to semaglutide by itself, as revealed in a research report Hurtado Andrade and Faubion recently co-authored. Improving vasomotor symptoms improved physical activity, sleep and overall quality of life, which can all affect your the efforts to shed weight.

Many patients who struggle to shed weight through the methods of exercise and diet by themselves usually don't keep an appropriate weight over the over the long haul According to Knight. Doctors require a comprehensive plan to provide options for patients such as medication or surgery if they are needed for long-term, weight-management solutions.

Strategies for primary care doctors to help postmenopausal women shed weight:

• Find a method that is suited to the patient's lifestyle. If you don't already have one you can refer them to a weight loss expert.

• Inform patients about the effects of obesity and postmenopausal weight loss difficulties, so that they can be less stigmatized the issue. Make clear how obesity can be a long-lasting condition such as diabetes or hypertension.

• The exercise suggestions must take into account aspects like walkable communities, accessibility and cost of gym memberships, and broadband connectivity at home.

• It is suggested to train for strength to combat the diminution in muscle size which occurs with age.

• Be aware of the culture of a patient when considering healthy alternatives to their normal diet.

• Start with simple suggestions such as removing simple carbohydrates like white bread, pasta and white rice as a good way to begin.

• The Body Mass Index was not intended to be a tool for clinical use and it isn't a comprehensive measure of the weight of a large population. The risk of developing chronic illnesses and obesity differs based on the degree to which an individual carries weight either centrally or on the hips or the thighs.
  

However, long before menopausal onset doctors can inform their female patients about what changes in their bodies to expect and be more aware of the medications that should not be prescribed.

Menopausal and perimenopausal women are often prescribed weight-loss medications such as antidepressants to treat mood swings, or gabapentin to treat hot flashes. The doctor should conduct a drug review and consider alternatives to medications that are related to weight increase.