Weight Gain, Hormones and Menopause

hi everybody my name is dr mary claire haver and i am the creator and founder of the galveston diet i am a board-certified medical physician medical doctor

i am a board-certified obstetrician-gynecologist and i am also certified in culinary medicine from tulane university

i am coming to you today to talk to you about hormones menopause and weight gain

i get this question a lot and i have actually it's so complex and it's so multi-dimensional i've been doing tons of research on this

and it all kind of feeds together with what i already preached but you know i wanted to specifically today just touch on if those of you who are going through the menopause transition

and feeling a little crazy that there's something wrong with you and you don't understand it and no one seems to be able to explain why i want to give you a little bit of

clarity as to what is going on with our bodies at this age um i'm going to walk over here and let my dog out who's crying all right rex there you go buddy good

boy sorry real life here i'm at my house um okay so um so what's happening so if you i'm going

to give you some stereo scary statistics first um this is coming from uh the it's a menopause review it's called

obesity and menopause our negligence or an unfortunate inevitability so if you take a woman who is normal weight and considers herself to be pretty

healthy and you you take her through that seven to ten year menopause transition process from you know stone cold normal to going through the process which takes

seven years on average all the way to the end you spit her out at the end where her ovaries are shut down and she's got nothing if she does not change

the quality of her nutrition how how and where and when she's moving her exercise if she keeps everything the same even though she was normal weight and completely healthy before here's

what's going to happen at the end she will gain weight she will replace muscle with fat and it's going to go into places she's never had it before she's going to take that

peripheral fat and there will be a change from what's on her hips and thighs and shifting to more of belly fat or the fat deposit and or the fat deposited around your

visceral organs okay that fat is dangerous the the subcutaneous fat is cosmetically distressing but it's not that dangerous other than it can be harmful to our

third you know arthritis hurts your hips and knees if you have a lot of it but it doesn't create an inflammatory environment like the visceral fat does so what what happens to us you know so

definitely you know there's there's newton's law of thermodynamics calories in his calories out and that by and large has a lot of truth to it and actually it was what i was taught in medical school it's all i was ever

taught but modern obesity research is proving that that is just not actually the answer when you look at people who try as hard as they can all the willpower in

the world they calorically restrict it is not enough for them to maintain weight or them to lose weight now when you're younger actually calories in calories

out works pretty well i did it for years and it was great um however when we start throwing in the gut hormone changes

the visceral fat the hormone changes suddenly these hormones are playing more of a factor hormones determine where you store fat how you store fat when you break it down

and it hormones also drive our hunger and our society that has nothing to do with calories nothing so i want everybody to understand that

there's a huge emotional physiological biochemical part of where and how and how much fat we store

that is hormone driven and when as women and i'm talking to specifically women here who are roughly my age i'm 52 years old when we go through these menopause

changes those things get compounded so scary statistics time so this is um from a menopause journal obesity and menopause it's a polish journal but it

was translated in english and it's phenomenal um so when you look at women in the u.s

okay menopause is defined as um okay the prevalence here we go the incidence of obesity in the united states among women

from 40 to 65 years old is calculated as 65 of us that is a dramatic increase

from pre-menopause then for women over the age of 65 it's as high as 74 percent

three-fourths of us are morbidly obese at the end of menopause and many many many many many of those women were normal weight before or close

to normal weight we see an average weight gain of 15 pounds through the menopause transition that is not willpower that is not calories in calories out that is your body your

metabolism your hormones are changing so one of the things i want to do is educate you you know through the galveston diet my program and everything

is you know what's happening to your body so you understand you're not crazy this is real what those changes mean to you and what you can do nutritionally

to hack those things to try to get your best outcomes so you don't end up as one of those statistics and it's very very doable i've got 42

000 students enrolled in the program now and they're killing it okay um so we look at there's two kind of two areas of hormones that you need to focus on

one affects everybody at every age at all times but it does tend to ramp up as we age with the aging process alone that is insulin

that is cortisol that is leptin that is ghrelin then some other hormones like cholecystokinin neuropeptide y there's several there's about eight or

nine that i do a deep dive into um in the in the hormone research that i've been doing so but the two biggest ones you need to think about are are the four are insulin

cortisol um leptin and ghrelin so insulin is what drives the glucose to be shifted and stored as

fat um it also helps control hunger it helps control satiety and the incidence of insulin resistance in this country is huge several of you i

know out there have been diagnosed with borderline diabetes or insulin resistance and there's definitely a huge nutritional component to that so instead of just counting calories in calories

out in the galveston diet we set our calories at somewhere around 1500 a day so a little less some days we focus on

the quality of the nutrition you're eating we focus on macronutrients we focus on micronutrients we focus on the things that are going to improve our insulin resistance through nutrition

we focus on the things that are going to lower our cortisol levels through nutrition and exercise and meditation and stress relief we also looked at you know we do a

really deep dive into leptin and ghrelin so leptin is created in fat cells and it is the hormone that tells your brain you're full stop eating that

system is broken in a lot of us and it gets way more broken as we gain weight and get more of this visceral fat um so you never get the signal to stop

eating it drives you to eat no amount of willpower can overcome an evolutionary drive yeah you could starve yourself but you are you know being manipulated by these

hormones and my job my goal is to make sure your calories are where they need to be of course you know so you're not starving but really to educate you as to what what we've been missing all these years the quality of the food

looking at a hard dive and macronutrients not all carbs are created equal you've got a you know complex carbohydrates legumes whole grains that's the way to go getting rid of the

simple sugars getting rid of the things that are so so so addictive and do nothing but dry fat to your viscera drive do to get more belly fat and make all of the things that aging is

doing to us worse so you end up in this vicious vicious cycle my job my goal is to break the cycle so i invite you to break up with calories think

differently think about the quality of the food think that you are hacking your own hormones to make them work better for you

because as women at our age we have the gut hormones what i talked about now we're going to talk about estrogen and what's going on with that so in the perimenopausal period

and give me a thumbs up or a wave if you guys are there right now so um our it's like mr toad's wild ride

we have dramatic fluctuations of estrogen and along with that with our androgens which are interesting diode and testosterone we have a little bit of that way more than oh thanks for the

thumbs up everybody okay so through the perimenopuzzle period all of a sudden we kind of had a steady state we had little fluctuations throughout the month normal cycle stuff and then we go through perimenopause and

it's like [Applause] and our brain is like whoa what's going on it can't figure out

what's happening so you start having hot flashes you start having lots of metabolic changes you start having more brain fog you know risks are going up so then as we end as the estrogen levels start really really

dropping your brain is like whoa where'd the estrogen go we need more it's programmed to do that so it creates a hormone in the hypothalamus called

follicular stimulating hormone and luteinizing hormone these are the hormones that are supposed to tell the ovaries get busy but our ovaries die okay our ovaries have shut down they're not doing anything

so it goes those those fsh and lh follicular stamina hormone and luteinizing hormone say hey anybody else out there in the body we need estrogen

so the adrenals get stimulated a little bit other parts of your body get stimulated and we have a relative rise in our androgens okay in our male hormones there it's not

a huge rise not like a man's level but we have a relative rise and there's no estrogen on board to counterbalance it so estrogen

is or very little estrogen comparatively estrogen is what drives the fat deposition in our hips and thighs that is called gynoid fat distribution is what makes a woman kind of curvy and

look like a woman we shift some of that fat over to the viscera and to our abdomen inflammation levels start skyrocketing and you start getting

into the vicious cycle the relative rise of androgens which is unopposed with estrogen so we have this this androstenedione testosterone

abundance we're not used to leads to lots of things increase that's when a woman's risk of cardiovascular disease approaches a man that's when we see her starting getting

visceral fat and belly fat where she never ever had it before um that that sorry i had a call i thought i had it on sleep but whatever um

that is what is driving this so you end up in this male-like pattern of hypertension heart disease metabolic disease

all of it which makes us really really ill so when they look at weight gain in a woman in perimenopause and menopause they can actually break down they put

people through the densiometers and they can measure how much hip fat you know hip and thigh fat versus visceral fat so a woman who's gaining this weight through menopause

will gain some in her hips and thighs again but will have a much greater gain and the visceral fat where she never had it before and that's what i'm focusing on that's what i'm

trying to bring down to get you out of this vicious cycle to break the inflammation cycle because that visceral fat is inflammatory that visceral fat creates cytokines not the fat on your

hips and thighs the fat in your abdomen that visceral fat is linked to all the disease states hypertension heart disease relative risk of cancer increase all of it all of it all of it

we can start to reverse some of this with good nutrition exercise and stress reduction it can happen it's happening it's

happening with our students they're going to the doctor their labs are amazing their weight's down they're getting you know high fives and woohoo's at the doctor's office and like hey

you must have had a major nutritional change they're like actually i did and you know it's it's all very very very doable

so whether or not a woman should go on hormone replacement therapy here's some important news if you're going to do it one it's an individual discussion with your doctor

okay it's not a one size fits all you have your own genetics you have your own environmental factors you have your own health where you are right now it's a risk benefit

ratio but if you're going to do it you need to do it sooner rather than later if you start hormone replacement therapy older once you're already through menopause it's not helpful

and it might even hurt so if you're going to consider hormone replacement therapy because your ovaries have shut down or been surgically removed

go talk to your doctor but you need to do it sooner like in your 40s don't wait until you're post-menopause because the sooner you get started you

actually when they look at women who are on hrt hormone replacement therapy um through the perimenopause and then look at their visceral fat and look at their

body fat they actually do better they don't have as much inflammatory markers in their blood their weight is a lot more stable they don't have the obesity levels

so i'm not saying it's for everyone there are women who absolutely should never take a hormone as long as they live but it's something to think about so um anyway

that combined and but don't leave nutrition out of the nutrition and exercise you've got to be doing weight-bearing exercise to keep the musculoskeletal unit small because what else is going on we're losing our

muscle we're losing our metabolism just with age a woman will lose five percent of her metabolic rate per decade guys it's all working against us we really weren't

meant to live this long we've artificially extended our lifespans but so you gotta like you gotta go in big you gotta go big or go home if you wanna be if you want to age well if you want

to be healthy as you age enjoy your life enjoy your grandchildren enjoy you know your relationships and not be feeling poorly not dragging this extra weight around not be on all this medication

it's doable it's very very doable but you need a sound nutritional program and that is what i feel like my purpose in this world is at 52 years old is to educate people

as to the best nutritional profile for us y'all are just like me a woman in midlife who's just okay guys i'm getting multiple calls i gotta go um hopefully you guys enjoyed

this and um you learned something take care