6 SIMPLE TIPS FOR WEIGHT LOSS AFTER MENOPAUSE
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Episode 216:
Show Notes
In this episode of the Menopause Series, Dr Mary Barson and Dr Lucy Burns discuss the challenges of metabolic health during menopause and share six essential tips to manage weight and well-being.
Metabolic Health Overview
- Dr Lucy explains that metabolic health refers to how efficiently our bodies access fuel at a cellular level. Key to this is insulin resistance, which can lead to chronic diseases and symptoms like fatigue and weight gain.
- Dr Mary highlights how metabolic rate (the energy used by the body at rest) is crucial for overall well-being, mood, and energy levels.
Menopause and Metabolic Changes
The decline in oestrogen, progesterone, and testosterone during menopause leads to several metabolic changes:
- Oestrogen: Helps maintain insulin sensitivity and metabolic rate. Its decline can lead to increased insulin levels and weight gain.
- Progesterone: Increases insulin resistance, leading to fat storage and cravings.
- Testosterone: Involved in muscle mass and metabolic health. Its decline contributes to loss of muscle and increased insulin resistance.
Managing Metabolic Health During Menopause
The doctors discuss six simple tips for weight loss after menopause:
- Sustenance: Adopting a low-carb, real-food diet to reduce insulin levels.
- Stress Management: Finding effective ways to manage stress, as high cortisol levels can worsen insulin resistance.
- Sleep: Prioritising good sleep hygiene, as poor sleep can negatively impact metabolic health.
- Strength: Building muscle mass through strength training to maintain a higher metabolic rate.
- Sunlight: Getting morning sunlight to regulate circadian rhythms and improve mood and sleep.
- Social Connection: Maintaining authentic social connections for overall well-being.
Dr Mary and Dr Lucy introduce the 12 Week Mind Body Rebalance program, which helps women manage the metabolic and psychological challenges of menopause.
Menopause Checklist: www.rlmedicine.com/checklist
The next round of the renowned 12 Week Mind Body Rebalance starts on August 31st! Hurry and join the waitlist here: www.rlmedicine.com/12WMBR
Episode 216:
Transcript
Dr Mary Barson (0:04) Hello, my lovely friends. I am Dr Mary Barson.
Dr Lucy Burns (0:09) And I'm Dr Lucy Burns. We are doctors and weight management and metabolic health experts.
Both (0:16) And this is the Real Health and Weight Loss podcast!
Dr Lucy Burns (0:17) Hello, lovelies. We are super excited to be bringing you this series in Menopause, where we're interviewing guests on their expert subjects regarding perimenopause, menopause, and beyond. As always, any information in this podcast is just considered general advice and we would urge you to seek medical attention if you have any concerns about your health. If you're interested in exploring the symptoms of menopause or perimenopause, we have a checklist that you can download at our website, www.rlmedicine.com/checklist or as always, you can click the link in the show notes. Thanks, lovelies, enjoy this series!
Dr Mary Barson (00:58) Hello lovely friend, Dr Mary here. So happy that you have joined us for this wonderful episode and I am joined by my gorgeous colleague at Real Life Medicine, Dr Lucy. Hello lovely Lucy, how are you going?
Dr Lucy Burns (01:14) I’m very well thanks, Miss. Very well indeed. I have just had a cracking morning. I've been to the pool. Some people will see that I have a consistent but inconsistent relationship with the swimming pool. So if I look back over the last, since I was a teenager really, I've always swam, but I've not been one of those people that goes, yeah, I've swam every day for the last 40 years. I have little bursts. There's always various reasons in my brain why I can't swim or I shouldn't swim or I haven't been able to swim. And one of them is, is winter when it's cold. So I have joined the local pool and because again, because I've invested in it as in I've made a financial investment, I am going, come hell or high water. So yeah, anyway, had a great swim.
Dr Mary Barson (02:07) That's good. Great for your mind. Great for your body. Great for your metabolism. Very, very good indeed. Yes.
Dr Lucy Burns (02:14) Indeed, indeed, indeed. Which brings us to the topic of today, which is the metabolic mayhem of menopause, because we do love, you know, I guess you and I love talking metabolism, metabolic health or metabolism and mindset. They're our two things that we're the queens of.
Dr Mary Barson (02:34) Yep yep, metabolism and mindset of which menopause is so very important.
Dr Lucy Burns (02:39) Absolutely. Yes. And I guess we've added a little third leg to our chair, which is we talk quite a bit about menopause, but because of its monumental effect on metabolic health and premenopausal women have much better metabolic health than post-menopausal women. And it's like, well, hang on, what's going on here? So I thought we'd chat about that today.
Dr Mary Barson (03:10) Sounds good. Do reckon you could just tell our lovely listener, what do you mean by metabolic health? Let's unpack that one a little Yeah.
Dr Lucy Burns (03:18)Yeah, absolutely. So metabolic health, the way I like to really think about it is it's the way our body accesses our fuel at at its heart, which happens right down to a cellular level. So the way that we access our fuel at a cellular level, which sounds very esoteric. What it actually means is that when we can't do that properly, there are reasons behind it. The heart, the heart of which is often insulin resistance. So we end up with high, higher than optimal levels of insulin, which then have this flow-on effect on our organs, the way we metabolise our fatty, our lipids, so our cholesterol profiles like that, the way we then even regulate things like our blood pressure. All of these flow-on effects go on to end up in chronic diseases, type 2 diabetes and fatty liver. But preceding all of this, we're actually tired and hungry and feel like rubbish.
Dr Mary Barson (04:33) Yep, that's true. It's how we feel. Yeah, yep.
Dr Lucy Burns (04:38) So yeah, that's kind of, yeah, yeah, blah, to use another one of our favourite words. We do, we feel blah or in menopause as I like to call it, you feel frumpy, grumpy and dumpy because you can't access your fuel properly and that's what we're gonna talk about today.
Dr Mary Barson (04:55) Mm. It's a fuel access problem. Love that. So what are the metabolic mayhem, the mayhems that occur during menopause that our lovely people need to be aware of?
Dr Lucy Burns (05:14) Yeah, well, look at its heart menopause or the period of the transition, whatever you like to call it, the peri. So the peri is that transition period. We have fluctuating and ultimately declining levels of oestrogen, progesterone and testosterone. And that's that causes a lot of symptoms as you've all been hearing about over the last couple of weeks. But oestrogen in particular has a very specific protective function in the pre-menopausal woman. And particularly around this metabolism, it does a couple of things. So we know that oestrogen improves or keeps us insulin-sensitive. Now, that's not to say that all pre-menopausal women are insulin sensitive, because as you well know, Miss, that's not true.
Dr Mary Barson (06:13) Hmm, indeed, yes.
Dr Lucy Burns (06:15) Indeed. But what we do know is that there are plenty of women who have been in, know, metabolically flexible all their lives and their menopause comes along. They start gaining weight around the middle. They start feeling tired. And they're wondering what the hell's going on. And that's the declining oestrogen is increasing their insulin levels. Interestingly, oestrogen also has a role in our metabolic rate. So, Miss, do you want to explain what metabolic rate means?
Dr Mary Barson (06:47) Yeah. So metabolic rate is just how much energy we use to be alive, essentially, how much energy our metabolism uses. What we use is actually our resting metabolic rate, also called our basal metabolic rate, because everybody's metabolic rate will increase if you start running up hills. But what we want to know is what your metabolic rate is at rest and not sleeping, just at rest, chilling out, not doing much. And this is all the energy that our body, the fuel that we need to beat our heart, digest our food, grow our skin, you know, just do all of the bodily functions, maintain our temperature. That's metabolic rate. And
Dr Lucy Burns (07:35) which is the vast majority of the calories that we expend throughout the day.
Dr Mary Barson (07:41) totally, totally. Yep. The exercise that you do is just sort of like the extra sprinkles on the cupcake. It's a terrible analogy, but that's what it is. We spend most of our energy just being alive.
Dr Lucy Burns (07:57) Yes. Staying alive, staying alive.
Dr Mary Barson (08:03) That's right. That's exactly it. so we want our
metabolism, our metabolic rate to be nice and high and that's that's when we feel good That's when all of our bodily functions are working well and optimally our brain is functioning better We're more likely to feel good to have a better mood when our metabolic rate is nice and high nice and amped up When our metabolic rate slows down we can do this for a few reasons when it when it's slower. We're more sluggish We're cold. We often have low mood. We're tired we can be, we can be depressed, we can have dry skin, and lots of things can be quite blah to use that highly technical medical jargon. So it's really important. know, our metabolic rate is important to how we function and how we feel.
Dr Lucy Burns (08:49) Yes, absolutely. The metabolic rate is determined by a number of factors. The number one, I mean, so number one is hormonal factors and thyroid function. We're not going to talk a lot about thyroid function today, but thyroid function is absolutely intrinsic to our metabolic rate. Muscle mass is another factor. the bigger your muscle mass, the higher your metabolic rate, which I kind of love the idea that the more muscles you've got the, you know, you can just lie around burning calories for free. And then, you know, the one that we talk about is the oestrogen. So oestrogen's job then is as a part not only does it increase metabolic rate, but it increase insulin sensitivity. So it also has a really protective antioxidant effect. So again, we talk a lot about metabolic health, and particularly excessive visceral fat or fat around our middle is often inflammatory. And, you know, as part of that inflammatory process, you know, we feel, we feel bad. The very technical term there, we feel blah. But yeah, we do, you know, you feel achy again, you know, our body is not designed to be living in a constant state of inflammation. Inflammation has a very, very vital role in the acute setting of wound repair and infection control, but really we're not designed to be constantly inflamed. So oestrogen is protective there as well as, you know, in lots of parts of our organs, so brain, gut, all of those things. Progesterone on the other hand is another interesting hormone and its effect on insulin and insulin resistance. And Miss, I reckon you might know a bit about this.
Dr Mary Barson (10:57) So progesterone, when it's elevated, it actually increases our insulin resistance, makes us more insulin resistant, which means that the insulin signaling in our body doesn't work as well. This is extremely important because if the insulin signalling isn't working as well, our body will make more insulin and insulin, among many other things, is our fat-storing hormone. And when insulin is elevated, we are in a fat-storing mode. And if we're in a fat-storing mode, our body actually biochemically turns off processes to be able to effectively burn fat. So elevated progesterone, elevated insulin, increased fat storage. Also increases our cravings and our hunger as well. This is particularly relevant for a lot of premenopausal women in the menstrual cycle towards the end of their period. Once you've cycled, when you're about to get your period, progesterone is elevated. And that is often when women will crave chocolates and be hungrier at other times. But it also has really important ramifications for perimenopausal and postmenopausal women.
Dr Lucy Burns (12:13) Yeah. Interestingly, this is part, well, this is the reason or part of the reason why many women will develop gestational diabetes in that third trimester with insulin, increasing insulin resistance. And, you know, like I look back now and I gained tons of weight in that third trimester, which I internalised as me just being hopeless and, you know, gutting myself because know the advice I always got was oh well don't put on too much weight and now I look back and think I didn't guts myself I did everything I could but I still gained 20 kilos in that last trimester which was all basically progesterone and insulin and yeah it's like ah no.
Dr Mary Barson (13:00) Absolutely. You're not a line there. I got gestational diabetes with my last pregnancy and despite really excellent nutritional control, I still needed insulin towards the end because the progesterone went up and up and up, the insulin went up and up and up, the insulin resistance went up and up and up and I could see my blood sugars going up and up and up. Yeah, absolutely. Thank you, progesterone. Thank you, babies. Thank you, babies. Lucky you're so cute. That's all I can say.
Dr Lucy Burns (13:28) Yeah, absolutely. And then the third change that happens with women is losing testosterone. It's not as like oestrogen declining, oestrogen is like a cliff that just sort of testosterone does decline not quite as rapidly, but it also has an effect on our metabolic health. So we know that testosterone and oestrogen are actually both involved in muscle mass, so muscle repair, and muscle growth. And as they decline, part of what happens is we lose muscle mass. So it's a common phenomena with aging called psychopenia, which just means fancy name for, you know, loss of muscle. And it is responsible, again, as in combination with these other things for our increasing insulin resistance, because muscle is your metabolic. So this all sounds rather bleak. And the, I guess the things that happen with these changing in these three hormones, so you can't stop menopause. If you're a woman, you will go through menopause.
Dr Mary Barson (14:43) It's an inevitable constellation of symptoms. It's coming.
Dr Lucy Burns (14:47) It's coming. Yeah. So what we can do is manage it and you can have, you know, this, the this and that. there's menopausal hormonal therapy is an option for some women lifestyle management. So strategic lifestyle options are what we think everyone should be doing. Now, if you use MHT, then you can get like not it's not just all this and that you know one on one equals two it's a one and one equals about 15 so you will get so much more benefit if you implement lifestyle treatments with your MHT. If you're not taking MHT for whatever reason and again it's not compulsory then the lifestyle options are really really important because we can slow down this metabolic mayhem.
Dr Mary Barson (15:45) And we can reduce the harms and even stop many of the harms that can happen that can occur to your health with this metabolic mayhem.
Dr Lucy Burns (15:54) Yeah, absolutely. So, you know, to summarise it, what we know, we call it the metabolic triad. We know that oestrogen declines and when oestrogen declines, insulin will go up. And we also know that cortisol will go up. Again, oestrogen regulates some of our cortisol production. So increasing insulin and increasing cortisol are not ideal. What we want to do, therefore, is go, well, what can I do? to reduce my cortisol and reduce my insulin. Miss, what can I do?
Dr Mary Barson (16:31) So many lovely levers you can push, but the main ones that are accessible to us all is to reduce and manage your stress in really practical, effective ways, not going out and buying a tropical island to live on, improving your sleep, and there are really sensible, practical things you can do there. You don't have to hit yourself over the head with a rubber mallet and moving, getting a bit of strength, moving your body. Getting those muscles stronger in a really whatever is an enjoyable way for you are three really powerful ways that people can improve their metabolism.
Dr Lucy Burns (17:10) And there's one, fourth one, the major sustenance. So, you know, we like to use the four S's. It's simple. Four S's, which are sustenance. And as we know, and there are buckets of evidence for it, low carb, real food will reduce your insulin. Plain and simple. Stress management, not in the absence of external stressors. As you know, Miss, you've got little kids, you can't get rid of them. No, you know, elderly parents, can't get rid of this. So there are things in life that are stressful. It's normal. This is normal to have external stressors. What we want to do is to be able to sometimes do an audit of them and see what are my external stressors that I can get rid of. We can always, you know, potentially get rid of a few things. But then what we need to do is what is my internal mechanism for managing those? Then sleep, as you've already mentioned, and for a lot of women, sleep is elusive. And sometimes, again, sick toddlers, you've got no option. If you're an obstetrician and you're out catching babies at night, you will be sleep-deprived. If you're a shift worker, then particularly for people whose sleep is outside of their control, they need to double down on all the other elements. But for lots of us, the reason that we don't sleep well is that we spend time watching Netflix till midnight or lie in bed scrolling on our phones, all of which are. And then of course we've got strength. The muscle, you know, muscle, metabolic organ. And then I've just started adding in a fifth S just for fun. Yeah. A sprinkling of sunshine.
Dr Mary Barson (19:06) go for it, good for you in so many ways. Good for your sleep. Good for your stress. You could move your body while you're doing it. So could be good for your strength. Yep. Yep.
Dr Lucy Burns (19:18) Yeah, yeah, so definitely. And in fact, because I like five, I've just added in six too, which is social connection. So sunlight, as you mentioned, morning sun, if we can get that again. So not waking up in bed, grabbing your phone and scrolling through 55 emails before you've even opened your eyes properly is, you know, really, it's a really helpful technique to get morning sun as quick, as soon as possible. Again, I mean, if you're waking up at six o 'clock in Melbourne at the moment, it's dark, so you can't do much about that. But if you have the opportunity to do some movement in the morning, particularly with a friend, then you're potentially doing strength, sunlight, social connection, and stress reduction, all in one hit. Indeed.
Dr Mary Barson (20:07) improves your sleep because getting some sunlight in the morning is really good for your circadian rhythms.
Dr Lucy Burns (20:15) Perfect, yeah, yeah. And whilst social connection is not really a particularly menopausal symptom that we need to manage around menopause, it is just genuinely good for humans. Authentic, genuine social connection, not just going to things and feeling lonely in a very crowded room, but really meaningful connection is wonderful for health.
Dr Mary Barson (20:41) So that's our six S's. I love it. Say that for our six S's
Dr Lucy Burns (20:48) Yes, I know, our six S's of metaphors. Actually, I reckon you could do some sort of six S's as successors. There's a whole heap of yes, you can make a tongue twister for sure. So, um, lovelies, if you're listening and you're thinking, yep, this sounds great. I love the successors. I would like to have six S's with the successors. Well, the 12 Week Mind Body Rebalance is just about to start.
Dr Mary Barson (21:16) It is. What is the 12 Week Mind Body Rebalance, Dr Lucy? Just for those who don't know.
Dr Lucy Burns (21:18) Yeah, it is the six S's with some gut health in there as well, which doesn't fit into the S. But yeah, basically it does go through, you know, we love mind and body like that's the key to life. The key to health is to manage your mind and master your body. And we do that, of course, by looking at all of those pillars. So it runs over 12 weeks. We are in it with you. There's live coaching to really help troubleshoot because we know for lots of women and particularly women who are going through menopause and I say this because you know I am one of those and I spent 35 years or longer dieting. So you've got to unlearn all that diet trauma that diet language. Work out how to overcome perfectionism like we go through all of that. Obviously we teach you the strategies around sustenance and low carb and make it fun. It's all fun. It's is fun. Yeah. So yeah, so it is our 12 week really process that looks at improving your metabolism, developing your mindset and giving you the tools to make it super easy. So last time we ran it for 2024 will run again till 2025. So anyone who's looking to join now, now there's no time like the present.
Dr Mary Barson (22:43) Absolutely check it out www.rlmedicine.com. All the information is there on our website we'll put a link in the show notes as well gorgeous people.
Dr Lucy Burns (22:55) Yep, you can just go, it's www.rlmedicine.com/12WMBR for you know, 12 Week Mind Body Rebalance. Yeah easy peasy lemon squeezy. All right, gorgeous people have the most beautiful week again, you don't have to go through metabolic mayhem around menopause. If you've you're travelling through, we know it can be a time of our people if you've finished. Can you not actually if you finish you're not actually off the hook like this is it some people go on to finish menopause. Yeah, great. So you won't have necessarily the ups and downs. But your risk factors for metabolic dysfunction or your risk factors for chronic disease have now escalated. And so now is the time to do
Dr Mary Barson (23:45) the six S’s are still important for you. See you later beautiful ones, wish you great success with your six S's. We'll chat next week. Bye.
Dr Lucy Burns (23:50) The information shared on the Real Health and Weight Loss Podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.
