Philip Pape: 0:01

Let me know if this sounds familiar. The scale keeps creeping up. Your genes keep getting tighter. That stubborn belly fat seems to have taken up permanent residence around your midsection. If you're in perimenopause or postmenopause, you've probably been told it's just your hormones, that weight gain is inevitable and you should just accept it. But what if I told you that's not the whole story? Today, we're exposing the real mechanisms behind perimenopause and menopause weight gain. Yes, hormones play a role, but there are surprising factors at work you may not know about. You'll discover why body composition changes even when the scale doesn't move the protein leverage effect that's sabotaging your efforts, and tips and strategies based on evidence that actually work to improve your body composition and fat loss.

Philip Pape: 0:56

Welcome to Wits and Weights, the show that helps you build a strong, healthy physique using evidence, engineering and efficiency. I'm your host certified nutrition coach, philip Pape, and today we're tackling one of the most frustrating and misunderstood topics in women's health why you keep gaining weight during perimenopause and menopause and I get more questions about this topic than almost any other, and for good reason, because if you're a woman in your 40s or 50s, you've likely experienced this yourself, despite maintaining the same diet and training routine that might have even worked for years, for decades. Suddenly your body seems to be working against you, and conventional wisdom, the industry, the fitness influencers out there tell you it's hormones, it's aging. There's a lot of fear mongering around this that you need to eat less and move more, or some other advice that you may have tried that still doesn't seem to be working. And when we look at the research, there's a more complex and interesting picture. That's also an empowering one, and that's really the point of this episode. There are specific mechanisms at play during this transition that create a perfect storm for weight gain and body composition changes, and what's important is that if you understand those, then you have the power to work with those changes instead of wondering what's going on and being frustrated for years to come or just throwing your hands up Now, before we get into the science. If you want a practical, evidence-based guide for women navigating fat loss during this time perimenopause and menopause I do have a guide called Menopause Fat Loss Over 40, and it breaks down how to adjust your nutrition and training, specifically the nuts and bolts. It's totally free. You can download it using the link in the show notes or go to witsandweightscom slash free. Again, that's the Menopause Fat Loss Over 40 guide, and it's really fairly comprehensive in covering all these details so that you can customize it for yourself and come up with an action plan.

Philip Pape: 2:50

So let's start with what's happening and changing in your body during perimenopause and menopause, because it's not what most people think. There are a lot of assumptions out there, myself included. I made them for years. Obviously, I'm a man, I'm not a woman. I'm not going to go through these personally, but I've studied this extensively and worked with lots and lots of clients. Probably two-thirds of my clients are women in this age range and I absolutely love helping them to figure this stuff out, because it can be challenging. I will admit that it can be challenging. You have to really know what's going on.

Philip Pape: 3:20

So I want to start with talking about the basics body weight versus body composition. When we look at studies, whether they're cross-sectional, longitudinal, high-quality studies we see a pretty consistent phenomenon of weight gain steady weight gain of about a half a kilogram or a little over a pound a year. That is correlated with age more than it has to do with menopause itself. But there's definitely conflicting evidence out there and that's where it gets confusing. At the start of the menopause transition, we see the rates of fat gain double and lean mass decline. Now, those are just averages, but these gains and losses continue throughout this whole hormonal transition, which is what's exacerbating the challenge for women in this period. And we have to acknowledge that. You know, even though at some point these trajectories tend to level out and match anyone you know men, women, any any age at after that point, the transition itself is what's calling, causing this acceleration. That's making things challenging.

Philip Pape: 4:20

So what's happening is your total weight, your body weight might not change dramatically. You might, in fact be intentionally preventing it from changing with dieting, cutting calories, with trying to do more cardio, things like that. But your body composition metrics, they have reduction in fat-free mass, increase in fat mass, and these opposing changes that result in weight changing very little still cause lots of other things to go awry. Let's just say and that's why the scale can be so misleading during this time because you think maybe nothing's happening because the weight is stable and, by the way, I know for many of you the weight is going up. So that's why the scale can be so misleading during this time, because you think maybe nothing's happening because the weight is stable. And, by the way, I know for many of you the weight is going up, so that's just compounding it when there's additional body fat accumulation. But for many of you you might maintain the same weight, but underneath you're losing muscle, you're gaining fat, and it's not just any fat. Post-menopausal women gain about 36% more trunk fat right Ab, 36% more trunk fat right Abdominal in the trunk area, 49% greater intra-abdominal fat and 22% greater subcutaneous abdominal fat than premenopausal women.

Philip Pape: 5:36

So when we talk about menopause belly and things like that, there is reality to those experiences. For good reason, there's something called the Study of Women's Health Across the Nation, or SWAN study. It followed over 3,000 women through the menopause transition and it revealed that the transition itself, not mere aging, the transition itself uniquely accelerates fat gain and lean loss in about a three and a half year window. So that's that transition I was talking about. It is not just the gradual aging, or else you would see it be fairly linear or fairly consistent. I should say it's a specific biological transition that dramatically accelerates these changes during a short window of time.

Philip Pape: 6:11

So women who come to me frustrated it's funny I've actually had some clients that worked with me who reached out maybe a year or two prior and were starting to have some challenges. And they said you know what? I'm not sure I'm ready for coaching or it's too expensive. I'm going to try to go it alone and do what I've been doing. And then things get worse and worse and harder and harder and they're like what is going on? And it's probably because these changes are kicking in and it's during that time when you've really got to lock down and figure out what you need to do for yourself personally, and that's what I'm trying to empower you to do here with this episode.

Philip Pape: 6:45

So you've probably heard that the reason for this is the declining estrogen, and that is partially true. Excuse me, but I think the real story again is more nuanced. It involves multiple players with hormones. Estradiol, which, yes, is the primary form of estrogen, declines. But there's another hormone that people don't talk about and that is FSH, follicle stimulating hormone, and the early menopausal transition shows a sharp rise in serum FSH levels, even when serum estrogen levels remain within normal limits.

Philip Pape: 7:17

And that's important because FSH, it's not just for reproduction, it also directly affects your metabolism Through something called high affinity receptors, some of which are variants of the ovarian FSH receptor, called FSHR. Fsh regulates bone mass adipose tissue, the function of your fat mass, energy metabolism and cholesterol production, and that's in both sexes, men and women. And so the SWAN study found that FSH was correlated with bone resorption. That's effectively the way bones release byproducts that maintain what's called calcium homeostasis. Basically, it has to do with your bone health. Let's just put it just to simplify it. And other studies in addition to the SWAN study found that the hormone regulates body fat and energy homeostasis. So it's very important.

Philip Pape: 8:06

And so as it rises, which happens before the estrogen drops significantly in menopause, it's already starting to change how your body stores and burns fat, and this explains why some women start noticing changes in early perimenopause, when their periods are still regular. So for all the gaslighting out in the world of, oh, you're too young, no, you're not, there's obviously still things happening as a precursor to the final. You know that three and a half year menopause transition. Where it gets more interesting is that genetics you know even race and ethnicity, body mass index all of these affect the trajectory of estrogen or the estradiol and FSH changes over the transition. So your genetic background, your current body composition, influence how dramatically these change, which explains why some women experience way more severe symptoms than others.

Philip Pape: 8:53

I've had clients who you know got into their fifties and said you know, I've had absolutely zero issues whatsoever, everything's been just the same as it always was. And others that are like what the heck is going on? This seems hopeless, everything is just going haywire. What do I do? Right? And these are all real experiences and they're biologically supported and they're largely due to genetic differences and lifestyle and behavior and your history and all of that. So here's where the research gets fascinating, if it isn't fascinating already, and that is what can be the game changer for you and how you approach your nutrition during this time.

Philip Pape: 9:27

There are researchers from the University of Sydney discovered something called the protein leverage effect that happens during menopause. When we look at analysis of nutritional changes during the transition, we see that there's enhanced protein breakdown as a trigger for weight gain via a mechanism called the protein leverage effect. All right, so enhanced. Now you might have heard, kind of at a surface level, that women seem to need more protein as they age or they have more rapid loss of muscle and things like that. Yeah, unfortunately, it compounds the weight gain and the way it works is that when the progressive loss in your protein occur, it causes an increased appetite for protein.

Philip Pape: 10:15

And if there's not a corresponding increase in your dietary protein, then the consequence is you have extra intake of energy from non-protein sources. You have extra intake of energy from non-protein sources, and so as you lose muscle mass during menopause, which gets accelerated by the declining estrogen and the rising FSH, your body develops a stronger appetite for protein. But if you're eating the same way you always have and you're not getting enough protein, you're also not getting nearly enough of the concentration you need now, and so your body keeps driving you to eat more food until you hit your protein target, and then those extra calories come from carbs and fats and chances are you're eating more calories in general because you don't have enough protein and satiety and blah, blah, blah, right. So it's like this vicious cycle. So, without increasing the proportion of protein in your diet, the body's drive to reach its protein target is going to make you hungrier and continue to eat unnecessary calories until you do so, and this is unique to menopause. So very important to understand one of the reasons why we like to up our protein for everybody, but especially women, during this time, and the researchers calculated that weight gain and fat mass adiposity, we call it, as well as the loss of your lean tissue, including the loss of muscle, might be mitigated or even prevented just by adding in a little more protein. I think they estimate around 16 or 17% of the daily value, something like that, or up to 20% something, but anyway, we are trying to get way more protein in that. Anyway, we're trying to get around 0.7 to 1 grams per pound of body weight. So if you're listening to this saying, yeah, I know all this, philip, I've already increased my protein. I'm still having issues. This is just one of many things going on, and the solution here isn't that you should eat less, right, it's eating smarter. It's eating more food volume, it's eating more protein and that's a common theme for everybody. It's a very effective way to eat, in a flexible way that doesn't cut complete macros, like you're not just cutting carbs, you're not just cutting sugar or cutting anything, right, you're eating more protein and more nutritious things and more filling things.

Philip Pape: 12:17

So let's get into some of the myths about menopause weight gain that I think are causing confusion, and then this leads to some of the other tips that I have today. The first myth is that it's not aging or it's not menopause, it's just aging. So you'll hear some fitness influencers, especially like 25 year old men, saying you know, it's not your hormones, it's not menopause, it's just because you're getting older. And that's incorrect, because while aging drives some changes for everybody, menopause adds unique shifts that we already referred to the accelerated fat gain and muscle loss, and it's for a decent amount of time. So that's myth number one.

Philip Pape: 12:53

Myth number two that weight gain means only fat gain, and this is dangerous because it's not just that you're gaining fat, you are also losing lean mass, and so you're gaining even more fat than you think. Does that make sense? So you're actually fat, you are also losing lean mass, and so you're gaining even more fat than you think. Does that make sense? So you're actually losing some lean mass, gaining fat, and even if your weight on the scale doesn't change, you've gained body fat and body fat percentage, and so that's why a lot of women get frustrated. They're seeing their bodies change, becoming more fluffy, frumpy. You know the muffin top, all the trigger phrases that we use, even when the scale doesn't move, and then, of course, it gets even worse when the scale does move.

Philip Pape: 13:32

Myth number three is that post-menopause means you can't stop gaining Like you're just going to. It's inevitable, like no matter what, unless you eat, you know 700 calories. It's inevitable. But actually, after the transition that the three and a half year average transition, the composition stabilizes and that gives you a new milestone where you can intervene If you're already there, for example, the good news is that the most dramatic changes only happen during a certain window, and after that window you have a little bit better environment going on. You have a little bit better environment going on, which is why I encourage you starting as soon as you can, cause the sooner you can get in place the proper lifestyle for you, uh, the easier it'll be and you might even get additional gains than you that you didn't expect. When things get, quote unquote easier which, again, every woman's different, some, for some women, women, that's a obvious improvement and for others it may be more subtle.

Philip Pape: 15:13

And then I'll I'll have one more myth for you here, the one that really bothers me of all this that you need to just eat less and move more. Right, and I can't stand it, because I see Facebook posts, youtube videos, whatever, and people try to get into nuances about this stuff and people. Somebody will reply and say you just need to eat less and move more, like that's it. No, no, this ignores the metabolic and hormonal changes happening in your body and if you just eat less, you're probably going to exacerbate them because of the stress you know. The mechanism of developing obesity in menopausal women is clearly a distinct phenomenon, a mechanism driven by the things we've talked about related to hormones, leading to muscle loss and fat gain and fat gain in certain areas that we don't necessarily want them right muscle loss and fat gain and fat gain in certain areas that we don't necessarily want them Right. The reality is, your body's metabolic landscape is basically shifting into a completely different identity and the approaches that you had in your 20s and 30s are not going to work now. They may not work now. It depends on your history.

Philip Pape: 16:07

So now we understand what's happening, let's talk about what works, and I want to be clear. This isn't about a detox or a quick fix or something you're going to fix in the next month or two. This is working with the new realities, having the right expectations and patience, and if you do, you can be absolutely successful. This is the common theme when I talk to my clients or we look in our physique university I actually just asked the question at last week's check-in. What's the one thing you would tell somebody who's just starting this journey? And the recurring theme is to be patient and follow the process. And I know we don't like to hear it, but as long as you have the right process which we're going to talk about here you will be successful.

Philip Pape: 16:45

So first I want to talk about hormone replacement therapy and kind of get that out of the way. We know that estradiol-based hormone replacement therapy does slow fat gain, it does preserve muscle and bone health, it does reduce cardiovascular risk and the benefits are greatest when started early in the transition. So I'm not against HRT at all if that is something you need. I'm not a medical doctor. This is not medical advice. The decision about HRT is between you and your healthcare provider. It may not be estradiol, maybe other forms of hormone replacement. So that's really not my area of expertise in terms of prescribing or recommending or anything like that. And I work with clients who have a team of professionals including usually a hormone specialist, who decides what makes sense for them. Maybe it's thyroid, maybe it's progesterone, something else, but research shows that when it is appropriate, hrt is incredibly beneficial for body composition during this transition. So I wanted to mention that first, I did a previous episode that compared HRT versus strength training and basically the conclusion was they're both great and they're both contextual Strength training. Everyone should be doing HRT. Not everyone should or needs to do it necessarily. Maybe, maybe not. Again, that's where it's very personalized. So that's HRT.

Philip Pape: 17:56

Secondly, is nutrition Based on the protein leverage research and what we know about the importance of protein period. It's just a far gone conclusion that we have to increase protein and I recommend at least 0.7 grams per day, getting up to one gram per pound per day. So per pound per day. So whatever you're eating now, it's basically trying to get to that new level. The best way to do that is to track your food and know what the heck is going on, know what is going into your mouth.

Philip Pape: 18:22

That is often the biggest missing thing here. That creates a massive level of confidence for women who are frustrated because they simply don't know how much they're eating. They think they're eating, you know, 1500 calories a day or 1200 calories a day, but they're actually averaging 2000, 25, maybe 3000 calories a day and just don't know it right. Don't know it and I'm not asking you to cut things out right, I'm not asking you to cut things out. I'm asking you to add in high quality animal and plant protein into your diet and as well as high fiber foods. That alone is going to make a massive difference. But you've also got to track to understand where the calories come into play. The calorie density comes into play, the food volume, all of those things. If you're not sure about all this I do have other episodes on it. You can just reach out. I'm happy to send you a link on that. So that's the nutrition. Protein fiber is the focus. And then, third, we have resistance training. That is absolutely non-negotiable.

Philip Pape: 19:12

Strength training is going to preserve your lean mass. It's going to counter sarcopenia, the loss of muscle mass. It's going to boost your metabolism in many, many ways. It's going to boost your hormones. It's going to help in just every way imaginable, even mental health. Muscle loss that happens during their transition is pretty much all prevented with proper strength training. So if I were to put a bow on this whole episode, it would be simply adding in and doing consistent. Strength training is going to mitigate significantly many of these issues because you're holding onto your muscle and you're building new muscle, and that is going to reverse your body composition into a positive direction. As far as your diet, overall, we want to have a flexible diet that's focused on satiety and eating without guilt and supporting your nutrients being nutrient-dense, high-volume foods, a diverse diet full of yes, all the macros, protein, fats and carbs really good carbs. Having plenty of energy, eating enough food for your goals, not constantly dieting. Again, that's an entire different topic we can dive into, but that is really, really important when you're in menopause to potentially take a pause and forget about losing weight on the scale for a bit and instead focus on building a resilient, strong body that supports building and holding onto muscle, which will then make fat loss so much easier.

Philip Pape: 20:34

And the last thing I really want to mention here, which I was I was wondering if I should or not because it's its own unique topic that affects everyone, but it exacerbates the situation during this time of life, and that is, uh, being in a high alert, chronically stressed state all the time. And this is a challenge no matter whether you're in the menopause transition or not, whether you're a man or a woman. It's the life obligations, it's the stress from raising or supporting a family. It's the stress from work, financial stress, all of the things that are going on around us and the way we live, with screens and our schedules and being on the go right All of that perceived stress physical stress, psychological stress is going to make things harder, and some of this stress is caused simply because you're trying to diet a lot, and some of this stress is caused because you are worried about the whole situation.

Philip Pape: 21:32

And I find that once you have some modicum of control over this, with regular strength training, with tracking what goes in your mouth, however you want to do it, my preferred way to do that is macro factor, because that app will calculate your metabolism for you and give you accurate targets, and that gives you confidence to then maintain your weight and then lose some fat, if that's what you're going after. All of these things create confidence. That then counteracts some of that stress. But being in this high alert state all the time itself is something that affects your metabolism, um, and it just exacerbates everything going on. So I did want to mention that, um, because the you know, the nutrition strategy, the training, the HRT, will definitely cover a big piece of the pie, but for some some of you out there, some of you women, the stress itself is so high that it can counteract almost anything, and some of that stress comes from the fact that you're just not eating enough, and so they play hand in hand. Right, all of this plays together. So this is why I like spending about two months initially dialing in those habits for lifting, for eating enough food, for eating enough protein and carbs yes, both and kind of seeing where you are with the numbers and with maintaining that high energy state, and then you can decide okay, from this point I'm in a really good stress situation training and nutrition situation, hormone situation to go after the fat loss, and even then you may need a more aggressive or less aggressive fat loss approach, depending on where your metabolism stands. So that's, those are my takeaways for like the big picture of what to do.

Philip Pape: 23:16

What's the solution framework here for women in perimenopause? Once you understand why this is happening and that it's primarily due to the loss of muscle mass, primarily and I would look at this transition as if we can reframe it for you as just the perfect time, just the perfect opportunity to develop more metabolic resilience and metabolic flexibility, because when your body is forced to adapt to new hormonal conditions. It can become more efficient and more resilient when you have the right strategy and you can end up with improved metabolic health, much more improved than you might have had even in your 20s and 30s and we sometimes neglect this aspect. But the health, the longevity, the metabolism because you have a better body composition, because you have more energy, because you're stronger than what you had in decades past and you're working with this new reality of your body, this transition could be just a completely new identity for yourself as a strong, functional, athletic person in life. And remember, your body is not broken during menopause. It's far from it. It's adapting to a new reality and you just have to give it the right inputs right the adequate protein, the resistance training, proper recovery, not constantly dieting, setting yourself up for fat loss in a more efficient, effective way. And that's a really, really positive thing when you can do that.

Philip Pape: 24:42

It's what I love helping women do, because it can be very challenging. The first, I'll say, few months of this process are a lot of discoveries happening, education along with patience, and that's the real challenge for a lot of you is that without that patience, all the learning and information in the world is not going to matter because you're not going to be able to apply it. And so knowing that this can be the beginning, just the very beginning, of the strongest, healthiest phase of your life, when you have the information but then you implement it with the patience, is going to pay off big time. It's just going to be amazing. So I want you to remember that the weight gain, the body composition changes during peri and post menopause are not inevitable. They are not right. They are not from just getting older, they're not just because of hormones. They're a sign that your body, or they're not a sign that your body's failing or you're doomed to struggle with your weight for the rest of your life.

Philip Pape: 25:36

When we look at the research research peel it back and when I look at real experience with many, many different clients across the spectrum of menopause and different situations, we see that the interplay between the declining estrogen, the rising FSH, the muscle protein breakdown, the protein leverage, all of that is understandable, it is objective. And then it shows us what works Strategically increasing the protein, strategically adding in progressive overload-based strength training and, in many cases, yes, hormone replacement therapy. It's all of those things. Now you may not want to have medications or therapy or whatever, and that's fine. I've worked with clients who said you know, I want to go all natural with this, and then we again have to have the realistic expectations for what that means. You can still have incredible progress, absolutely Okay, absolutely.

Philip Pape: 26:26

The women who thrive during this transition are those who understand what's happening in their bodies, their personal own bodies. That's what I mean, not just the science, that's great, but they actually collect the data, they measure things, they track things Not in an obsessive way, not in a way that's highly convenient or takes a lot of time In a very efficient way, measuring the right things, making it a habit, and not trying to fight physiology by doing it too quickly or being impatient or throwing up your hands saying no, no, no, this doesn't work, I'm done. Or I tried this for a week and I got frustrated. My scale weight popped up. It doesn't work. Those attitudes are not going to serve you well, but an attitude of patience and ownership and positivity, of hey, I know this can work. I'm going to take the philosophy and the steps that Philip just talked about and figure out what the low-hanging fruit is for me and for many of you.

Philip Pape: 27:17

It might be that you're not strength training or doing it in a way that progresses, or maybe you're not strength training or doing it in a way that progresses, or maybe you're not tracking your food. You're not even sure how much you eat. Maybe you're not eating enough, maybe you're not eating enough protein or carbs. All of that and it's just updating your strategy objectively to match your phase of life, and then you're going to be amazed at what's possible. You really are All right.

Philip Pape: 27:36

So if you're ready to take some action with an evidence-based approach that we talked about for women navigating fat loss during peri and post-menopause, the guide that I put together lays out the key steps that we talked about today so you can personalize it for yourself. It's called Menopause, fat Loss Over 40. It includes everything we discussed how to plan your calories and macros, how to train, all of it. Go to witsandweightscom, slash free or click the link in the show notes. Until next time, keep using your wits lifting those weights and remember this transition isn't the end of your fitness journey. It's the beginning of a new, empowered chapter of life where you understand your body better than ever before. I'll talk to you next time here on the Wits and Weights Podcast.