Thursday, May 5, 2011

The Skinny on Hormonal Fat

Okay,  true enough:  I told Nina, my oncology nurse, that of all the symptoms brought on by Arimedex (painful achey joints, sudden debilitating tiredness, and significant increase in centrally-located pudge) the one I was least concerned about was the weight gain.  Hey, I've had practice being fat!  

But the truth is, it has been discouraging to experience my weight going up up up (again) after years of working to bring it down.  (Okay, sure, the cancer/not-being-able-to-eat-thing accounts for the last 25 lbs that fell away last summer.)  It has come back so suddenly that I have not grown accustomed to it, and I am newly aware of just how uncomfortable it is--- and that's besides the challenge it presents to my ego and my aesthetic sensibilities.

I am also newly aware of how often we are invited to hate our bodies in this culture (and I still think that applies especially --although not exclusively-- to women).  I have to remind myself, Hey, you know-- I can still walk around in this body (not as far or as fast as I used to, but it gets me from here to there).  I can see, smell, hear, taste, feel  and experience beauty.   I can go to the bathroom (Yay!  No, really, if you've never been challenged in this area you have NO IDEA how grateful I am).  And when I consider all the thousands of functions my body takes care of without my even being aware of it -- I don't remind myself to blink or or breathe or circulate blood.  If I want a drink of water, my body picks up the glass without my brain even consciously issuing the command--  I really have to admit that there is so much more going right in my body then going wrong.  For a 50+ year-old vehicle with some major issues, it is holding its own pretty damn well.    

Still...  I was more comfortable about 35 lbs ago.  Is there something I can do about this?  What IS the connection between every molecule of estrogen being sucked out of my system and this newly inflated spare tire?  Well, I've done some looking into it -- after all, Curious Minds (especially female minds over 45) Want to Know.  Here's the scientific skinny:
Hormones Involved in Weight Maintenance
Estrogen: Estrogen is the female sex hormone that is responsible for causing monthly ovulation. During female menopause, your estrogen levels decline rapidly, causing your body to stop ovulating. However, estrogen also seems to play a big role in menopausal weight gain. As your ovaries produce less estrogen, your body looks for other places to get needed estrogen from. Fat cells in your body can produce estrogen, so your body works harder to convert calories into fat to increase estrogen levels. Unfortunately for you, fat cells don't burn calories the way muscle cells do, which causes you to pack on the unwanted pounds.
Progesterone: During menopause, progesterone levels will also decrease. Like estrogen, lower levels of this hormone can be responsible for many of the symptoms of menopause and that includes weight gain, or at least the appearance of it. Water retention and menopause often go hand in hand since water weight and bloating are caused by decreased progesterone levels. Though this doesn't actually result in weight gain, your clothes will probably feel a bit tighter and you may feel a bit heavier. Water retention and bloating usually disappear within a few months.
Androgen: This hormone is responsible for sending your new weight directly to your middle section. In fact, weight gain during menopausal years is often known as "middle age spread" because of the rapid growth of the mid-section. Often, one of the first signs of menopause is an increase of androgen in your body, which causes you to gain weight around your abdominals instead of around your lower half.
Testosterone: Testosterone helps your body to create lean muscle mass out of the calories that you take in. Muscle cells burn more calories than fat cells do, increasing your metabolism. In natural menopause, levels of testosterone drop resulting in the loss of this muscle. Unfortunately, this means a lower metabolism. The lower your metabolism is, the slower your body burns calories.
Terrific!  At least now we know-- it is Real, it is, in some ways, Not Our Fault.  But.  Is there anything we can do about it?  Pretty much the same old, same old:

Eat a balanced diet. Avoid refined sugars and indulge in fruits and vegetables. 
Avoid crash diets. Starvation will only cause your metabolism to slow down, causing you to gain more weight later on.  
Don't lose large amounts of weight. Being very thin can lead to an increased chance of developing osteoporosis. 
Limit your intake of caffeine, nicotine, and alcohol. These can exacerbate water retention.

Remain active. Do aerobics to increase your metabolism and burn fat. Do weight bearing activities such as walking and cycling to increase muscle mass and ward off osteoporosis.

But here's some advice beyond the usual suspects:
Instead of hating your new body, try to be more accepting of yourself. 
Focus on being healthy and active, not trying to fit into your old clothes. 
Yeah.  I hear that.  Accepting where you are, not despising what you have. Cultivating gratitude.  For the first year of our practice together, my yoga teacher Meg would end nearly every session by saying, "A grateful heart leads to a peaceful life."  The presence of pudge can definitely present a daily challenge to my ability to cultivate gratitude for my body.  

Theodore Roethke has a poem that goes, in part:

God bless the Ground!  I shall walk softly there,
And learn by going where I have to go.

Yeah.  As another poet said, 
Aye, there's the rub!