Menopause + Obesity: A Lethal Combination

We tend to think of excess weight as something benign, more an aesthetic problem than anything else.  This couldn’t be further from the truth.  Did you know that fat is actually an active endocrine organ?  In other words, it is producing tons of hormones, cytokines and growth factors, all of which play an active role in inflammatory processes.  This inflammation underlies multiple chronic conditions, including diabetes, coronary heart disease, cancer, and Alzheimer’s disease; inflammation has also been shown to suppress immunity.  So yeah, fat can be lethal.

This is especially important for women to consider as they enter perimenopause and menopause, as our weight distribution shifts towards excess “central adiposity” or belly fat, which has a direct correlation to sex hormones and makes women more vulnerable than men to chronic inflammatory conditions of the body and brain. And the brain in particular is at risk, as both independently and cooperatively, aging, menopause, obesity, and inflammation have been shown to lead to cognitive decline and Alzheimer’s.

We need to get real about obesity.  It is not possible to be both healthy and overweight at the same time – no matter what popular culture would like us to believe. 

I know, it sucks!  It’s much harder to keep off weight as we age, and things that used to not make a difference – for me, lots and lots of cookies and cake (my sweet tooth was always out of control), not to mention wine – now pack on the pounds.  But if we want to be vital and active and disease-free in midlife and beyond, those extra pounds need to go. 

The good news is that with every excess pound of fat you release, so goes some measure of inflammation; and with less inflammation, our joints work better, our cardiovascular system improves, we enjoy greater immunity (so important right now!), and we protect our brain from age-related cognitive decline and Alzheimer’s disease.  

One thing to note: there are some studies that have pointed to this connection between hormones, estrogen depletion at menopause, and inflammation as an argument for using hormone replacement therapy to combat both excess fat and cognitive decline in middle age.  And in fact you often find HRT being marketed as a protective measure against weight gain, cognitive decline, and cardiovascular disease. 

But there are conflicting findings out there when it comes to HRT, and logically it just doesn’t make much sense: fat cells actually make estrogen, and there is a close correlation between obesity and breast cancer, heart disease, rheumatoid arthritis, and osteoarthritis.  It’s even been theorized that predisposition to certain inflammatory conditions has to do with total lifetime estrogen exposure, which explains why men and women who have never given birth have a lower incidence of these diseases.  So why would you want to add more estrogen to the mix?  Better to lose the fat, turn down the inflammation, and let the body find homeostasis (its hormonal happy place) on its own.  You don’t need hormone therapy to do that, you just need a healthy diet and some exercise.

Here’s the bottom line, and it’s okay if you hate me for it: now more than ever, it is absolutely critical to lose any extra weight you are carrying around, and it has nothing to do with how your clothes fit.  Your life literally depends on it.