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[Noheroicsplease]

It's pretty unlikely you know everything covered in the Metabolism and Menopause podcast, and going by your other thread you know everything there is to know about ferritin levels and it was ridiculous of me to give advice on that one too.

As my old school maths teacher used to say - you can take a horse to water but you can't make it drink....

Hi Joziel, sorry if you are offended by my responses. This was not my intention. Communicating online with a strange always lacks nuances.

I haven't visited MM in a long time and you're clearly very active on the board. But I guess I get a little peeved when someone makes assumptions about my lack of knowledge and takes on an almost clinical role with me. I come on here with specific questions about personal experiences around certain issues. My fundamental knowledge of menopause, stuff like ferritin levels, nutrition etc is actually very strong (it's in my line of work).  But I'm probably not the best person for these boards, as I can come across as slightly icy.

 

[ElkWarning]

No one should be eating 1200 calories for any longer than 12 weeks at a time, as a diet or cut. If you remain in a low calorie state, your body will adjust and your metabolism will slow down - making it impossible to lose weight.

Hi Joziel, you seem very knowledgeable, how do you know all this, is it your job?

However, I don't understand how the above quote can be true, as someone who is anorexia still carries on losing weight.

I used to work in psychiatry and a branch of it was disordered eating.  Here's a useful starting point - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639963/

[joziel]

Hi Joziel, you seem very knowledgeable, how do you know all this, is it your job?

However, I don't understand how the above quote can be true, as someone who is anorexia still carries on losing weight.

I know all this from hard-won experience and a lot of personal suffering, ended by research and understanding. (And a lot of help from people who are experts in their field.)

As for how someone who is anorexic continues to lose weight, there is a point below which everyone will lose weight. After all, you don't see concentration camp victims gaining weight....

But unless you are literally trying to eat as little as possible (which is anorexia) and unless you are existing on something like 300 calories a day, you will gain weight if you are eating 1200-2000 or below maintenance long-term.

The body has many mechanisms (thyroid is one) to down-regulate metabolism at times when food is scarce. That's how our ancestors survived. You are telling your body that it is a period where food is scarce and so the body should be economical with energy expenditure - to survive. Sex hormones are one of the things which get down-regulated because reproduction is not a priority at times of scarcity.

Typical maintenance calories are something like 2000-2200 for most women and that's where you should be, most of the time. That will ensure hormones are optimal and the body is able to function optimally. If you want to lose weight, you need to go into a deficit of between 200-500 calories (depending on how resistant your body is) but for no longer than 12 weeks max. Then you need to reverse diet back up out of it again and go back to maintenance. If you didn't lose enough weight and want to lose more, you repeat the process after a period of time back at maintenance.

You can't stay long-term in a caloric deficit or your metabolism will slow down, you won't lose more weight and you will be stuck eating hardly anything. Then you cut calories again - and so on.... until you end up gaining weight whilst eating below maintenance.

You can find this info on loads of fitness Instagram accounts for women these days, by the way. As well as in that excellent Metabolism and Menopause podcast I mentioned.

[Twinmummi123]

This is a more specific question than 'does HRT make you put on weight'...but I've noticed my thighs and buttocks are a fair bit bigger after HRT. I can't decide if this is just the passage of time - I work out a lot and don't eat very much. My stomach is fine, my breasts are bigger, but I def look more pear shaped. Waist is small.

thoughts welcome. I take Estrogel and Utrogestan and Testogel (testosterone might also be encouraging weight gain?)

I think I am able to regulate my weight easier when my HRT dosage is right.

If my HRT is off then I am anxious and stressed and this leads to overeating.

1200 calories is a very low amount of food and will not remove fat in particular areas, if you are doing a lot of exercise…your body will cling to any fat you have. I speak from experience of this…1200 calorie eating was the most miserable time of my life.

Good fats, proteins etc are the way to go…I eat a whole avocado a day, add high polyphenol oil to all my meals and add seeds such as pumpkin or flax to most meals.

Plenty of fresh berries, plenty of water and a little bit of what I fancy too. I don’t drink alcohol any longer and now my sleep is improving that also helps with regulating weight.

I enjoy walking and tend to be on my feet for at least 11 hours a day with my work.

So in summary no, I don’t feel weight gain on hips or bum or thighs is directly related to HRT.

[Twinmummi123]

Noheroics, if you are only eating 1200 calories a day and you are working out a lot and gaining weight, you urgently need to do a reverse diet.

It is very hard to get this information across to women - but I myself was in this situation most of my life.

I was eating hardly anything but, if I ate any more, I gained weight. I felt like I was constantly depriving myself of food - or I would quickly gain the weight. Please don't make the same mistakes I did and live in the misery I lived in.

No one should be eating 1200 calories for any longer than 12 weeks at a time, as a diet or cut. If you remain in a low calorie state, your body will adjust and your metabolism will slow down - making it impossible to lose weight.

You need to eat consistently (3 meals a day), enough protein (1g per lb of body weight) and importantly you need to do a reverse diet upwards if you find yourself on a low calorie intake for a prolonged amount of time with a slow metabolism.

With a reverse diet, you increase your calories by 100 every 2 weeks. The increase is so gradual your body doesn't notice it and adjusts to roll with it without gaining weight. So you can end up back on your 2000-2200 maintenance, which is what most women should be eating. If you do want to lose more weight, after a period at maintenance you then cut calories by a few hundred for NO LONGER than 12 wks. You will lose weight before your metabolism can adapt. And so on.

For more information look up the podcast called 'Metabolism and Menopause' and find the episodes on the reverse diet.

Don't eat 1200 calories a day, that's insane and unhealthy - your body will not get the nutrients it needs on that low calorie intake, long-term... plus you will only gain weight... whilst eating nothing. That is what happened to me.

****THIS****

[joziel]

The thing is, before I reached rock bottom with it all, someone could literally have told me this and I would have basically ignored them or thought it wasn't relevant to me (for some reason).

I had to reach the point where I was able to eat almost nothing with no end in sight, wondering what the point of life was if I couldn't ever enjoy food, before I became desperate enough to actually be able to hear people who were trying to help.

And there are so many women out there like this.

Men don't get it, either. If you watch fitness posts on Insta by men, they will say things like 'eating 1200 calories and still gaining weight? you can't be eating 1200 calories, you're calculating wrong' and that kind of thing. It is absolutely possible to eat F-all and gain weight if your metabolism has down-regulated over years of under-eating....

[AngelaH]

This is a more specific question than 'does HRT make you put on weight'..

In some ladies and in some cases HRT does make us put on weight. Because changes in hormonal levels can cause weight gain or loss.

From my experience only. Before peri I always was a slim lady, no bigger than size 8 until the age of 46. When peri started I did notice my metabolism slowed down and as a result I put weight and change my size to 10. Because my problem in peri was only progesterone, after I started progesterone treatment my metabolic process was back to normal and I lost weight, back to my previous. When I reached menopause and my estrogen went low, causing meno symptoms, I started HRT, which I couldn’t put right for more than a year, and despite I was on very low dose of estrogen I noticed I looked fatter than before, I still wore the same size of clothes, but I felt all my clothes were quite tight. Since I changed my type of HRT, which is now synthetic one, my metabolism is back to normal and all my clothes are quite loose now.

So it’s all about hormonal balance. If hormonal balance is right for the body, metabolism is good and you can easily control your body weight. If imbalances take place, metabolism slows down and weight of the body is out of control.

And because you are asking about specific parts of the body, I only can suggest that we all have different bodies shapes and this is why we can put weight in different parts of our bodies.

I don’t think Testosterone itself has effects on body weight. All my life I was a very androgenic lady, but I never had problems with weight.

[VioletAquarius]

Thanks Joziel and ElkWarning.

[Hurdity]

It is well known as Kathleen below points out ( and highlighted on this website https://www.menopausematters.co.uk/weightgain.php scroll down to weight distribution)  that our shape changes as we reach menopause because of the balance between oestrogen and testosterone - as oestrogen declines dramatically at menopause, our ratio of O to T decreases to more on the androgenic side. Adding oestrogen  can reverse this to some extent though I'm not sure there is research on exactly how much oestrogen one would need to make a noticeable difference!

I have put on weight ie fat just recently but I've been on HRT for 16 or 17 years and the fat gain is fairly recent. I should do more strength training especially as I take testosterone. My waist size is ridiculous - ie far too big though I can get away with this to some extent because I have a medium frame size and the oestrogen I take has caused my boobs to maintain their density so I do still have a figure as such. Personally probably my oestrogen level is too low to make a noticeable difference to my hips and thighs, but actually I would welcome the redistribution back to a more favourable female shape generally!

Hurdity x

[Furyan]

I have had huge issues with weight particularly when oestrogen is either too low or high (or generally out of balance with progesterone. Much is water weight and less oestrogen is much better for reducing water retention for me. I recently had to up my patch to 75 and I then discovered that the weight around my mid area was probably caused by too low oestrogen! As some have said, metabolism is more about the relative balance between the hormones rather than the absolute quantity of each in isolation. I also learned that a keto diet and fasting is no longer healthy for my post-menopausal state especially taking in exogenous oestrogen so I have to increase my carbs (healthy ones) a little.

[joziel]

Furyan, too right.

I think many women are on starvation rations of estrogen which are almost homeopathic for the effect they have. We are not testing routinely to ensure absorption and not monitoring to be sure women are above a certain amount in serum estradiol. We are also giving it by dosage applied rather than amount absorbed. You get lucky if you absorb well and so have decent levels, and tough poo if you have thick skin (or something!) and don't absorb it.. you just suffer the consequences unless you are incredibly resourceful.

It's unfair and it's medical misogyny.

[AngelaH]

“Pear” and “apple” shapes are both classic female shapes of the bodies. They are not androgenic. Unfortunately using HRT doesn’t guarantee right balance for the body. Transdermal HRT this is pretty much DIY kit, I even don’t know how on Earth anyone can get right balance  on it, to be honest. Since I changed type of HRT I lost so much water and fat through all my body, unbelievable!!!

[joziel]

What did you change to/from, Angela?

[AngelaH]

What did you change to/from, Angela?

I was trying transdermal HRT for more than a year. Patches, gel, spray with Mirena, Utrogestan. Unfortunately due to my highly sensitive body it made me feel worse and more imbalanced. I felt better on over the counter transdermal HRT, but was not able to get stable results. Because I am post meno I changed to Tibolone, no DIY anymore, just choose right time for your body when you prefer to take it and go.

[Hurdity]

“Pear” and “apple” shapes are both classic female shapes of the bodies. They are not androgenic. Unfortunately using HRT doesn’t guarantee right balance for the body. Transdermal HRT this is pretty much DIY kit, I even don’t know how on Earth anyone can get right balance  on it, to be honest. Since I changed type of HRT I lost so much water and fat through all my body, unbelievable!!!

We're not talking about the natural variation in the female body shape, but the change that results in increasing amoints of fat that are laid down in the mid-section post-menopause, rather than hips and thighs, and "apple" and "pear" are convenient (if crude) ways of summarising this. The change happens to (many? most?) invididuals. This is a consequence of reduced oestrogen and by implication a change in the oestrogen:testosterone balance. Waist get larger even if bust and hips remain the same. Some people prefer not to use the term androgenic but it is well known that high androgens can result in a change in the female body shape.

Hurdity x