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Perimenopause Doesn't Cause Weight Gain (Your Metabolism Is Fine) · Wits & Weights | Strength & Fat Loss Over 40

• 0:00
  Philip Pape: If you've been gaining weight since your late 30s, into your 40s, and somebody told you, well, that's just perimenopause, maybe you don't question it anymore because, hey, it explains everything.
• 0:10
  Philip Pape: It also takes the blame off you at the same time.
• 0:12
  Philip Pape: Today I'm evaluating that claim against the longitudinal data.
• 0:16
  Philip Pape: And that means a study that followed more than 1,200 women through the transition using DEXA scans.
• 0:22
  Philip Pape: You'll learn what the scale actually does across those years, what genuinely changes that, hey, it's not your fault and not under your control, and why the metabolism piece of the story is actually the weakest link.
• 0:37
  Philip Pape: Welcome to Wits and Weights, the show that puts a popular piece of fitness advice under the microscope, finds the hidden reason it doesn't work, and gives you the deceptively simple fix that does.
• 0:50
  Philip Pape: I'm your host, certified nutrition coach, Philip Pape.
• 0:53
  Philip Pape: And on the last episode, our big 500, I went through five beliefs that I used to hold about strength training over 40 and no longer do.
• 1:02
  Philip Pape: Today it's sort of a sixth one, except this isn't something that I believe, but something that the entire industry has a collective delusion about, I'd say, and they keep repeating over and over, likely in the interest of selling you their quick fix program or the program that is the only one that can solve your problem.
• 1:19
  Philip Pape: So menopause weight gain is probably the single most repeated explanation in midlife fitness right now.
• 1:27
  Philip Pape: I see it on threads, Instagram, Facebook, everywhere.
• 1:30
  Philip Pape: And I understand why, because it happens exactly when your weight does often tend to go up, or at least you have trouble losing weight around for many women in your early to mid-40s.
• 1:43
  Philip Pape: Sometimes it's earlier, right?
• 1:44
  Philip Pape: Like perimenopause, uh, that window can be quite long, can start in your mid-30s.
• 1:48
  Philip Pape: But let's say 44, 45, 46, your genes get a little tighter, your cycle's getting a little more volatile because of the hormones.
• 1:56
  Philip Pape: Of course, everybody's saying, oh, it's because of your hormones.
• 1:59
  Philip Pape: And of course, that sounds reasonable, right?
• 2:02
  Philip Pape: It sounds kind of intuitive.
• 2:04
  Philip Pape: And you hear things like, hey, the math no longer applies because your body's changing.
• 2:08
  Philip Pape: Whatever worked in the past doesn't work today.
• 2:10
  Philip Pape: Your metabolism might be slowing down.
• 2:11
  Philip Pape: Maybe you're losing muscle, maybe you're losing both.
• 2:13
  Philip Pape: There's so many things.
• 2:15
  Philip Pape: And I want to examine that today and kind of separate the wheat from the chaff, right?
• 2:20
  Philip Pape: Get to the heart of the matter, like things that you can actually control that matter, and the things you can't, or maybe things that aren't even really happening.
• 2:28
  Philip Pape: And then stick around to the end because I'm gonna share a study where lifting weights cuts hot flashes by 44% and what they did.
• 2:37
  Philip Pape: And you're gonna like it because the recommendation is pretty much what I recommend anyway, but we're gonna reinforce exactly what that is.
• 2:44
  Philip Pape: Okay, I know I'm such a tease.
• 2:45
  Philip Pape: Okay, so here's the roadmap for today's episode.
• 2:48
  Philip Pape: And I'm gonna come back to them, but I always encourage taking notes.
• 2:51
  Philip Pape: First, what does the data, the human trials, longitudinal data show about weight versus body composition across the menopause transition?
• 3:01
  Philip Pape: All right, I'm already giving you a little bit of a hint.
• 3:04
  Philip Pape: Second, what about the metabolism claim specifically?
• 3:07
  Philip Pape: Uh, and I want to spend a decent amount of chunk of time there because I think that is the one that is has the thinnest evidence that people misstate.
• 3:14
  Philip Pape: Third, what about men over the same decades?
• 3:19
  Philip Pape: What if we compare to what happens to men?
• 3:21
  Philip Pape: That's gonna be interesting to see because if if we if men are doing something that is also happening to women, maybe we can take away some of the variables and simplify this.
• 3:29
  Philip Pape: Um, and then finally, I'll tell you where I think the whole argument just falls apart.
• 3:34
  Philip Pape: And I'm gonna have a little bit of tough love.
• 3:37
  Philip Pape: Maybe you think I'm unkind, but it's gonna be the truth.
• 3:40
  Philip Pape: It's gonna be tough love, and I think it might be the most important part of the episode.
• 3:43
  Philip Pape: Okay, let me start with a mainstream position.
• 3:47
  Philip Pape: And I mean the real like medical bodies or organizations, not the interwebs or Reddit or whatever.
• 3:54
  Philip Pape: Although Reddit could be pretty good, but also could be pretty terrible because it the real like medical and scientific advice does not say what you've necessarily been told it says.
• 4:06
  Philip Pape: Okay, so if you go to Mayo Clinic's page on menopause weight gain, it says hormonal changes alone don't necessarily cause the weight gain, and that it's usually related to aging along with lifestyle and genetic factors.
• 4:18
  Philip Pape: Then we have the menopause society.
• 4:20
  Philip Pape: I love the menopause society personally, actually.
• 4:22
  Philip Pape: I think if you can provide a find a provider, like an OB, that is associated with them, you'll probably have a higher quality person who really gets this stuff and tends to treat symptoms and understand things like HRT better.
• 4:34
  Philip Pape: Anyway, the menopause society says aging is the primary driver of weight gain and that menopause plays its role in redistributing fat.
• 4:43
  Philip Pape: The International Menopause Society published a position statement in 2012 saying that weight gain per se cannot be attributed to the menopause transition and that the steady gain of about a half a kilogram a year is due to age rather than menopause itself.
• 4:59
  Philip Pape: So the official organizations already say roughly what I'm gonna spend 20 minutes saying.
• 5:05
  Philip Pape: And that's important because medical consensus does have some weight.
• 5:10
  Philip Pape: As much as the world we live in today with HHS and RFK Jr.
• 5:15
  Philip Pape: and social media and broscience and everything else, right?
• 5:19
  Philip Pape: And people pushing hormone treatment and the clinics and everything else, there's something to be said about scientific medical consensus based on real studies.
• 5:27
  Philip Pape: There really is.
• 5:27
  Philip Pape: There is a drift off of that consensus that has happened over the last roughly 15 years and it's been it's happened on social media.
• 5:37
  Philip Pape: A lot of the loudest menopause causes weight gain messaging comes from people selling hormone therapy or a supplement or a menopause coaching program or menopause stack or whatever.
• 5:48
  Philip Pape: I'm not saying that they are lying.
• 5:50
  Philip Pape: I'm not saying that they don't have good intentions.
• 5:52
  Philip Pape: Some of them are clinicians with lots of letters after their names that I might even take seriously on other topics.
• 5:58
  Philip Pape: I'm not, I am saying that a claim which conveniently requires the thing that is being sold, it deserves a second look, a little bit of skepticism.
• 6:10
  Philip Pape: Okay.
• 6:10
  Philip Pape: And I like to disclose my conflicts, right?
• 6:14
  Philip Pape: I sell an app, Fitness Lab, that tries to debunk all these mixed myths in the very essence of its messaging.
• 6:21
  Philip Pape: So you should always apply the claim to me as well.
• 6:23
  Philip Pape: Like, what am I trying to sell you?
• 6:24
  Philip Pape: I have coaching, I have an app.
• 6:25
  Philip Pape: What am I trying to sell you?
• 6:26
  Philip Pape: Okay.
• 6:27
  Philip Pape: The British Menopause Society is the interesting exception, by the way.
• 6:30
  Philip Pape: Their patient fact sheet leans closer to the popular framing of this.
• 6:36
  Philip Pape: They describe perimenopause as a kind of perfect storm for weight gain.
• 6:40
  Philip Pape: So this is not a case where every expert body agrees in its own form of an echo chamber and that only influencers are dissenting here.
• 6:48
  Philip Pape: I'm not going to tell you that either.
• 6:50
  Philip Pape: All right.
• 6:50
  Philip Pape: Even in the literature, there's always some disagreement.
• 6:53
  Philip Pape: Okay.
• 6:53
  Philip Pape: So let's go to the best data that we have, which I think is the Swan study, the study of women's health across the nation.
• 7:00
  Philip Pape: You probably heard me reference this many times at this point on the podcast because it's such a good data set.
• 7:05
  Philip Pape: They followed women through the menopausal transition for up to 18 years with DEXA scans.
• 7:11
  Philip Pape: Now, I've talked about DEXA versus other forms of body fat measurement.
• 7:14
  Philip Pape: And I think it's a great tool when used in a research context, especially, where they're able to control how it's used.
• 7:20
  Philip Pape: Okay.
• 7:20
  Philip Pape: And they tend to use higher quality or better calibrated machines and things like that too.
• 7:24
  Philip Pape: But it is a good tech, it is a good way to measure distribution of tissue.
• 7:30
  Philip Pape: So we're not just using, for example, scale weight.
• 7:34
  Philip Pape: Okay, we're gonna measure fat and lean tissue.
• 7:36
  Philip Pape: Fat and lean tissue.
• 7:37
  Philip Pape: Lean tissue includes muscle mass.
• 7:39
  Philip Pape: The body composition paper from Gail Greendale and her colleagues in 2019 included 1,246 women, and they lined every woman up by her final menstrual period rather than by age.
• 7:54
  Philip Pape: And what they found is that body weight climbed steadily through perimenopause or through pre-menopause.
• 8:00
  Philip Pape: Okay.
• 8:01
  Philip Pape: Body weight climbed steadily through pre-menopause, through the transition to menopause and out the other side, and that slope of increase didn't accelerate in any meaningful way at menopause.
• 8:14
  Philip Pape: It just kept going the way it had been going.
• 8:16
  Philip Pape: Now, underneath that increasing line of body weight, two things were changing at once.
• 8:21
  Philip Pape: Fat mass gain roughly doubled, going from a quarter kilogram a year before the transition to 0.45 kilograms a year of increase after the transition.
• 8:32
  Philip Pape: And then lean mass, which again includes muscle, flipped around from very slightly gaining to actively losing right around two years before the final period.
• 8:42
  Philip Pape: Now it's interesting that these women were at least even just slightly gaining weight beforehand or gaining muscle.
• 8:47
  Philip Pape: Now, that could be because we tend to gain a little muscle mass as we gain weight, regardless.
• 8:52
  Philip Pape: So that probably explains it.
• 8:54
  Philip Pape: But over the three and a half years of the menopause transition, that's about 1.6 kilograms of fat gained and two tenths of a kilogram of lean mass lost.
• 9:03
  Philip Pape: And then both of those trajectories flattened out about two years after the final period.
• 9:08
  Philip Pape: And I went to a workshop maybe a year ago with Dr.
• 9:10
  Philip Pape: Bill Campbell showing that graph, a very fascinating graph.
• 9:13
  Philip Pape: Okay.
• 9:13
  Philip Pape: So, ladies, there's definitely something happening.
• 9:16
  Philip Pape: But we need to understand what is happening and what you can do about it.
• 9:19
  Philip Pape: So the scale isn't going to show you that.
• 9:21
  Philip Pape: And the reason is fat gain went up by about 200 grams a year.
• 9:25
  Philip Pape: Lean lean loss, lean mass loss went down by 120 grams a year.
• 9:30
  Philip Pape: So when you add the two, they net out to roughly only 80 grams a year.
• 9:35
  Philip Pape: And that's hardly anything.
• 9:37
  Philip Pape: So the body composition changed dramatically, kind of under the scene or behind the scenes, whereas the weight barely showed any change, which, you know, going from an individual basis from woman to woman, you might have a slight drift up or slight drift down.
• 9:53
  Philip Pape: My point is there's a lot more going on under the hood that you don't see.
• 9:57
  Philip Pape: Okay.
• 9:57
  Philip Pape: And that's what makes like trusting or relying on the scale weight so much very problematic.
• 10:03
  Philip Pape: Now, the scale, you know, I've talked many times about how it's an important, helpful tool when used in the right way, especially when you're looking at your trend.
• 10:12
  Philip Pape: But in this context, the scale can be very, very misleading.
• 10:16
  Philip Pape: It could make you feel like nothing is happening in the exact years when a lot is happening under the hood, and you might be doing a lot of things about it too.
• 10:24
  Philip Pape: And then it's easy for that, you know, passenger in your brain, you know who she is, who beats up on you on a regular basis mentally, to tell you, hey, that's your problem.
• 10:37
  Philip Pape: Okay, now the body fat distribution piece is where menopause really does its thing.
• 10:43
  Philip Pape: The Swan Regional Fat Paper, okay, so this is a kind of a substudy or subset in 2021, it found that visceral fat, good old belly fat, the fat around your organs, the dangerous fat.
• 10:54
  Philip Pape: We don't, it's not great to have too much visceral fat.
• 10:56
  Philip Pape: It's very inflammatory fat as well.
• 10:58
  Philip Pape: And I mean that in the very scientific way of it creates inflammatory compounds like cytokines, et cetera, in your body, which causes a whole host of other issues.
• 11:06
  Philip Pape: Anyway, the visceral fat started rising at the transition at over 6% a year.
• 11:12
  Philip Pape: And android fat, which is that trunk pattern, went from 1.2% a year to 5.5% a year.
• 11:21
  Philip Pape: This is the so you know the bigger uh belly fat and the more hip fat and things like that.
• 11:26
  Philip Pape: There was also a study uh earlier by Pennington or out of Pennington by Jennifer Lovejoy, and it was a four-year study that used CT imaging.
• 11:35
  Philip Pape: I like this study because of how it isolates the variable.
• 11:37
  Philip Pape: Every woman in it gained subcutaneous abdominal fat with age.
• 11:42
  Philip Pape: Okay, that's that's the safer, okay, fat.
• 11:44
  Philip Pape: Only women who actually became postmenopausal gained significant visceral or belly fat.
• 11:50
  Philip Pape: So there is a very real effect from menopause that we've seen with imaging, and that's distinct from aging.
• 11:57
  Philip Pape: Very interesting, right?
• 11:58
  Philip Pape: Nobody should be trying to disabuse you of that notion.
• 12:02
  Philip Pape: That's the truth based on the evidence.
• 12:04
  Philip Pape: And it's also not talked about in the right way, I think, in this industry.
• 12:10
  Philip Pape: Now, let me do the comparison to men, which a lot of people don't do, because this is gonna be fascinating.
• 12:16
  Philip Pape: So if you're a man listening or a woman listening, this is gonna be fascinating.
• 12:19
  Philip Pape: The Fells longitudinal study followed 102 men and 108 women between ages 40 and 66.
• 12:26
  Philip Pape: Men gained weight at about 0.3 kilograms a year and women at 0.55.
• 12:31
  Philip Pape: The fat gain was almost identical, about 0.37 kilograms a year in men and 0.41 in women.
• 12:38
  Philip Pape: Men, of course, don't go through menopause.
• 12:41
  Philip Pape: They don't have a big cliff with their hormones like estrogen.
• 12:44
  Philip Pape: You know, they might have a gradual transition to testosterone, but they don't have this transition that's distinct like women do.
• 12:50
  Philip Pape: And they gained fat across those decades anyway, anyway.
• 12:55
  Philip Pape: So we need to start to say what's causing what here.
• 13:01
  Philip Pape: Now that was a small cohort, right?
• 13:04
  Philip Pape: I said 102 men, 108 women, which isn't nothing.
• 13:07
  Philip Pape: It's not like studies I have 10 people, but it's not as good as maybe somebody with someone with 500 or 1,000.
• 13:12
  Philip Pape: The day is a little bit older.
• 13:14
  Philip Pape: It's hard to compare the sexes across studies because of other variables, potentially.
• 13:19
  Philip Pape: Women did gain somewhat more total weight and women lost fat-free mass faster.
• 13:24
  Philip Pape: So I'm not claiming the sexes are identical.
• 13:27
  Philip Pape: I'm just saying that there is some overlap happening with age that we have to account for before saying, okay, what is left?
• 13:33
  Philip Pape: I hope that makes sense.
• 13:34
  Philip Pape: Now I just want to take a quick moment to talk about if you are wondering how to control the lifestyle factors that we're gonna talk about, especially your nutrition and your training, and you've been hearing the message over and over my metabolism is broken.
• 13:49
  Philip Pape: I'm not sure what to do.
• 13:51
  Philip Pape: I can't stay consistent.
• 13:52
  Philip Pape: I can't see the results.
• 13:54
  Philip Pape: That is the problem my app was built around called Fitness Lab.
• 13:58
  Philip Pape: I'm very proud of this app.
• 13:59
  Philip Pape: Everyone who's using it now are finding it very helpful because of not just the features, but how it keeps you going to the gym, watching what you eat, being flexible, being sustainable, actually starting to move the needle in a very confident way that integrates your whole lifestyle.
• 14:16
  Philip Pape: It's kind of like a lifestyle app almost.
• 14:18
  Philip Pape: Okay, it doesn't just give you numbers like here's your expenditure, here's a calorie target.
• 14:23
  Philip Pape: It is far, far, far more than that.
• 14:26
  Philip Pape: It's a little bit unusual, in fact.
• 14:27
  Philip Pape: So I want to explain it today.
• 14:29
  Philip Pape: Yes, this is part of a pitch, I'll say, but it's also why we need to think of these a different way.
• 14:35
  Philip Pape: All right.
• 14:35
  Philip Pape: Total energy expenditure estimates typically have enough error that when you anchor to it with your calorie deficit, for example, you tend to just start distrusting the idea of calories in, calories out, or the idea of calorie deficits, fat loss, all of that, especially when you do it in conjunction with your scale.
• 14:54
  Philip Pape: I also have seen that having targets, just having numeric targets, can create these all or nothing past fail comparisons in your brain.
• 15:03
  Philip Pape: And then you start to judge yourself.
• 15:05
  Philip Pape: And then you start to feel like even in even in neutral apps, you know, like some apps that I like that don't really judge you intentionally, you still tend to judge yourself and you create this loop that is connected with dieting history and dieting culture, probably from your past, that led to these multiple cycles of cutting and gaining and cutting and gaining.
• 15:24
  Philip Pape: So we take something like my app Fitness Lab, it uses AI.
• 15:28
  Philip Pape: It's technology.
• 15:28
  Philip Pape: I'm gonna admit that because AI is amazing when you can use it for good.
• 15:32
  Philip Pape: So, what it does is it reads the rate of change in your weight, it reads the trends, it looks at your lifting, it looks at your biofeedback.
• 15:40
  Philip Pape: If you use an iPhone and connect it to Apple Health, it can pull up to 85 metrics from sleep to nutrition to workouts, everything, to then infer, hey, what is going on with your body right now?
• 15:52
  Philip Pape: Let's put those patterns together.
• 15:54
  Philip Pape: And I know you want to lose fat, but here's some tough love on the reality of what's going on and how you can do that successfully.
• 16:00
  Philip Pape: So, anyway, I wanted to just kind of take that detour because we are running a Labor Day sale right now through September 15th.
• 16:07
  Philip Pape: And the only way to get the 30% off permanently is if you're on my email list.
• 16:12
  Philip Pape: If you're not on the list, go to witsandweights.com slash email.
• 16:15
  Philip Pape: That's witsandweights.com slash email.
• 16:18
  Philip Pape: As soon as you join the list, the welcome email will give you the discount.
• 16:21
  Philip Pape: Again, it expires at the end of September 13th.
• 16:24
  Philip Pape: It's our Labor Day sale, 30% off permanently, but you have to be on our list.
• 16:28
  Philip Pape: Witsandweights.com slash email.
• 16:31
  Philip Pape: Okay, so that's what happens to fat and lean tissue during the menopause transition.
• 16:35
  Philip Pape: Now let's talk about metabolism.
• 16:37
  Philip Pape: Okay, metabolism, this is probably the weakest link of the whole discussion around menopause right now.
• 16:44
  Philip Pape: The popular version says, hey, menopause slows your metabolism.
• 16:47
  Philip Pape: And some people say, oh, it's two or three hundred calories a day.
• 16:50
  Philip Pape: Okay.
• 16:51
  Philip Pape: I don't believe it.
• 16:52
  Philip Pape: I don't believe it because of the evidence, and I don't believe it because of anecdote and personal experience.
• 16:57
  Philip Pape: All of it put together.
• 16:58
  Philip Pape: Herman Poncer published a paper in science in 2021.
• 17:02
  Philip Pape: And if you've read his book, Burn, like I have, I have it on my shelf.
• 17:05
  Philip Pape: It's a great book.
• 17:06
  Philip Pape: You know his work.
• 17:07
  Philip Pape: And he has changed how a lot of us think about energy expenditure.
• 17:12
  Philip Pape: He and his group pooled doubly labeled water data, very high quality way to measure metabolism.
• 17:18
  Philip Pape: And he did it on over 6,400 people.
• 17:20
  Philip Pape: Now, doubly labeled water is the gold standard because you drink water with tagged hydrogen and oxygen.
• 17:28
  Philip Pape: And then they can measure how fast you clear those from your body, which tells them exactly what you burned for your metabolism.
• 17:35
  Philip Pape: Pretty cool, right?
• 17:36
  Philip Pape: And what they found is once you adjust for fat-free mass and fat mass, total energy expenditure is essentially flat from about age 20 to age 60.
• 17:46
  Philip Pape: It is flat across pop the populations, across cultures, Western, tribalism, tribal cultures doesn't matter.
• 17:54
  Philip Pape: Active, inactive, it doesn't start declining until roughly 60 years old.
• 17:59
  Philip Pape: And then it's like 0.7% a year.
• 18:01
  Philip Pape: So this entire window where women are told their metabolism is crashing is the same window where the best measurement we have says, no, it's not really happening.
• 18:11
  Philip Pape: All right.
• 18:12
  Philip Pape: It's not really happening.
• 18:13
  Philip Pape: Now, Ponser's own group will say, you know, we had some limited resting data through midlife specifically, but still they have it all the way from 20 to 60.
• 18:22
  Philip Pape: Then we have a 2023 paper from Carpin and colleagues that went at this directly in 120 women.
• 18:27
  Philip Pape: Some of them were mother-daughter pairs.
• 18:30
  Philip Pape: The adjusted resting energy expenditure did decline with age, which we expect, but the menopausal status didn't contribute anything to that decline.
• 18:39
  Philip Pape: Not estradiol, not FSH.
• 18:42
  Philip Pape: None of them predicted resting energy expenditure once you accounted for body composition.
• 18:47
  Philip Pape: Now, if we look at the other side of the research, Eric Pullman published a six-year longitudinal study in 1995 showing that women who went through menopause had resting metabolic rate drop by about 103 calories a day, compared to eight calories in women who didn't, okay, who didn't go to menopause.
• 19:04
  Philip Pape: And a lot of people cite that study, but when you look at what else happened in the same group, they lost three kilograms of fat-free mass versus only half a kilogram in the non-menopause group, and their leisure physical activity dropped by 127 calories a day, but the comparison groups went up by 64.
• 19:22
  Philip Pape: So the metabolic rate went down because why?
• 19:25
  Philip Pape: Because the muscle decreased and the movement decreased.
• 19:30
  Philip Pape: That's a totally different claim than menopause is just independently lowering your metabolism.
• 19:36
  Philip Pape: Now, Lovejoy's group also measured sleeping energy expenditure in a metabolic chamber.
• 19:42
  Philip Pape: And the decrease was about one and a half times larger in women who became postmenopausal.
• 19:48
  Philip Pape: And fat oxidation fell by about 32%.
• 19:50
  Philip Pape: Now it was a small sample.
• 19:52
  Philip Pape: It hasn't been, I don't think it's been replicated.
• 19:54
  Philip Pape: I'd love to see it done again.
• 19:55
  Philip Pape: But there still does seem to be something genuinely menopause specific happening with how you use fuel.
• 20:01
  Philip Pape: And if you've heard me talk about menopause belly fat and you know substrate oxidation before, that's what I was talking about.
• 20:10
  Philip Pape: And then I think that stands.
• 20:11
  Philip Pape: I think that still is a thing.
• 20:13
  Philip Pape: What doesn't hold up is taking this leap of logic from okay, my body's changing in how it uses the fuel and distributes fat to, oh, you're just gonna burn 200 fewer calories fewer per day.
• 20:27
  Philip Pape: And hey, come come to my program.
• 20:29
  Philip Pape: We're gonna do the reverse diet, metabolic, hormonal reset, optimized program for you.
• 20:35
  Philip Pape: Okay.
• 20:36
  Philip Pape: So one claim is physiology, which is true, the other one is an excuse to sell you something.
• 20:42
  Philip Pape: Now, we have a natural widespread experiment that has occurred for a long time in the world that we should look at, and that's called hormone therapy.
• 20:49
  Philip Pape: If estrogen loss causes weight gain, then guess what?
• 20:52
  Philip Pape: Replacing estrogen should prevent weight gain, shouldn't it?
• 20:55
  Philip Pape: Right?
• 20:56
  Philip Pape: Well, the Cochrane Review looked at 28 randomized trials, over 28,000 women, and they found no evidence that hormone therapy prevents menopausal weight gain.
• 21:06
  Philip Pape: That's crazy.
• 21:07
  Philip Pape: Wow.
• 21:08
  Philip Pape: I've heard a lot of podcasters make the claim that, oh, just go on HRT and it's gonna solve your weight gain issues, issues.
• 21:13
  Philip Pape: What it did find in the Women's Health Initiative body composition substudy, which I know women's health initiative has a huge asterisk because of how it's been interpreted and used for some nefarious purposes, like saying that there's a link, there's a cancer link that that's not there.
• 21:28
  Philip Pape: But if we actually look at the data of 835 women, they found that hormone therapy the hormone therapy group lost quite a bit less lean mass over three years and carried less trunk fat.
• 21:39
  Philip Pape: So guess what?
• 21:40
  Philip Pape: I will agree that estrogen appears to affect where the fat goes and how much muscle you hold on to versus what the scale weight says.
• 21:48
  Philip Pape: And that's exactly everything else we've been talking about.
• 21:50
  Philip Pape: So going back to all the people claiming you you need HRT to lose weight, that's not accurate.
• 21:56
  Philip Pape: But it could probably help with your body fat distribution, which then can help you.
• 21:59
  Philip Pape: With other things, including potentially gaining or losing weight.
• 22:02
  Philip Pape: But again, weight doesn't really matter.
• 22:03
  Philip Pape: What matters is are you healthy?
• 22:05
  Philip Pape: Do you have the energy?
• 22:06
  Philip Pape: Do you have the fuel?
• 22:06
  Philip Pape: Are you functional?
• 22:07
  Philip Pape: Do you look good?
• 22:08
  Philip Pape: Like feel good?
• 22:09
  Philip Pape: All those things that matter, whatever matters to you.
• 22:12
  Philip Pape: Okay.
• 22:12
  Philip Pape: Now, I am not saying menopause is in your head either.
• 22:15
  Philip Pape: Hopefully you couldn't get that from this episode.
• 22:17
  Philip Pape: You know, I'm not saying nothing changed.
• 22:18
  Philip Pape: I'm not saying you're eating more than you think and you won't admit it or you're not tracking properly and all that, you know, things that 25-year-old influences will yell at you about.
• 22:26
  Philip Pape: I'm not saying this is a discipline pro discipline pro discipline problem, because I've seen so many of you be working so hard at this for that to be true.
• 22:34
  Philip Pape: What I'm saying is that four things have changed and they're very specific, just to recap.
• 22:38
  Philip Pape: Your fat moved toward your midsection, toward your organs.
• 22:42
  Philip Pape: That is hormonal and it is measurable.
• 22:44
  Philip Pape: Not your fault.
• 22:44
  Philip Pape: Your muscles started to decrease faster around that final period as you get into post-menopause, not your fault.
• 22:51
  Philip Pape: Your sleep probably got worse.
• 22:53
  Philip Pape: And when we look at the Swan data, it shows hot flashes precede the weight gain with sleep problems affecting part of that, right?
• 23:01
  Philip Pape: Kind of a bi-directional thing.
• 23:02
  Philip Pape: So activity and then adherence are negatively affected by that.
• 23:07
  Philip Pape: And your physical activity most likely dropped, which is behavioral, but it's often downstream of the other ones.
• 23:14
  Philip Pape: Again, rather than quote unquote, your fault.
• 23:17
  Philip Pape: What didn't change in all this is whether energy balance works, calories in calories out, that still does work.
• 23:22
  Philip Pape: That's kind of good news buried in here.
• 23:24
  Philip Pape: Okay.
• 23:24
  Philip Pape: As well as lifting weights and all the other things we talk about.
• 23:28
  Philip Pape: That is the good news because if your body's still gonna respond perfectly normally to those inputs, well, then it's in your control.
• 23:36
  Philip Pape: You are the captain of the ship.
• 23:38
  Philip Pape: It might take you a little long to steer the ship, a little long to turn it around, but you can do it.
• 23:44
  Philip Pape: Okay.
• 23:44
  Philip Pape: So what is the fix?
• 23:46
  Philip Pape: Well, there's four things.
• 23:47
  Philip Pape: So this is where we get to okay, here's the simple fix.
• 23:50
  Philip Pape: Simple, not always easy.
• 23:52
  Philip Pape: Two different things.
• 23:52
  Philip Pape: Simple, but you got to make it happen.
• 23:55
  Philip Pape: First, the scale should no longer be your primary measurement instrument.
• 24:00
  Philip Pape: Okay, it's it can be one of them, and it probably should be if you're trying to calculate your metabolism, right?
• 24:07
  Philip Pape: Like we do in our app and fitness lab or in macrofact or whatever.
• 24:10
  Philip Pape: But waist circumference and strength are probably better indicators.
• 24:15
  Philip Pape: Those two track the things that actually change.
• 24:17
  Philip Pape: If your weight is flat, but your waist is decreasing, that's a huge win, right?
• 24:21
  Philip Pape: You're getting leaner.
• 24:22
  Philip Pape: Second, progressive resistance training is the biggest lever.
• 24:29
  Philip Pape: Okay, but it has to be progressive.
• 24:31
  Philip Pape: As in the loads, weight on the bar, weight on the dumbbells, weight on the machine, and/or the reps are going up over time.
• 24:37
  Philip Pape: You are getting stronger.
• 24:39
  Philip Pape: You're not just doing the same three sets of 12 forever with the pink dumbbells.
• 24:43
  Philip Pape: That's my uh flippant way of characterizing a lack of increasing weight.
• 24:48
  Philip Pape: I apologize.
• 24:50
  Philip Pape: Muscle loss is around three to eight percent per decade after 30, and the menopause transition accelerates it for a few years.
• 24:56
  Philip Pape: Training, therefore, is the only input that can reverse all of that.
• 25:01
  Philip Pape: And we see this in trials in postmenopausal women that are, you know, which are consistent when it comes to strength and lean mass.
• 25:07
  Philip Pape: Okay, this is not just something I believe, this is something that works.
• 25:11
  Philip Pape: Third, protein, protein, protein, protein.
• 25:13
  Philip Pape: We can't talk enough about protein.
• 25:15
  Philip Pape: I'm sorry.
• 25:15
  Philip Pape: And if you're at the point where you're sick of it, then great, then you know what to do.
• 25:19
  Philip Pape: Okay.
• 25:20
  Philip Pape: I work with a minimum of 0.7 grams per pound of body weight.
• 25:24
  Philip Pape: That is what I always say all the time, and I will continue doing that.
• 25:27
  Philip Pape: All right.
• 25:28
  Philip Pape: A an increase above that has small additional benefits.
• 25:31
  Philip Pape: So we always say that anything higher than that is more about preference, lifestyle, balancing your macros, things like that.
• 25:38
  Philip Pape: Maybe even a little bit of optimization if it if it gives you a little bit more muscle potential.
• 25:43
  Philip Pape: That's the third one, protein.
• 25:44
  Philip Pape: Fourth is sleep.
• 25:46
  Philip Pape: Now, I want you to think of sleep and hot flashes as a body composition intervention.
• 25:52
  Philip Pape: Because remember, in the Swan study we talked about, that's the pathway that tends to connect menopause to weight.
• 25:57
  Philip Pape: If you can fix the vasomotor symptoms, right, to use the technical term, and the sleep, it then helps you be more active and be more adherent.
• 26:08
  Philip Pape: And also, by the way, tend to eat fewer calories just naturally.
• 26:12
  Philip Pape: And all of those things then help you affect your fat loss, right?
• 26:16
  Philip Pape: So again, a lot of this does come back to sleep, not just for recovery, but for how it downstream affects these other things.
• 26:22
  Philip Pape: And speaking of eating, which I know where there's a lot of fear about eating for a lot of you, both fear of like what to eat, that you're gonna gain weight, that you're eating the wrong things, and all these things are just toxic for you.
• 26:33
  Philip Pape: There was a the Monet study looked at energy intake across the menopause transition, and they found that it didn't go up.
• 26:39
  Philip Pape: In women who became postmenopausal, it actually went down.
• 26:43
  Philip Pape: So, this story, this narrative where menopause makes you ravenous and you eat your way through it, it's not what the data shows.
• 26:50
  Philip Pape: Now, maybe as an individual you're eating more, and there could be other reasons for that.
• 26:54
  Philip Pape: And if anything, guess what?
• 26:56
  Philip Pape: Most of the women I see and coach and eat more lift heavy or those who use my app are probably under-eating relative to what their training demands.
• 27:04
  Philip Pape: The key being that they are training.
• 27:05
  Philip Pape: If you're a sedentary, it's probably a lot easier to overeat and have it, the body fat distribution thing work against you.
• 27:12
  Philip Pape: All right.
• 27:13
  Philip Pape: So it's not that you have to be in a surplus, by the way.
• 27:15
  Philip Pape: We're gonna have an episode coming up soon about how you can build muscle without even being in a surplus.
• 27:20
  Philip Pape: So definitely follow the show if you're not already.
• 27:22
  Philip Pape: So before we wrap up, I wanted to share the hot flash trial and how you might be able to reduce hot flashes naturally.
• 27:31
  Philip Pape: Okay.
• 27:31
  Philip Pape: Quick reminder that the Fitness Lab sale runs through September 13th.
• 27:35
  Philip Pape: Join my list at witsandweights.com slash email.
• 27:37
  Philip Pape: And the permanent 30% off for life of Fitness Lab will be in the welcome email.
• 27:42
  Philip Pape: If you're already on my list, you'll be inundated with several emails about this anyway.
• 27:46
  Philip Pape: Hopefully you don't under unsubscribe so you can get that.
• 27:49
  Philip Pape: You can then unsubscribe after you if you want.
• 27:51
  Philip Pape: But that's through September 13th, wits and weights.com slash email.
• 27:56
  Philip Pape: All right, so let's talk about hot flashes for a second.
• 28:00
  Philip Pape: Researchers in Sweden took 58 postmenopausal women who had seven moderate to severe hot flashes a day, and they were not exercising.
• 28:09
  Philip Pape: Half of them started lifting three times a week for 15 weeks, and they did chest press, leg press, rows, leg curls, and pull downs, and their loads went up over time.
• 28:19
  Philip Pape: So progressive overload.
• 28:20
  Philip Pape: Their hot flashes dropped 44%.
• 28:23
  Philip Pape: In the control group that didn't change anything, they didn't start exercising, their hot flashes dropped 2%.
• 28:30
  Philip Pape: Now, they dropped, but that's hardly anything.
• 28:32
  Philip Pape: And I'm guessing that's like a placebo effect potentially.
• 28:35
  Philip Pape: So what do you do with that data?
• 28:36
  Philip Pape: Well, are you lifting weights?
• 28:38
  Philip Pape: Okay.
• 28:39
  Philip Pape: If not, big lever right there for a million reasons.
• 28:42
  Philip Pape: And if you are lifting weights, are you actually progressing?
• 28:45
  Philip Pape: Are you actually progressing?
• 28:48
  Philip Pape: If you're not training frequently enough or with enough volume or intensity, any of those things can prevent you from progressing.
• 28:54
  Philip Pape: And if hot flashes or anything else are your concern, just lifting the right weight and getting stronger, you'd be surprised at how much that can help.
• 29:00
  Philip Pape: And again, if you want to use my app Fitness Lab, it does that for you.
• 29:04
  Philip Pape: It will give you a program based on your needs.
• 29:06
  Philip Pape: It'll tell you exactly what to lift, what you lifted last time.
• 29:10
  Philip Pape: It is bang on an amazing experience for all those who want it.
• 29:13
  Philip Pape: You got to go to witsandweights.com/slash email to get the 30% off.
• 29:16
  Philip Pape: Okay, until next time, keep using your wits, lifting those weights.
• 29:19
  Philip Pape: And remember that menopause changes where the fat is distributed and how fast you lose muscle.
• 29:26
  Philip Pape: It doesn't change whether the overall math works.
• 29:29
  Philip Pape: So don't let anybody sell you that when you have all the control.
• 29:34
  Philip Pape: I'm Philip Pape, and I'll talk to you next time here on the Wits and Weights podcast.