Dr. Ade
Welcome to the Modern Midlife Collective podcast. The place where we get unapologetically real about thriving in midlife health, hormones, and everything in between.
00:12
Dr. Jillian
I'm Dr. Jillian.
00:13
Dr. Ade
And I'm Dr. Ade.
00:14
Dr. Jillian
Together, we're your guides to navigating this powerful season with confidence, strength, and the wisdom you deserve. Welcome back to the Modern Midlife Collective. If you've noticed the scale creeping up after 40, even though you're eating the same, exercising, doing all the right things, you are not alone. Perimenopausal weight gain is real. Menopausal weight gain is real. And today, we're diving into the science behind why it happens, and more importantly, what can we do about it.
00:48
Dr. Ade
Yes, we need to do a lot more talking about this, because so many women are struggling with this same issue, thinking that they need to eat less and move more. But that approach has really been backfiring for women, especially during perimenopause. So we'll break down the science. Hormones, stress, and what's actually happened to you so that you can lose weight and not burn yourself out while trying to lose weight.
01:10
Dr. Jillian
So grab your coffee, your tea, your green smoothie. I've got La Croix sparkling water, and let's get into it. Awesome.
01:19
Dr. Ade
Awesome. All right, now that we're all ready and settled, let's start with that big question. Why does this happen? You hit your 40s, and all of a sudden you start to have these changes going through. Your body starts to change in ways you didn't expect. And what do we think the biggest culprits are? It's probably due to hormones.
01:39
Dr. Jillian
Yes, I agree. I think hormones are the biggest culprit. And when we enter perimenopause, which can be quite early, some people may not even come consider this, because they may be in their 30s. They could be in their late 30s and having these symptoms. But menopause perimenopause starts in your late 30s, your late 40s, and estrogen, progesterone, testosterone levels are all start to change. So your estrogen levels going up and down, fluctuating wildly, and your progesterone levels just going down, and your testosterone levels also going down. And these play a major role in how we feel, how we store fat, how we burn energy, how we use glucose, and again, how we feel. That's the most important thing.
02:31
Dr. Ade
Yeah, and it's very tricky because all these hormone imbalances are happening, right? One minute it's high, one minute's low, and it almost kind of becomes very. You're not really sure. What's happening? One minute, maybe you had times when it was really easy for you to lose weight, and then all of a sudden it's really hard. It seems like as you start to get older, it's like your metabolism, the way you process sugar, the things that you used to be able to eat become harder on your body. So it's almost like, well, what's happening? Why am I gaining weight around the midsection? Why are the clothes that I used to be able to wear I can't wear anymore? So it's very frustrating for women, isn't it?
03:09
Dr. Jillian
I think that's the biggest thing that people come into my office really concerned with during this time period is their weight. And some of the women that come in have never had a weight issue before. And so they are starting to notice that they're putting on pounds when they've been doing the same thing that they always do. They may be very healthy eaters. I have some that are bodybuilders, others that are distance runners, and they're also putting on weight around their midsection and finding it really frustrating. And. And then those who struggle with their weight, that frustration when they have learned what their body needs to lose weight, and they've been losing weight, and all of a sudden they can't do what they used to do and find the same success.
03:54
Dr. Ade
Absolutely. I actually had a lady the other day that. And she's not obese to someone who's been very active. She's actually well into her 60s now, and that's one of the things she thought was frustrating. She says, I'm an avid hiker and I do triathlons, but I am gaining all of this weight around my midsection. What can I do about it? And that's the thing that's really frustrating, especially if you. Someone that was already very fit, and all of a sudden it's like, yeah, I'm not, you know, considered obese, but I'm not comfortable in this body. I'm not used to having weight around the midsection or not being able to feel comfortable in the clothes that I wear to the beach and things like that. So that makes it really frustrating.
04:34
Dr. Ade
So what I've noticed is when this happens, the first thing women want to do is exercise more and really cut back on those calories. But I think at this time is when we really need to try to adapt to how we're living now. What's happening with those hormonal shifts and actually fueling our bodies right. With the right nutrients. That's Going to shift our metabolism back into fat burning mode because you can be very healthy, but maybe you don't have great muscle mass like you used to because now you've lost a lot of those hormones that like testosterone, for example, that really helps with lean muscle mass. So I think that's one of the things that can be very frustrating. What are you seeing in clinic?
05:16
Dr. Jillian
Well, exactly the same thing. And it's not just one hormone. If it were only that easy, but we could just replace this and that's it. No, that's not what happened. Everything is affecting us. So you mentioned testosterone and how when that testosterone level goes down, we lose muscle mass. And not only that, we find it difficult to build muscle mass. And muscle is something that influences and supports our metabolism and muscle. You know, you've heard muscle burns fat, so that's a problem. Our progesterone levels are going down and when that happens, we have bloating and water retention. And so there you go. Your clothes aren't fitting the same, right? Can't button your pants, just that little thing. And then estrogen, we said that goes up and down. And so they're going to be different symptoms when it's high versus when it's low.
06:08
Dr. Jillian
But when estrogen goes down, that affects our insulin. And we need insulin. We need our cells to be sensitive to insulin so it can bring our sugar, our glucose, into the cells to be used for fuel. So if we have insulin in our bloodstream, because our cells are like, no, thanks, I don't recognize you anymore. Do not come in. And, and so it's just floating out there with the glucose, with our sugar, it gets, has to do something. So it gets stored as fat. But sugar causes all sorts of other havoc and so does insulin. It's a growth factor. So it leads to growth.
06:44
Dr. Ade
Correct. And unfortunately, that's something I feel like starts to sneak up on women during that age, is because you may not necessarily be diabetic or pre diabetic, but you know, you can start to see those subtle signs. You know, there's expanding waistline, those blood sugars, especially those fasting blood sugars start to creep up into the 80s and 90s before you know it. So those are the small keys or even looking at your cholesterol levels, right, you start to see your triglycerides getting higher, your cholesterol, your, the ldl, the one we call the bad cholesterol, so to speak. Those are like little clues that you might be getting to the point where you may not be Considered diabetic or obese. But those are signs of insulin resistance. So it's those subtle changes along with those symptoms.
07:30
Dr. Ade
Maybe brain fog, fatigue, you know, those up and down sugar crashes. Finding that you're having to rely on caffeine to be able to get through the day. Sometimes those are subtle cues to tell you like, hey doc, I need for you to look into these labs. What can I do? What can I do to optimize my health so that I can be able to lose weight again? I mean, that's just part of the puzzle, Right?
07:52
Dr. Jillian
Right, exactly. And also in the clinic we're seeing what we already mentioned is that people are coming in and they're saying, I'm a healthy eater, I already exercise. And those same things aren't working. But then the other side of this is they're saying, I'm doing more, I'm not eating as much, I am exercising more, I've increased my cardio. And these things are just as detrimental, maybe even more because. Because this is causing a stress. It's seen as a stressor. We think we're doing something good, but we're actually stressing our body and probably don't have the nutrients even to support that level of exercise that we're trying to do in good faith. I guess like thinking that we're doing something good.
08:39
Dr. Ade
Yeah, it's just that automatic. Eat less, move more, go to cardio. I know some women will say, I'm fasting. And I think we had talked about that in one of our episodes, how too much fasting can also be an issue. You're fasting and you're putting your body into more stress and your body wants to hold on to fat, it's trying to protect you. So, you know, it's that cycle of trying to figure out. And that's why when you're in this stage, looking at, yes, you're having all these hormone changes, but what can we do in your lifestyle, in your environment, what can we tweak? How can we optimize your nutrition? And most of the time it's usually opting for more proteins, healthy fats, making sure that you have that fiber in your diet so your blood sugars are more stabilized versus up and down.
09:22
Dr. Ade
So it really does takes a lot of work, unfortunately. But if you work with someone that is willing to guide you and give you some more personalized guidance, I think that's probably the best.
09:31
Dr. Jillian
I do think it takes that because as your body changes, you have to get to know that new body and make it what you want it to be. And so having somebody that can guide you, I think would be quite important because your nutrition needs do change, your exercise needs do change, your cardiovascular needs change in order to decrease risk in the future. So having somebody that is well versed in this aspect of your life, I think would be really important. And, Dr. Day, I think I'd love for you to talk more about cortisol, because we talked about stress. Talk about how stress increases cortisol. Men. Yeah, what that does.
10:11
Dr. Ade
Oh, my goodness. Yeah. I use myself as an example because I don't know if I talked about this before, but during the pandemic, I think I was probably the most stressed being in school and having two little boys at home and having to manage all of that. I got to see firsthand what stress does to the body. You know, I was stress eating and trying to manage everything. And that's when I ballooned the most and really gained the weight. And I was exercising, of course, I was also exercising. I was trying to do not eat. Then I would stress eat. So it was the whole cycle. I wasn't sleeping well. So what would happen is you have your cortisol levels rise really high, so you're not sleeping, you're running on fumes, and then your body again, what does it want to do?
10:54
Dr. Ade
It wants to protect you, so you end up holding onto that fat. So no matter what I did, it just wasn't working. So the high cortisol level is something I feel like as we get older, and I don't know if it's the hormonal, maybe you can shed some light on that. Dr. Jill I find it difficult to manage it as well as before. They struggle with it. I think it's probably because we're multitasking. You know, all the things that we have on our plate doesn't change, but our bodies are changing. So you still have your children, you still have your calendar of events. It doesn't stop, but you are changing. What do you have to say about that? I feel like it's a struggle, at least for me, anyway.
11:35
Dr. Jillian
Oh, absolutely, it's a struggle. And, you know, the same things aren't going to work for everyone. But I think acknowledging that these things are happening and that the stresses are there and then figuring out the stress relief techniques that it takes for you, it's important and it's tough work. In January, I did a nutrition class with our nutrition friend and we had to wear a glucose monitor. They make a glucose monitor that's not for diabetics. It's called Stello. And you wear this monitor and throughout the day for, I think you wear it for two weeks straight and it follows your blood sugars and then the nutritionist also can see what your blood sugars are during that time. And you're supposed to be documenting your meals and documenting stress activities and things like that.
12:25
Dr. Jillian
This is something that's coming up to interact with many other of our biohacking sensors like sleep rings and our apple watches and all sorts of things. But when I wore this, I noticed that when I was stressed, my blood sugar went up. So cortisol levels spike. Your blood sugar spikes and that spike. You're not supposed to increase your blood sugar by so much after a meal. That's how you know that you're eating the proper amounts of carbohydrates and things. When your blood sugar doesn't go up by, I think it can't go up more than 30 points. I believe it was. But, but when I had stress, so usually in the morning when I was getting the kids ready for school, my blood sugar was like, whoa, so high. And when I practiced stress reduction techniques and that is without food. Yes.
13:14
Dr. Jillian
I had a birthday cake one evening and my blood sugar didn't go up as high. And it's going to be so different for everyone. Right. Because something that affects me is not going to affect you the same way.
13:25
Dr. Ade
Absolutely. Oh, I'm so glad you said that. And that Stelo is something that I've been recommending for a lot of my patients too. Because you don't need a prescription for it.
13:33
Dr. Jillian
Right.
13:33
Dr. Ade
You can just get it online and just highly recommend it. I mean, I've seen some women put it on and they're like, oh, wow. The things that they thought was going to spike their blood sugar is not what's spiking it. Stress will do it when you don't sleep. Does it? Yeah. Very, very key. And this is why women in perimenopause need to shift their focus from fewer calories, cardio, pounding the treadmill and working as hard as they possibly can, adding fuel to the fire. So the key here is to nourish your body, work on stress reducing methods, whether it's getting up and finding a way to not go and just go for that cup of coffee. I know it's easier said than done. You feel like you need to go grab that coffee and go.
14:20
Dr. Ade
Well, sometimes starting the day with things that are going to shift you into slowly rising your cortisol level instead of that Having that initial spike. So when I can, it doesn't happen all the time. Stretching is good. I think even just mild weightlifting is also really good. Anything you can do that will slowly get you going. And even in terms of meals, if you can reach for things that are richer in fiber and greens, that those are great things that will fill you up and not keep you hungry. Because I find that some women will eat nothing until like maybe 12, 1pm and they're really hungry and then they're reaching for the first thing that's going to give their blood sugar up. So it eats carbs, breads and things. That's something that's fast or fast food. And unfortunately that wreaks havoc.
15:11
Dr. Ade
Of course that spikes your blood sugar and then you have that crash afterwards. You don't have something that stays stabilizing your blood sugar throughout the day. So nutrition, we talked about stress management and also foods that are going to stimulate your own natural production of that hormone, that GLP one that we talk about all the time. That's that hormone that is in those popular medications like semaglutide and tirzepatide, those popular weight loss drugs. So they work by increasing your GLP levels, which keeps you full faster. Right. So if you eat foods that are rich in fiber and those proteins, even carbs, you know, very healthy, whole carbs are good for you too. You know, I tell people all the time, carbs are not the enemy.
15:53
Dr. Ade
So if you can do that consistently, that will also help shift your metabolism into not relying on eating less and moving more and to kind of get your body back into fat burning mode anymore. Anyway, I digress. So the whole point of that is nutrition, stress management, learning the foods that you are sensitive to, I think is really important. Food sensitivities can cause it. Foods that will spike your blood sugar. You know, like we talked about the cgm, a continuous glucose monitor, those are great ways to start.
16:24
Dr. Jillian
Yeah. You shared so many important nuggets there. A couple I want to reiterate. You talked about your eating something that spikes your cortisol level and then you have that crash afterwards. And, and that is something so important to mention because it increases our cravings as well. So not only are you going to be hungry again because you didn't have anything that kept you full for long, but then you're going to have cravings and they're typically for things that are not healthy. So that's another thing. And then you mentioned the sleep and the stress. So a lack of sleep is also another thing that increases stress. And so one of the important things that I try to evaluate in patients just through talking to them and their history is whether they have sleep apnea or some sort of other sleep issue.
17:16
Dr. Jillian
Because with these things, even with insomnia where you don't have sleep apnea, all of this lack of sleep increases blood sugar. So in people who have high blood sugars in the morning and don't necessarily throughout the day, that's something that makes me think that they may have sleep apnea or some other sleep disorder. So just yet another thing to check out because that's something that can be treated. If you were to have some obstructive sleep apnea where you're not oxygenating overnight correctly, that's going to increase stress, increase blood pressure or blood sugar, increase cortisol, increase that crash later, increase cravings, increase weight. And then if you're not getting that deep breath, restorative weight sleep, that's when your body is doing things like supporting your metabolism and helping with weight loss by regenerating all those processes that need to happen.
18:11
Dr. Jillian
If you're not sleeping, you're not going to be losing weight. I don't know what you can do if you don't have that deep restorative sleep time.
18:20
Dr. Ade
Sleep has become a non negotiable for me because I can tell the difference when I don't sleep, kinds of foods I reach for, caffeine that you end up taking because you just are tired, you just can't function. Yeah, it's something that you have to. I know someone will say I need more than 24 hours in a day. I have to make it, I have to stay up and do. But you have to find ways to make it so that you can get that restorative sleep like Dr. Jill just talked about. If, if it's a problem, if you're not sleeping well because you have sleep apnea, definitely get a sleep apnea test. They make it so easy now to get these tests done. Do it at home, there's portable devices.
19:00
Dr. Ade
And if sleep apnea is not a problem, if it's a hormonal issue, if it's something that maybe progesterone loss is a problem, you know, there are great supplements that are just very, you know, they don't have a lot of adverse effects that you can take that will kind of harm you and help you sleep. I love magnesium. I take that once in a while and that usually helps. Hot bath, whatever routine you can do to get your body to recognize that. Now it's time to shut my brain down now. It's time for me to go to sleep. And then once you get into that routine, it becomes a habit. And then everybody knows, like my kids, I'll tell them, like, if you're not going to bed, I'm going to bed. It's a wrap. So you have to make it a lifestyle thing.
19:40
Dr. Ade
It's a lifestyle thing for sure.
19:42
Dr. Jillian
Yeah. Like you said, it's prioritizing that and it's difficult because there are so many things on my list to prioritize. So I don't know how I'm going to get to all of them because sleep is on there, intimacy's on there, your relationship's on there. More time with your kids. You know, we realize it's a lot to be healthy, and it does seem to take more work as we get older. But maybe it's not that it takes more work. You know, when you're younger, you have hopefully a mom and you have a dad or you have two parents or somebody else that looking out for your health. And now it's just you have to look out for not only your health, but your family's health, your aging parents health. Right. So there's just so much more to do. There's just more responsibilities that we shoulder.
20:30
Dr. Jillian
And so that affects us. And so we have to realize that. I think just realizing that there's so much that affects us is something that actually will help us in the end to understand.
20:40
Dr. Ade
Yeah, great point there. It's realizing that, yes, things have changed. There's a lot more responsibilities. But in realizing it and being aware of that, oh, my goodness, I haven't stopped and eaten anything today. I haven't stopped to drink some water. I haven't stopped to take a break. And then finding ways somehow to carve that time out for you is important, otherwise the repercussions down the line, you know, it's a lot more if you don't take that time out for yourself.
21:07
Dr. Ade
When I think of it that way, that if I keep going in this direction, I won't be healthy to be able to spend time with my kids when they're older or take the trips that I want to do, or just, you know, looking at your health in a different way sets the tone so that you can make those changes at least as consistent as you can.
21:24
Dr. Jillian
Absolutely. Well, let's recap. I think you talked about the nutrition, already talked about increasing protein. We do need a lot of protein. I think it's really difficult to get the amount of protein that we need. And it's gonna be a little different for each of us. But I think that's where maybe even protein powders that can come in. I'm not the hugest fan. Because it's processed. Right. We're trying to take away processed foods. However, some things you have to, I guess, accept, and other things you can go forth and be strong. I'm not going to do this. I'm not going to do that. So it's just prioritizing. Right. Choosing the most important thing for you, the thing you can do is going to be the best thing. So getting the protein, getting fiber, getting healthy fats.
22:11
Dr. Jillian
Know, avocado is one of those really healthy fats. So that's going to be important. And then you talked about exercise, and maybe the shift from cardio to strength training is important now. Cardio is a great exercise for your cardiovascular health, and it's still important for cardiovascular health. But when our issue is hormonal fluctuations in menopause, and we know that we have certain things that are decreasing, like our muscle mass, then we do need to focus a little bit more on that strength training and building up that muscle mass. And then hormones, they may play a role here. Balancing hormones, for one, or even increasing hormones that are lost.
22:52
Dr. Ade
Absolutely.
22:52
Dr. Jillian
Or decreased.
22:53
Dr. Ade
Yeah, I think it is definitely still very possible. Amongst all the things that we do as women over 40 and beyond, we can still be confident, we can still have energy, we can still thrive. And if you need that extra support, that's where Dr. Jill and I come in. We can, you know, give you some tips on what you need to do personalized, you know, in a personalized way. So, yeah, just, you know, if you need that support, definitely reach out. If you loved this episode and you feel like, oh, my goodness, these women get me and they understand what I'm going through. Yes, we do. We're living it alongside you. So definitely share it with a friend, whoever you think would benefit from this as well.
23:35
Dr. Jillian
Absolutely. And follow us. If you have a question that you'd like to hear answered or want a program developed around it, then email us@connectodernmidlifecollective.com and I thank you so much for joining us. Thank you for listening to the Modern Midlife Collective, and we will see you next time.
23:57
Dr. Ade
Thank you for tuning in to the Modern Midlife Collective podcast. We hope today's episode has inspired you to take bold steps towards thriving in midlife.
24:06
Dr. Jillian
If you loved what you heard, please leave us a review and share this episode with a friend who's ready to step into their power.
24:13
Dr. Ade
We'll be back next week with more insights, strategies and real talk to help you live your best life at any age.
24:20
Dr. Jillian
Until then, remember, thriving at 40 and beyond isn't just possible. It's your birthright. We'll see you next time.