Weight Changes

Body Fat & Hot Flashes

Subcutaneous body fat is positively associated with vasomotor symptoms (primarily hot flashes), so the more body fat you have (both subcutaneous and central adipose), the more likely you are to have vasomotor symptoms. This is consistent with the idea of body fat acting like an insulator.

The relationship between fat gain and hot flashes is most pronounced among Caucasian and Chinese women, compared to African-American or Japanese women. However, no consistent associations between subcutaneous fat gain and night sweats was observed in the study. [5]

Your “Set Point Weight”

The brain strives to keep balance in all body systems by the process of homeostasis. Every person has a ‘set point weight’ that their brain perceives as ‘normal weight’ and will work to maintain that set point weight. This is why many women lose weight but have it return in months, even if it includes less healthy excess fat.

This is supported by recent studies that show total body fat is regulated by the body. When fat stores decrease, homeostasis acts to restore fat to ‘normal’ levels. This is what allows for the relatively stable maintenance of body weight over long intervals. [6]

Hormone Therapy

Hormone therapy may help delay or avoid some of the typical weight changes that occur during perimenopause, as estrogen has the same types of effect as exercise relative to weight changes.

For example, estrogen hormone therapy (HT) in younger postmenopausal women (aged 50 – 59 years), reduced fat mass, improved bone-mineral density, and preserved lean body mass, reducing the risk of type-2 diabetes specifically and overall mortality risk generally. However, because of the relationship between fat mass and lean body mass, net weight may not change. [3]

Prescription Weight-Loss Drugs

Prescription weight-loss drugs that you can use for more than 12 weeks are called long-term use drugs. They are prescribed by your healthcare provider. These can lead to a 3% to 12% loss of total body weight compared to weight loss with lifestyle changes alone. These drugs have mild side effects including nausea, constipation and diarrhea. Serious side effects are possible. [11]

Fat contributes to metabolic balance, or homeostasis but when that balance is off, obesity can result. [3]

Fat is stored in five major ‘depots’ in the body, although the majority of research has focused on the first two depots, subcutaneous fat and visceral fat.

1. subcutaneous fat – under the skin, all over the body in obese individuals

2. visceral or intraperitoneal fat – fat is attached to the organs, including the stomach, the small intestine and the large intestine. Also called central adipose tissue or central adiposity, this type of adipose tissue poses greater health risks because it releases proteins and other molecules that contribute to insulin resistance and inflammation more than other adipose tissues do. The inflammation not only affects your organs and tissues, but contributes to narrowing blood vessels, increasing the risk of cardiovascular disease.

3. retroperitoneal and pelvic fat – usually classified with visceral fat because they are hard to tell apart using imaging.

4. intra- and extra-pericardial fat – found around the heart and large blood vessels.

5. intramuscular fat – in the muscle tissue

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There are two main types of fat, brown adipose tissue (BAT) and white adipose tissue (WAT). There are similarities between these types of fat in that they both produce and secrete hormones (including estrogen), and immune factors (including macrophages* and T lymphocytes** that are both important elements of the immune system).

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However, WAT and BAT differ in their cell structure and metabolic function. White adipose cells contain only a few mitochondria in addition to a single large lipid droplet, and their primary function is to store energy. Brown adipose cells, on the other hand, contain many mitochondria, multiple smaller lipid droplets, and their primary function is to release heat for thermoregulation.

Studies indicate that improvements in how fat tissue is burned as energy may be caused by enhanced mitochondrial function in fat cells. The interrelationship is clear: Healthy fat cells (brown fat) have highly functional mitochondria, whereas unhealthy fat cells (white fat) on the other hand, have dysfunctional mitochondria that inefficiently burn fat. [8]

*Macrophage
A type of white blood cell specialized to surround and kill microorganisms, destroy dead cells, and stimulate the action of other immune system cells.

**T lymphocyte
A type of cell in the immune system specialized to kill infected cells, stimulate the action of other immune system cells, and regulate the immune response.

Insulin Resistance

Insulin resistance occurs when the cells in your body stop responding properly to insulin, a hormone in your pancreas that regulates blood glucose levels.

Normally, the food you eat is converted into glucose (your body’s main energy source), which enters your bloodstream and lets the pancreas know that it’s time to release insulin. Insulin causes glucose carried in your blood (your blood sugar) to enter into cells where it is used to make energy. Any excess blood sugar is stored in the liver for when your body needs energy but there is no new food (glucose) available, such as when you’re asleep.

But when too much blood sugar enters the bloodstream, the pancreas has to pump out larger and larger amounts of insulin to manage the high glucose levels. Eventually, the cells become desensitized to this excess amount of insulin and stop responding properly, resulting in higher-than-normal blood glucose levels. This is insulin resistance.

Some of the most common side effects of insulin resistance include weight gain, difficulty losing weight, blood sugar spikes after eating, extreme hunger or thirst, and tiredness.