Hills I’ll Die On As a Dietitian When It Comes to Losing Weight & Belly Fat in Midlife

As women are going through especially late perimenopause and postmenopause, you'll see cardiovascular risk factors change a lot of times because of these changes that are happening with estrogen dropping, abdominal fat mass increasing, and lean mass actually decreasing. Now, that doesn't mean that that is your destiny, but if you're not making any changes, then that is the most likely seen outcomes. So this is why a lot of women will say, I'm following the same extremely low calorie diet that used to work for me in the past. And it's not working as you develop more insulin resistance. Insulin resistance, no matter your age, is absolutely reversible. Improving inflammation is absolutely possible, and decreasing your waist circumference is completely achievable. And that can happen without obsessively restricting or having to go keto or follow extremely low-fat diets. Hills I'll die on when it comes to why you can't lose weight, and especially visceral fat that becomes more challenging for women as they age, where I hear a lot of women say what used to work is no longer working, and the way that I'm carrying weight has actually changed. It's shifted from other places to now in my belly that I can't actually lose. Now, as a dietitian, I have worked with women over the last 12 years to help to better understand this process, although I don't consider myself to be a weight loss expert because my goal is really to help you better understand comprehensively how a number of different symptoms and lab values are impacting your comprehensive metabolic health. Cardiovascular issues, your energy, your mood, your sleep, and other symptoms beyond just thinking about food as weight loss. Because I truly believe that food is medicine and we need to take a more comprehensive approach when thinking about it across the board. But I do feel that it's important for us to address this specific aspect of nutrition because it absolutely impacts so many women and can be super frustrating. So let's start with hill number one, which is that often you go to the doctor and you express the difficulty of losing weight, and it's often stated, well, this is just your age, or it's your stress, or it's whatever the, the reason. But a lot of times it'll be just chalked up to age. And so often, yes, as you age, your metabolism shifts, especially as women go through perimenopause and menopause. That drop in estrogen will change your overall metabolism. But what I see very commonly is that it is an underlying insulin problem that also can become worsened by the transition of perimenopause and menopause because estrogen helps with actually improving our insulin sensitivity. As estrogen drops in menopause and even starting in perimenopause, this can increase risk of insulin resistance. So what could be changing underneath the surface is actually insulin resistance because insulin is a fat-storing hormone. So it doesn't matter how deep your caloric deficit is, if your body is more insulin resistant, then you will hold on to fat more, especially around your visceral fat area, or that belly fat. So this is why a lot of women will say, I'm following the same extremely low-calorie diet that used to work for me in the past, and it's not working, as you develop more insulin resistance. And actually, shifts in your weight can be an indicator of insulin resistance, which is why it's really important to not only test your hemoglobin A1C but also your fasting glucose and your fasting insulin so that you better understand. Anything greater than a 7 for your fasting insulin will indicate signs of insulin resistance. And then being able to address that is extremely important. Now you may think, oh, I don't have insulin resistance because I have a normal hemoglobin A1c. And you could still have a normal hemoglobin A1c but have an elevation in your fasting insulin. We see increases in fasting insulin happen up to 5 to 10 years before actual changes in fasting glucose or hemoglobin A1c happen. And we know that 115 million Americans have prediabetes. It's estimated that about 30% of US adults have prediabetes. Pre-diabetes, and 8 in 10 of those people do not know that they have it. So you may think, oh, I don't have this condition because I haven't had a conversation about it with my doctor, but it's important to know that, one, insulin resistance can manifest years before pre-diabetes, that, two, pre-diabetes is extremely common, and that 8 in 10 people who have pre-diabetes don't know that they have it. That's a statistic from the CDC. And then third, that as your hormones change, your risk of pre-diabetes and insulin resistance goes up, which can increase the risk of belly fat. Okay, hill number 2: eating less and exercising more can actually make everything worse. Now, the actual underlying issue of whether you're eating too large in a caloric deficit or you're eating too many calories is going to be person dependent, because two things can be true. Chronic undereating can spike your cortisol, and cortisol, we know, is a catabolic hormone, so it actually makes it then very hard to gain any muscle. And you really need to be able to gain muscle in order to be able to increase your overall energy expenditure and be able to lose fat. This also, as cortisol is increasing, it's a catabolic hormone which can also raise blood sugar all on its own. So when it comes to cortisol, if you are constantly and chronically stressed and you're under eating and you're overexercising alongside of that, it will make it really difficult to lose weight because cortisol can actually spike your glucose all on its own through a process called gluconeogenesis. This can increase the circulation of glucose into your bloodstream, which can then lead to the same issues that present when you're just constantly eating all the time., and this can also drive more inflammation. So absolutely, if you are skipping meals on a regular basis, if you are completely under eating calories— let's say you're eating 1,000 calories a day and you've been doing that for months and months and you're not seeing any change on the scale— this could be why. You need to be eating on a regular basis. You need to be eating enough calories in order for your metabolism to actually fuel itself. Now, at the same time, for as much as insulin resistance plays a role in all these things, calories absolutely do matter. And you want to be in a mild caloric deficit. So at the same time that eating less and exercising more and chronically undereating can lead to issues with your metabolism, the opposite is also true. Eating too many calories, eating above your actual caloric burn, can make it harder for you to lose weight because you want to be in a mild caloric deficit. That's what I recommend in order to prevent completely tanking your metabolism and your energy expenditure and making it more sustainable across the board. One of the benefits to eating a blood sugar balanced diet, which is what I recommend for any woman, but especially as you're trying to figure out the weight loss component and decreasing belly fat, which I'll talk more about mechanistically, it's important to know when taking a blood sugar balanced approach to improving your weight, your belly fat, and then other symptoms, um, that commonly go alongside insulin resistance. Things like energy slumps in the afternoon, brain fog that's on and off at all times. Sleep disruption can also be a symptom. A lot of mood swings. And a lot of cravings. This is why I recommend a blood sugar balanced approach. And when you're using a blood sugar balanced approach, this will often increase people's fat consumption from what they're used to consuming, in addition to their fiber, in addition to their protein, so that you're able to activate more of those satiety hormones. Now, when a person is completely under-eating fat, this is often when I see increases in cravings that lead to ongoing overconsumption of food. So while some people will argue that a low-fat diet more beneficial because fat is more calorically dense, and it— when you're eating low fat, it helps to decrease the overall caloric density. On the other side of things, when you decrease your fat too much, it actually can increase your cravings, which will increase the frequency that you're eating. And eating too often and grazing will increase insulin resistance, and it can also lead to overconsumption of carbohydrates, sugar, refined grains that you're craving and that you feel out of control with. This is where Blood Sugar Balance can help with decreasing that feeling of white knuckling, and this is also supported in the research. So there was a randomized controlled trial that was done that included 609 participants that were assigned to either eating a low-fat diet or a low-carbohydrate diet for 12 months. The average age was 40 years old, they had an average BMI of 33, and it was 263 males and 346 premenopausal women. Now, they had a 21% dropout rate, but what they saw in the people who completed the study was that at 12 months, the low-fat group had lost 11.7 pounds, and the low carbohydrate group lost about 1.5 pounds more on average than the low fat group over a 12-month period of time. But that difference was not statistically significant. Now, that means that the low carbohydrate group didn't necessarily lead to significantly higher weight loss, but what it does indicate is that just focusing on a low fat diet to decrease foods that are calorically dense doesn't actually lead to significantly greater outcomes. And what I find in women that we work with is that when you're actually able to increase fat, it helps to turn off those ongoing cravings. It helps to regulate your hunger hormones so that you feel more in control around the food while you're also losing weight at the same time. So in this study, they didn't have specific caloric restriction. Each group was advised to eat low fat or low carbohydrate, and the head of the research study, Dr. Christopher Gardner, said that he wanted them to find a new eating pattern that they could maintain without having to even think about it as a diet. So he said that they got a lot of feedback throughout the time of the study that people were happy that they didn't didn't have to specifically count their calories. But they did find that people did achieve a caloric deficit without that being prescribed fairly consistently throughout the 12 months by focusing on the benchmarks that were recommended within the study, which was either the low-fat prescription or the low-carbohydrate prescription depending on the group. Now, a few other things is that the physical activity only went up slightly in both groups. It was not statistically different than what it was at baseline. The researcher, Dr. Christopher Gardner, had said that he thinks that there's a few important commonalities for every single diet when you're trying to lose weight. One, more whole foods. Two, more vegetables, specifically increasing your vegetable consumption, which we recommend about 2 cups of non-starchy vegetables at both lunch and dinner, not only to get your fiber but to get phytochemicals and other nutrients that help you feel satiated, that help to decrease inflammation, etc. Number 3, less added sugar. And number 4, less refined grains. Grains. So not eating grains that are refined, that are stripped of that bran in the endosperm, or that are stripped of the bran in the germ, which leave only the endosperm, which is that starch component that increases the glycemic effect. Hill number 3: falling estrogen is like pouring fuel on the fire. So estrogen, as I already stated, is an anti-inflammatory, and it helps your body handle blood sugar and improve your insulin sensitivity. So as it's dropping in perimenopause and menopause, because both insulin resistance and inflammation can worsen, which is why it feels like what used to work is no longer working. So as women are going through especially late perimenopause and postmenopause, you'll see cardiovascular risk factors change a lot of times because of these changes that are happening with estrogen dropping, abdominal fat mass increasing, and lean mass actually decreasing. Now that doesn't mean that that is your destiny, but if you're not making any changes, then that is the most likely seen outcomes, and that will impact fat oxidation. It also increases dyslipidemia, meaning increases in cholesterol and other factors related to cardiovascular health. It increases insulin resistance and glucose intolerance and can also increase sleep disturbances, which sleep disturbances further increase your insulin resistance because 1 to 2 hours of sleep deprivation can increase insulin resistance the next day fairly significantly. So as women are becoming more glucose intolerant is what's outlined in this research study that was published in 2022, where they have a diagram showcasing that this is one of the common changes that they see. This is when a lot of women will start to report that eating higher carbohydrate foods become harder for them to get away with without seeing changes on the scale, and also without seeing these cardiovascular changes, sleep disturbances, and other symptoms that can accumulate the body's changing. There was a 2000 study that was called Relation of Regional Fat Distribution to Insulin Sensitivity in Postmenopausal Women, where they found in postmenopausal women without obesity, increase in abdominal fat during menopause was associated with decreased tissue insulin sensitivity and glucose tolerance. Now, in other studies, there was another longitudinal study that was done in 2008 called Increased Visceral Fat and Decreased Energy Expenditure During the Menopausal Transition, and they found no changes in glucose, fasting insulin, lipids, or insulin sensitivity. But this is something that has been shown in a number of other studies. So the key metabolic shifts that are happening here— researchers have shown an average of 250 to 300 calorie per day drop in total basal metabolic rate. The average weight gain in this transition period is about 4 to 7 pounds. We're looking at an 8.2% increase in visceral fat per year, which was shown in the SWAN study, and then other changes like increases in insulin resistance, as I stated, decreases in muscle protein synthesis, and changes in your overall bone health. Hill number 4: as insulin resistance increases and as visceral fat increases, which is that fat storage around your organs, the visceral fat can increase the release of inflammatory cytokines, which can increase inflammation across the board. So visceral fat is metabolic physiologically active, it raises your risk of cytokine release, which increases inflammation. It also increases risk of cardiovascular disease and diabetes because of this relationship. And then at the same time, as you have lower muscle mass, it actually decreases your ability to burn glucose, which is why some women can become so much more glucose intolerant or carbohydrate intolerant as they're experiencing these hormonal transitions, which can lead to more fat storage. Age. And because of the changes that are happening with estrogen, that visceral fat— a lot of times some women won't even see a change on the number on the scale, but they'll actually just change the fat distribution where it goes from more of their legs to that apple shape more around their midsection, which is what is that metabolically active fat that increases our risk of inflammation, that increases our risk of cardiovascular disease, that increases risk of insulin resistance and diabetes. And it's kind of like a vicious cycle. So as your blood sugar is increasing and you're on more of this blood sugar roller coaster, it increases the release of insulin. When you have an increase in insulin release, insulin is a fat storage hormone and can also increase inflammation. So you see an increase in inflammation that can increase belly fat. And then at the same time, you can see an increase in the blood sugar roller coaster that can increase the production of insulin. As your cells become more insulin resistant, this can increase belly fat. As you have more belly fat, this can increase that cytokine release that can increase inflammation. So it's kind of like two different things can be happening mechanistically, a little bit out of order, but at the end of the day, it's all very much interconnected. And what this can lead to— there was actually a Harvard article that was done by Harvard Medical School that showed that as cells become more insulin resistant, it's a diagram that they drew, as cells become more insulin resistant, sugar stores as fat, which leads to the arrow of feeling more tired and hungry, which leads to the arrow of eating more food, which leads to the arrow of making more insulin. And as you're overproducing insulin, it means that your cells are reducing insulin, which leads to this vicious cycle that, that started with— so as you make more insulin, your cells become more insulin resistant, and then it goes back to that, that arrow of sugar being stored as fat. So this is a very normal process that's happening, even though it sounds so unbelievably depressing, but it helps to better understand what's happening so that you also can identify what you're possibly doing that may not be working in your favor that may be leading to the lack of outcomes that you're trying to see, and hopefully less frustrations in knowing that it isn't just your body that this is happening to. This is women's bodies across the board. I've been testing fasting insulin in women that I've worked with for literally the last 12 years. This is not a new thing that I just started doing, and I think that it helps to know that this is a pattern and a trend that so many women are experiencing, and that there's hope, which I will get to in this episode as well. Well, Hill number 6 is fairly related to what I just talked about, but I wanted to pose it from the opposite direction. As long as your blood sugar is spiking— if your blood sugar is spiking more throughout the day, especially as your hormones have changed, making you more insulin resistant, and as you're losing muscle mass or lean mass, because our muscles help to soak up that glucose— then it can lead to more inflammation, like I just talked about, which will lead to you holding on to more weight. So it's not just about identifying the right caloric deficit for you to be in, which I recommend about 200 calories per day and not drastically large caloric deficits like some weight loss plans recommend. So the opposite is that the key is not only identifying that caloric deficit that helps, but stabilizing your blood sugar to help to improve your insulin sensitivity, to help to lower inflammation, to help to lower your waist circumference. So stabilizing blood sugar so that you're not on that roller coaster, so that you're giving your pancreas a break, so that it's not producing so much insulin, so that your cells have the opportunity to become sensitive to the insulin they're actually producing, to be able to help to lower that inflammatory release. Because as I was talking about in that model of saying that blood sugar roller coaster increases insulin resistance, which increases belly fat, which increases inflammation, we know that every time that your blood sugar is increasing across the board, that it can increase the inflammatory response, increasing cytokine release. This was something that Dr. Tim Spachter talked about when he came on my my show in March, which was one of our most popular episodes, titled Eat This Way for Better Gut Health, Number One Gut Microbiome Doctor Tim Spector. And he talked about how what they've seen in their research is that as blood sugar— anytime that your blood sugar is really spiking, that it can increase the release of more of these inflammatory cytokines. So in order for you to stop this process, you have to go upstream, stabilize your blood sugar to decrease the release of insulin, to decrease that inflammation, to decrease that belly fat. And then at the same time— I hope that I don't sound repetitive stabilizing blood sugar helps to improve your insulin sensitivity, which helps to decrease belly fat, which also helps to decrease that inflammatory response. Hill number 7 is that this is reversible. I will absolutely die on that hill that insulin resistance, no matter your age, is absolutely reversible. Improving inflammation is absolutely possible, and decreasing your waist circumference is completely achievable. I have helped thousands of women do this over the last 12 years, lose stubborn weight, improve energy, and lower inflammation. And that can happen without obsessively restricting or having to go keto or follow extremely low-fat diets. And I've started to talk about what some of those can look like, but I want to pull them all together for you right now. Number one is identifying a caloric deficit that is beneficial, about understanding your actual baseline calorie needs. This is something that we talk about a lot in my membership, but identifying your baseline calorie needs. There's a lot of awesome calculators that you can get online to understand what that is in relation to your age and your weight and your physical activity, and then taking that and decreasing that by 150 to 200 calories per day. I'm not a big calorie counter, so for instance, in the Blood Sugar Reset that we have coming up, we're not obsessively counting calories. The plan that I've laid out is 1,600 calories per day, and most women will follow that at baseline and then maybe make some weeks based on what their personal needs are, but that helps you to not have to count calories. And then the second piece is being able to eat blood sugar balanced meals. This is something that we've laid out for you in the Blood Sugar Reset. So if you are interested in joining us for the Blood Sugar Reset to learn more about this exact process, you can go to www.beingbridget.com/blood-sugar-reset. But eating blood sugar balanced meals where you have the protein, the healthy that's the fiber and whole food carbohydrates, so that you're not eating too low in carbohydrates, but you're eating in a way that the carbohydrates are whole food and intact carbohydrates in the right proportions, so that's the protein and the fiber are helping to lead to a slower glucose release that helps to decrease that insulin release on the pancreas, that helps to decrease that belly fat and that downstream inflammation. The next recommendation is making sure that you're not grazing. Eating 3 standard meals is really important, maybe 3 meals and 1 snack. But they have shown that as you're eating frequently throughout the day, or you're constantly snacking or picking up food, that, that makes it much harder for your insulin to regulate. Tip number 4 would be to walk and move your body on a regular basis. As I already have said, when your muscles are moving and when you have larger muscles, you're able to soak up that glucose from your bloodstream and carry it into the cell more efficiently. So this is why they've shown in some research studies that even doing a 10-minute walk throughout the day, 10-minute walks 3 times a day, is equivalent to saving up just 30 minutes of physical activity at the end of the day, and potentially even greater outcomes as far as improving insulin sensitivity and improving your baseline metabolism. Number 5 would be making sure that you're sleeping. So as I said, just a few hours of sleep deprivation can increase your insulin resistance the next day. So making sure that you are prioritizing sleep. This is something that we recommend doing alongside with the blood sugar reset so that you're able to improve your hunger hormones the next day. This actually helps you feel more in control of the food choices that you're making, which is why getting to bed at the same time and waking up at the same time the next day and making sure that you're sleeping enough and that you're incorporating sleep hygiene practices prior to going to bed that help you get a deeper, more restorative state of sleep can be so incredibly important for improving your overall insulin resistance and belly fat. So this is so much more than just calories in versus calories out. It's being calculated in the lifestyle choices that you're using to support your overall health. Now, there are many supplements that can help with this, and they are person-dependent, so I'm not going to get into supplements in this episode today because I think that nailing the basics is the most important focus for you to really prioritize. If you're interested in going deeper with me into how you can improve your hormones, your inflammation, your belly fat, your your energy, your mood, your cravings, then I'd love for you to join us for the Blood Sugar Reset. Like I said, you can find out more about that at www.beingbridgid.com/blood-sugar-reset. It's a $29 program, and for 7 days I will plan all of your meals. Right when you join, you get instant access to the meal plan so that you can start to plan and prep for the 7 days. And then throughout the 7 days, I go live for coaching calls to be able to dive deeper into these mechanisms. We have incredible support from my team of functional medicine dietitians and nutritionists. And we also have the best community of women on the internet, I really believe. We have thousands of women who are signed up for this summer round of the Blood Sugar Reset that you can learn so much from in the group, to see everyone's messages and comments and things that are working for them that'll help to motivate you to stay more consistent with a new routine and a new pattern that will help to hopefully pull you out of a slump that you feel like you're in and get you greater results than you've been able to achieve in the last however many months or that you've been struggling with this in particular. I am honestly just so unbelievably excited to support so many of you. I, I love doing podcasts, but I really don't believe that podcast episodes can change your life in the way that committing to a specific challenge with a group of people that activates you into action, right? It's not just about passively consuming information, it's about getting yourself into action. And that is exactly what the Blood Sugar Reset is all about. We've had more than 29,000 women go through the program and the results and transformations are truly so astonishing. We just had Kimberly— the episode with Kimberly a few weeks ago where she had shared that she's lost 90 pounds since starting her first blood sugar reset 4 years ago, decreasing her fasting insulin, decreasing her hs-CRP, her inflammation marker, by over 11 points, which is just so astonishing that these changes can happen. I mean, for her it took 4 years, but for some people, they'll see significant changes in literally the first 3 to 4 days. So once you're doing the right thing, it doesn't take long for your body to actually respond, which is another sign that if you've been trying the same things for weeks or months or years and not seeing the results that you're looking for, then it's absolutely time to think about how you can change things up in order to support the goals that you're working towards. There's a quote that I've seen from Gary Vee, which is essentially that you can't get good at swimming by watching other people swim, that you have to actually participate in swim lessons in order for you to get better at swimming. And the same is absolutely true with getting into the kitchen and making meals that support your health. So I would love for you to join us for the Blood Sugar Reset. Thank you so much for tuning in to today's episode of the Being Brigid Show. I hope that you got a lot of value from it. If you did, please subscribe to the show, share it with a friend who may be struggling as well, and leaving a comment also always helps too. Have a great day, and I'll see you next time.