How dieting during menopause might be the straw that breaks the camel's back.
I have to say, “dieting” is my pet peeve. The idea of trying to fit into an externally imposed ideal shape or weight, that by the way changes every couple of years, is completely absurd and, let’s be honest, it’s such a waste of time. Of course, carrying excess weight has health risks and should be addressed but should we be trying to fit into a certain beauty standard that might not even be our own?
A study done in 2016 revealed that almost 57% of women in Britain were on a diet and about two thirds of those said they were dieting "all or most of the time".[1]
To be honest, I have a feeling that the numbers are even higher. I fear a lot of women, even if they are openly not on a diet, they are secretly trying to ‘conquer’ the body or ‘cheat’ the body.
As if we actually could do that!
As if the body somehow hasn’t noticed that we ‘forgot to eat’ or ‘bookend our meals’ or just run on empty for as long as it was feasibly possible. It’s almost as if we can get some brownie points from starving so that we can then perhaps give ourselves an award and binge on donuts or cakes because ‘we finally deserve it!’…?
Imagine if all this energy, this dedication and mental focus on forcing the body into submission went somewhere else – how about the things that we love, are passionate about, and truly enjoy doing? Or have we gone down the rabbit hole so far, we cannot possible even enjoy anything else unless we fit into a certain dress size?
And thus, the more unhappy we are by the way we look, the more we diet. We feel miserable most of the time. As the diet doesn’t usually work, we get more obsessed and diet even more… and then perimenopause happens and the years of under-fuelling and ‘cheating the body’ is the final straw that breaks the camel’s back.
So, unless dieting is done under a watchful eye of a dietitian with a careful long-term plan on precise nutrition combined with a small (small!) calorie deficit, there is no surprise that we set ourselves up for a bumpy road ahead.
Looking at the history of dieting, there was a huge surge in the slimming obsession as early as post war Britain[2]. And guess what, as a consequence of these decades of undernourished women, we now see a surge in anxiety amongst perimenopausal women. A study of 2000 women aged between 46-60 carried out in 2021 reported that:
53% suffered from low mood and depression, 50% reported anxiety, 42% reported anger and mood swingsand 33% reported feelings of worthlessness.
58% of women reported low energy and lack of motivation as the leading mental health issue, and this rises to 67% among 46–49-year-olds; [3]
Since women’s physiology hasn’t really changed that much, surely, we must look at the external factors.
Of course, there are countless environmental causes (stress, women entering the work force, balancing a career with raising children, oftentimes burnout to name a few…) but why nobody speaks of under-fuelling? There is a huge correlation. Let me explain why.
Under-fuelling can have a serious effect on your health. What starts as a genuine desire to shed a few pounds can easily backfire and result in a continuous state of under-nourishment. Here I’m not just talking about ‘calories in – calories out’ but also about the density of the nutrient content. We women, we love to either bookend our meals or just live on snacks. Usually sugary snacks with not much nutrient content. So even if we do hit the calorie threshold, what about getting the right amount of proteins, carbs, vitamins & minerals? I know we think we can live off thin air, but for how long?
So, if a woman diets for the majority of her life that means that day after day, week after week, she is not eating enough to meet her basic energy needs (to cover basic physiological demands).[4] This is super important as we don’t need to wait long for the repercussions to happen.
With only 4 days of Low Energy Availability:
The thyroid starts to be downregulated.
Everything goes into survival mode trying to conserve every bit of energy.
Downregulation of the thyroid hormone (T3) is linked to:
reproductive hormones disruption
upregulation of stress hormones such as cortisol
This in turn has an effect on our mental health, with consequences such as low mood, anxiety, anger, mood swings, and depression. Sounds familiar?
Now, back to those who diet for years and years. As you can imagine, it doesn’t look good. A mountain of problems can arise from constant under-eating. Below are some of the symptoms of Low Energy Availability:
Amenorrhea (the absence of a menstrual period for 90 days or longer).
Early menopause - women who are very underweight for a long period of their lives are more likely to go into menopause early because estrogen is stored in fat, and not having an adequate amount of fat over many years can halt estrogen production, and even eventually lead to early menopause if left untreated. [5]
Low bone mineral density causing bone stress fractures.
Persistent (extreme) Fatigue.
Disrupted sleep patterns, which exacerbates the above-mentioned fatigue.
Decreased immunity (picking up every flu / cold).
Gut malfunctions: IBS symptoms, bloating, gaseous, distress, feeling nauseous.
Chronic inflammation which if untreated, leads to an increased risk of cardiovascular disease and reduced healthy life expectancy.
Now, if you look at ALL the above symptoms you will notice that these are the EXACT SYMPTOMS OF PERIMENOPAUSE. Of course, not every woman is going to experience all of them but if you are in a low energy availability you might, even if you are not perimenopausal!
And if you are in your menopausal transition, these symptoms most likely become aggravated. So even if you refuse to agree that there is a correlation between under-fuelling and low mood / anxiety, to be honest, if I was to experience only a handful of the above symptoms, I’d feel pretty low!
And, on top of it all, when we add the obsession of controlling food and body weight, then let’s face it ladies, we’re in a pickle.
To read more go to Part II - Anxiety in Perimenopause? What can we do about it.
[1] https://www.mintel.com/press-centre/brits-lose-count-of-their-calories-over-a-third-of-brits-dont-know-how-many-calories-they-consume-on-a-typical-day/
[2] https://theconversation.com/how-slimming-became-an-obsession-with-women-in-post-war-britain-76166
[3] A study of 2000 women aged between 46-60, carried out on behalf of Health & Her® by OnePoll https://committees.parliament.uk/writtenevidence/39340/pdf/
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