Intermittent Fasting in Menopause
Managing weight is a struggle for many people, and the slowing metabolism, fatigue, and poor sleep of perimenopause and menopause don’t make it any easier.
We ditch sugar, we cut carbs, we trade in the evening glass of wine for a brisk walk and still the extra weight arrives and makes itself at home.
According to our Director of Health here at genneve, ob/gyn Dr. Rebecca Dunsmoor-Su, a few extra pounds at menopause and after aren’t necessarily a bad thing. Body fat produces estrogen, and while it won’t replace what menopause took away, it can help replace some of the protective benefits of estrogen.
However, too much adipose body fat (the belly fat that can accumulate after menopause, when fat distribution changes) isn’t good for our hearts and can be a risk factor for diabetes.
How to manage weight after menopause is one of the most common questions we get to genneve’s telemed docs. We wanted to understand how we could manage weight in a way that emphasized fitness and healthy habits, so we turned to a great source, Nutrition and Wellness Coach Dr. Becky Gillaspy of Dr. Becky Fitness.
Specifically, we asked Dr. Becky to enlighten us about intermittent fasting: What is it? Does it really work? and most of all, Can I really go that many hours without eating and not self-destruct?
What is intermittent fasting (IF)? How does it work?
Dr. Becky: Intermittent fasting is a simple fat-loss strategy that involves shortening the hours in which you consume your daily calories. It helps keep insulin levels low. Insulin is your fat-storing hormone, so intermittent fasting helps prevent fat storage and promote fat loss.
What makes intermittent fasting particularly good for women in peri/menopause?
Dr. Becky: As we approach menopause, hormonal changes make us vulnerable to unpleasant and serious conditions. Fasting helps us deal with many of them, from belly fat to cardiovascular disease to diabetes.
In 2016, there was a comprehensive review of research published in the Journal of Midlife Health to determine how fasting impacted numerous aspects of women’s health. The study showed fasting to be beneficial for dealing with Metabolic Syndrome. This condition markedly increases in a woman’s menopausal years and is defined by risk factors like increased belly fat, high blood pressure, and elevated blood sugar levels. So, there are both weight loss and health advantages of fasting as we age.
Which timing pattern do you recommend?
Dr. Becky: The idea of skipping a meal can be intimidating. When a woman is first starting to practice fasting, I recommend the easiest schedule, which I refer to as 12:12 intermittent fasting, which means that she fasts for 12 hours overnight and consumes all of her calories within the remaining 12 hours of the day. When this routine is comfortable, she can progress to 16:8 intermittent fasting, which involves fasting for 16 hours and is most easily performed by skipping breakfast.
If I start IF, should I do it forever? Or just until I reach my goals?
Dr. Becky: Many women are attracted to intermittent fasting for the fat-loss benefits but find that it has additional benefits that they enjoy. For one thing, it is a simplified way to maintain weight loss. It also has health benefits, as I mentioned earlier. So, there is no reason why a woman would need to stop utilizing this tool.
I have digestive issues (bloating, diarrhea/constipation, etc.) – will IF help me, hurt me, or neither?
Dr. Becky: The beauty of fasting is that there is no food coming in, so a woman may find that fasting allows her digestive system to rest and reboot. To improve how she feels, a woman may find it beneficial to drink plenty of water and supplement with electrolytes during the fast. If symptoms persist, it would be best to consult with her doctor.
Do I need to change what I eat to manage my weight? Or just when?
Dr. Becky: A woman may find weight loss success with intermittent fasting alone. However, I think she’ll be happiest with her results if she uses fasting as a tool to enhance a healthy low-carb diet. There are two reasons: First, her excess weight will come off quicker with the combination of diet and fasting. Second, when you reduce the carbs in your diet, your blood sugar level remains steady, which helps you avoid the hunger and cravings that come with low blood sugar.
I’ve tried this before and can’t get farther than a day or two. Does it get easier?
Dr. Becky: I’ve found that there are physical and mental hurdles to overcome when starting intermittent fasting. As I mentioned above, if you combine a low-carb diet with fasting, you tackle the physical hurdles of hunger and cravings. But, there is also a mental aspect that centers around the fear of the unknown. We have been brought up to believe certain things like, “Breakfast is the most important meal of the day.” and “You need to eat often to stimulate your metabolism.” Intermittent fasting breaks these rules and challenges some well-established beliefs.
I work out pretty regularly. How do I time my meals to support my activity level?
Dr. Becky: How a woman handles fasting around her exercise routine will vary depending on the intensity level, length of the fast, and her unique metabolism. Once a woman is experienced with intermittent fasting, she may find that she can exercise during her fast without feeling unusually depleted. However, if she is fasting for longer than 16 hours or her exercise session is intense or long, she may find that consuming a small amount of food before, during, or after her workout is helpful.
I’ve been compulsive about food restriction in the past, and I don’t want to go there again. How can I be sure I have a healthy mindset?
Dr. Becky: If a woman has a history of an eating disorder, intermittent fasting could trigger some deep emotions and may be contraindicated. For others, they will find a level of comfort if they start with a longer eating window and remove A.N.T.s from their thinking. The acronym A.N.T.s is a concept that I borrowed from Dr. Daniel Amen. It stands for Automatic Negative Thoughts, which are those persistent thoughts that pop into our heads when we try to change habits, “This will never work.” “I’m going to starve.” I explain how to exterminate A.N.T.s in my coaching program, but the first step is hearing them.
My sleep is terrible in peri/menopause – I wake up often in the night and frequently struggle to get enough sleep. Can IF help with that?
Dr. Becky: There are many reasons for poor sleep at this stage of life, so it's hard to say that fasting will improve sleep for every woman. However, when practiced in accordance with your circadian clock, or natural wake-sleep cycle, fasting can help you fall into the deep sleep needed for quality rest. When you eat too close to bedtime, blood flow is directed toward your stomach, so your core temperature rises, making it harder to fall into the deep sleep needed for rest and repair. So, starting your fast three hours before you go to bed may improve your sleep quality.
Do you have favorite resources (and these can be your own!) you recommend to women who are considering or embarking on IF?
Dr. Becky: My YouTube channel has videos on intermittent fasting for the general public. Many of the members of my coaching program have reached menopause and are finding weight loss success by combining intermittent fasting with a low-carb diet. The program walks you through how to make these elements work in your life.
Dr. Becky Gillaspy, DC, spent most of her professional career teaching a range of college courses from anatomy to nutrition. She now works full-time helping people reach their health and weight loss goals through her website, DrBeckyFitness.com, and her YouTube channel.
genneve is an online clinic for women in midlife and menopause. Connect with menopause specialist physicians and nurse-practitioners, discover products that solve many of the problems that come with hormonal change, celebrate and commiserate with a robust community of women, and access resources to help you understand your body better, including our Menopause Assessment.