By Dr. Diana Bitner
The number one reason women call or visit a midlife or menopause office is, “I don’t feel like myself.” And the number two reason is, “I am gaining weight and I haven’t changed anything—and it’s all in my belly!” If this describes you and you’re wondering about all that belly fat you’ve noticed lately, you came to the right place.
In this Let’s Chat blog, I will cover why women gain belly fat, why there is a connection to chin hair, how belly fat is different from other fat, and what belly fat means for your health. I will also give you five tips on how to NOT gain the dreaded belly fat and give you five questions for you to ask your healthcare provider about your own health. Let’s get started on this crucial topic.
When I was a young OB/Gyn running around delivering babies and seeing many patients daily, patient after patient would tell me she had gained 30 pounds and had no idea how it happened. I have to admit, I would think to myself, “How can you not know how you gained 30 pounds?” I wanted to ask each woman the obvious question: “Are you eating more and exercising less?” Instead, I gave them the polite version of the “eat less and exercise more” talk, and we would move on from there.
But, I started seeing a pattern and was faced with the question so often that I decided to figure out why this was happening to so many women. As I took time to ask more questions, I realized that the first ten pounds always made sense—they had been on vacation, sprained an ankle, helped a sick parent for a long period of time, or struggled with a bad case of bronchitis for three weeks. As a result, they couldn’t exercise and ate the same amount of food—or possibly even more comfort food. Given all the different scenarios, the initial weight gain made sense.
The good news is that for some women, once they start to be active again and drop 200-300 calories a day, the weight comes right off. Unfortunately, for a small group of women, the weight doesn’t come off and the weight gain rapidly increases! It’s not fun for them and definitely NOT GOOD for their health—not to mention their diminished self-esteem and increased chance of getting chin hair (more on that correlation later).
Women and Insulin Resistance
It may seem like a complicated issue, but it really comes down to one thing: some women are very insulin resistant. This is important, so really pay attention here! Insulin resistant means just what the words say—your cells are resistant to insulin. Why is that important? Think of insulin as the key to opening the doors in a cell wall to let sugar inside. If insulin is in the blood, then the cell doors open and sugar goes in. If there isn’t any insulin, the sugar stays in the blood. If the cells are resistant, they need more insulin to get sugar into the cell, out of the blood. To complicate things even more, some women are genetically more insulin resistant than others.
Here’s an example to simplify things a bit: If a woman comes from a family where several family members have Type II Diabetes, or if the woman’s mother was diabetic when she was pregnant with her, that woman is more likely to be insulin resistant, be more sensitive to sugar, and get diabetes in her lifetime. It may not seem fair, but unfortunately, it’s true.
Insulin resistance may often lead to higher insulin levels and a bigger release of insulin when sugar or high glycemic foods are eaten. A book that explains the glycemic food index very well is called “Sugar Busters” and I highly recommend reading it if you have the time. Higher insulin levels promote fat storage, especially into the belly fat. Insulin levels are also higher and response is higher when someone is stressed—either in the moment or with chronic stress. In addition, sleep deprivation can also cause increased insulin levels, and these higher levels then create sugar cravings. And it just keeps getting worse: The larger the number of fat cells that are full, the more your brain tells you to keep them full, so you eat more. Add to all of this aging and menopause, where estrogen levels typically fall, and the insulin resistance increases even more. And, the clincher? As belly fat (or waist circumference) increases, insulin resistance also increases. It’s a vicious cycle!
As you can see, if you have several of these factors working together in your body, you are more likely to gain belly fat, to crave sugar, and to get pre-diabetes and diabetes. As your belly fat increases, you are more likely to get hot flashes, have mild or worsening depression, struggle with poor self-esteem, and increase your risk for various health issues (cardiovascular disease, diabetes, breast cancer, and other cancers).
Here’s an example to make things really clear. Let’s say we have two women in front of us, and one is insulin resistant and one is not. They both eat a bowl of white rice or a serving of mashed white potatoes (both high glycemic foods). These high glycemic foods will raise their blood sugar quickly, but the woman who is insulin resistant will get an even bigger insulin surge from her pancreas which will then push the sugar straight into her belly fat. The woman who has a normal insulin response will more slowly absorb the sugar and have the opportunity to “spend” it before it is saved in the belly fat.
The Truth About Belly Fat and Chin Hair
So, how does all of this relate to chin hair? What happens is that as we get extra belly fat cells, we store more prohormones that can be converted into hormones that look like testosterone. The hormones can be stored in the fat cells and the excess is converted to testosterone, which can stimulate hair growth in areas like the chin, above the lip (mustache), the sides of the face, the belly, and the chest. These hormones are also at least partially responsible for deep cystic acne. You may know about this type of acne if you suffer from a condition called Polycystic Ovary Disease (PCOD). If you are familiar with this, then you know that insulin resistance is often the cause, and chin hair and belly fat are two symptoms of PCOD. The best treatment for PCOD is weight loss and medications to reduce insulin resistance. The hard thing about chin hair is that once it starts, it can be very hard to stop. The hair cells cannot be turned off once they are turned on and can only be destroyed with laser treatments or other techniques. The trick is to stop new cells from being turned on with weight loss, less insulin resistance, or a medication called Spironolactone which blocks the testosterone receptors on the hair cells.
Now you know the “why” behind belly fat and chin hairs, but it’s also important to look at who this affects: All women in menopause, and especially women who already gain weight easily, or who have a hard time losing weight when they hit midlife and menopause. You may also find it interesting that some women are genetically predisposed to insulin resistance, including women of Indian descent (30% of Indian women have diabetes), women of Mexican descent, and women of Asian descent. African American women also have a higher risk of diabetes. And, anyone can become diabetic if they gain enough weight, but your genes will determine at what weight it happens.
Thankfully, the dreaded belly fat and subsequent chin hair can be avoided if women understand what is happening and then make even small changes.
Here are five tips to help you on your journey
- Know what glycemic index means—The higher the number on a scale of 0-100, the more likely it will go to belly fat.
- Take in small servings of complex or low glycemic index carbs throughout the day—This will help to support your activities and keep blood sugar stable. Stay away from white carbs, treats, and alcohol.
- Limit simple (high glycemic) carbs at night—This is especially true if you are stressed or sleep deprived.
- Learn new recipes—Create menus that make a low glycemic diet easy to fit into your lifestyle and budget.
- Maintain muscle mass or lean body weight—This will help you maintain a healthy weight and healthy waist circumference.
Five important questions to ask your healthcare provider:
- What is my Phase of Ovarian Function (reproductive, perimenopause, menopause)?
- Do I have pre-diabetes, and how do I know if I have it?
- What are my numbers: waist circumference, blood sugar, triglycerides, High Sensitivity C-Reactive Protein (hsCRP)?
- What is my Reynold’s Score (used to help predict your risk of having a heart attack or stroke in the next ten years)?
- What are my options for treatment to help me in my efforts? Should I take Metformin, Spironolactone, Estrogen?
Your healthcare provider can help you answer all of these questions, and the answers can help you live your true life and add years to your life. At true. Women’s Health, our Certified Menopause Practitioners have extra training in how hormones affect your health, and we can help you with all your questions about belly fat and chin hair.