Why is it harder for women to lose weight?

Lisa Scharinger
Why is it harder for women to lose weight?
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A combination of hormonal and metabolic differences makes losing weight more difficult for women than for men. 

Women often find it difficult to lose weight. To make matters worse, it often seems that their male partners, brothers and friends can change their diet or lifestyle and the pounds tumble off. Meanwhile, many women who have made the same changes are still waiting for results. Research shows that we are not imagining this phenomenon. In a systematic review of 58 studies directly comparing diet-only and diet/exercise interventions in women and men, 10 of the studies found that men lost more weight than women on both types of weight loss interventions.

This is due in large part to key differences in men's and women's metabolisms. Our body composition, hormones, pregnancy and more can complicate weight loss and weight management.

The metabolic differences between women and men

Research has identified a number of factors that explain why women's bodies are more likely to accumulate body fat and have difficulty losing weight:

Basic physical differences: On average, women are smaller than men and have more body fat and less muscle mass. This size difference is the reason why women have a lower basal metabolic rate on average. This measures the number of calories the body burns while performing life-sustaining functions such as breathing and pumping blood. Some studies show that 24-hour energy expenditure in women is 5 to 10 percent lower than in men, regardless of physical activity.
Women are more likely to suffer from diseases that are associated with weight gain: Women are also more likely to suffer from thyroid conditions that can affect weight. For example, women are five to eight times more likely than men to suffer from thyroid problems such as hypothyroidism, a condition that slows down the metabolism and is associated with fatigue and weight gain. Other conditions such as polycystic ovary syndrome (PCOS), which affects up to 12 percent of women of reproductive age in the U.S., are closely linked to obesity and insulin resistance. About four out of five people with PCOS are obese, and studies have confirmed that PCOS interferes with weight loss. The researchers suspect that the effects of PCOS on mental health and changes in energy expenditure influence weight loss.

Stronger cravings and appetite: Research suggests that the neurobiological mechanisms underlying cravings and appetite are different in men and women. For example, a 2009 study published in the Proceedings of the National Academy of Sciences found that brain scans of men and women who smelled and tasted foods such as pizza and cake showed significant activity in regions that control food cravings. However, when they were asked to suppress their feelings of hunger and cravings, only men showed a relative decrease in activity in brain regions activated by food.

Pregnancy puts some women off: around half of pregnant women put on weight during pregnancy or keep the extra pounds for at least a year after giving birth. The hormone prolactin, which increases during pregnancy and breastfeeding, is known to affect appetite regulation systems and promote weight gain, obesity and metabolic syndrome due to its effect on behavioral pathways in the gut and brain. Studies also show that weight gain during pregnancy is an independent factor in long-term weight gain and obesity in women.

The role of sex hormones and weight

In one way or another, all the metabolic differences mentioned above can be traced back to one and the same thing: Hormones. In women, for example, sex hormones such as oestrogen and progesterone play a paramount role in body composition, and hormones are what trigger hunger and cravings.

How does it work? Generally speaking, I like to compare hormones to a symphony - the official conductor of the orchestra is the brain: two particularly important parts of the brain are the hypothalamus and the pituitary gland. These parts of the brain communicate with organs to produce hormones. When these brain regions function normally, common weight loss strategies, such as increasing physical activity and reducing calorie intake, work.

However, poor diet, excessive alcohol consumption and excessive stress can affect the hypothalamus and pituitary gland, which in turn disrupts the hormonal balance. The hormones can work individually to counteract weight loss, but they can also work together in a way that makes weight loss more difficult.

Take oestrogen, for example. Oestrogen is the most important female sex hormone. It is responsible for female sexual and reproductive development. It also plays an important role in weight and body composition, although its specific effects are complex and vary according to life stage. A study examining the relationship between estrogen and insulin concluded that too much or too little estrogen can lead to rapid changes in overall body metabolism, including fat distribution, insulin sensitivity, energy expenditure and food intake.
Estrogen dominance [a high level of estrogen relative to progesterone] leads to weight gain around the waist, hips and buttocks and promotes insulin resistance. In my clinical experience, too much estrogen is the main reason why women find it harder to lose weight, regardless of age. Oestrogen dominance is associated with conditions such as PCOS, insulin resistance and endometriosis.

However, too low an oestrogen level in relation to progesterone can also be problematic for the metabolism. Falling oestrogen levels can also lead to weight gain, usually around the middle, and lean body mass decreases. This typically happens during the menopausal transition. And why? Sex hormones such as oestrogen and in particular the oestrogen receptors play an important role in fat cell activity and fat distribution. Studies show that women gain an average of 12 pounds within eight years of the onset of menopause.

Women's hormone balance also changes drastically during the menstrual cycle, which can lead to weight fluctuations. One study has shown that women in the follicular phase (before ovulation) burn an average of 106 calories less per day than in the luteal phase (after ovulation), regardless of physical activity. Other studies show that the body's insulin response changes during the menstrual cycle, with insulin sensitivity being higher in the follicular phase and decreasing in the luteal phase.

In addition, studies show that pre-menstrual cravings are a common problem and can contribute significantly to the cardiometabolic side effects such as high blood sugar and visceral fat accumulation associated with obesity.

Support hormone and weight management

There are ways to help the body maintain its hormonal balance, making it easier to lose weight and keep it off.

Here are some good ways to get started.

1. focus on strength training

Women are at an inherent disadvantage when it comes to calorie expenditure during the day, but certain types of exercise - particularly resistance training - can increase basal metabolic rate. A systematic review of more than 18 peer-reviewed articles comparing the effects of cardiovascular exercise and resistance training found that aerobic exercise has no effect on resting metabolic rate, while resistance training increases resting metabolic rate on average compared to controls.

2. focus on healthy protein

You may need to reduce calories and increase certain macronutrients like protein during menopause. Here's a list of our favorite sources of protein:

  • Nuts (macadamia nuts, walnuts)
  • Seeds (pumpkin, flax, hemp)
  • Eggs (from cage-free hens)
  • Wild-caught fish low in heavy metals (salmon, mackerel, sardines, trout)
  • Shellfish (crabs, mussels, oysters, scallops, prawns)
  • Free-range poultry (preferably dark meat with skin)
  • Free-range and grass-fed meat

3. avoid hormone-disrupting foods

Research shows that eating lots of trans fats, refined carbohydrates and added sugar can affect fertility and female hormone balance, as progesterone, a hormone that regulates follicle development and parts of ovulation, decreases. Alcohol is another known hormone disruptor. Studies of pre- and post-menopausal women have shown a general link between hot flashes and alcohol consumption. And one study showed that average salivary estradiol levels throughout the menstrual cycle were 18 percent higher in women who consumed more than 10 grams of alcohol per day than in women who consumed less than 10 grams of alcohol per day. To promote hormonal balance, you should limit your consumption of alcohol as well as beverages and foods with added sugar and processed carbohydrates, such as sodas, juices and most packaged foods.

4. cope with stress

There is a clear link between stress and weight gain. In a controlled study, participants who added mindfulness-based stress management to their eight-week weight loss program were able to significantly reduce their BMI (-3.1) compared to the control group (-1.7), even though they were only instructed to use the techniques once a week. The program included diaphragmatic breathing, progressive muscle relaxation and guided visualization. There's no magic number for how often or how long you should do these exercises, but one commonly cited study showed positive changes in emotion regulation and mood with just 13 minutes of meditation a day for eight weeks.

5. professional help

The interplay of different hormones and metabolic health is extremely complicated, and if you're having trouble losing weight, it may be worth consulting a doctor who is trained in integrative and functional medicine. These doctors look at the whole person. They will look at: metabolic health, gut health, hormone levels, as well as diet, supplements, exercise and stress management. 

6. control your weight in a healthy way with Hello Inside.

The best way to understand how your diet and behavior affect your metabolic health - and your weight - is to use a continuous glucose meter and an app like Hello Inside to help you understand your data.

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