Women and Weight: An Intersection of Physical and Mental Health

Overweight and obesity impact millions of individuals worldwide, with women often facing unique challenges due to biological, societal, and psychological factors. Excess belly fat, particularly visceral fat, can increase health risks, especially for women post-menopause. General statistics related to women’s health, such as the average weight and height, highlight the importance of understanding these metrics in the context of a balanced lifestyle. Research underscores a strong connection between excess weight and mental health issues, such as low mood and anxiety, highlighting the importance of a holistic approach to addressing these interrelated concerns. Understanding the underlying causes and recognising effective treatment options are essential steps in supporting women on their journey toward better health and effective weight management.

Understanding Healthy Weight

What is a Healthy Weight?

A healthy weight is more than just a number on a scale; it’s a weight that supports overall well-being and reduces the risk of chronic diseases such as heart disease, stroke, type 2-diabetes. Obesity is also considered a contributing cause of several different types of cancer, including breast cancer (in postmenopausal women). The World Health Organization (WHO) estimates that 40 percent of all cancer can be prevented. While smoking for a long time has been seen as a leading cause of cancer, obesity is becoming an equally significant risk factor. Unlike the often unrealistic ideals set by societal beauty standards, a healthy weight is individualized, focusing on what makes you feel energetic, confident, and able to maintain a good quality of life. Managing belly fat is crucial as it can significantly impact your overall health and well-being. It’s about finding a balance that works for your body and health goals, rather than striving for an “ideal body weight” that may not be realistic or healthy for you.

Measures of Adiposity Beyond BMI

Body Composition and Metabolism

Understanding your body composition is crucial in assessing your health. It’s not just about the number on the scale but how your body is composed and how efficiently it burns calories. Listed below are some key points to consider:^1-3

• Body Fat Percentage: Provides a detailed assessment of body composition, and is measured through techniques like skinfold assessments or BIA. Maintaining a healthy body fat percentage is essential for overall health. For women, a body fat percentage of 21-33% is considered healthy. This range supports bodily functions and reduces the risk of chronic diseases. A smart scale of good quality is a great way to conveniently track changes in body fat percentage over time for each and everyone at home.
• Muscle Mass: Building and maintaining muscle mass is vital for a healthy metabolism. Muscle tissue burns more calories than fat tissue, even at rest. Incorporating resistance training into your routine can help you build muscle mass, which can aid in weight loss and weight maintenance.
• Metabolic Rate: Your metabolic rate is the speed at which your body burns calories. A higher metabolic rate can help you lose weight and keep it off. Factors such as age, sex, and body composition influence your metabolic rate. For instance, having more muscle mass can boost your metabolism.
• Body Fat Distribution: Where your body stores fat matters. Visceral fat, which accumulates around the abdominal organs, poses a higher risk for chronic diseases like heart disease and diabetes. Maintaining a healthy body fat distribution can help mitigate these risks.
• Waist-to-Height Ratio (WHtR): is an effective predictor of intraabdominal fat and cardiometabolic risk; a ratio >0.5 indicates increased health risks.
• Waist Circumference (WC): Measures abdominal fat distribution; a circumference exceeding 80 cm for women and 94 cm for men elevates the risk of cardiovascular disease.
• Waist-to-Hip Ratio (WHR): Assesses fat distribution; a ratio of 0.8 or lower for women is considered healthy.
• Body Mass Index (BMI): BMI is calculated by weight in kg divided by height in meters squared, and is considered healthy if between 18.5-24.9. BMI does not account for body composition differences, why it should only be used as a complementing measuring method, not a sole indicator. Calculate your BMI with Yazen’s BMI calculator.

By understanding these aspects of body composition and metabolism, you can make informed decisions about your diet and exercise routine, ultimately supporting your journey towards a healthier weight.

At Yazen we keep track of measures and follow up several of these different criteria, to be sure to have a thorough and comprehensive evaluation of our patients’ health.

The psychological impact of excess adiposity and overweight, obesity, as well as body mass index

Mental health issues are significantly more prevalent in individuals with overweight or obesity compared to those with a normal weight. For women, this relationship is often amplified by societal pressures, body image concerns, and stigmatisation. Overweight and obesity can lead to:

• Low mood and depression: Studies have shown a higher prevalence of depression among individuals with obesity, particularly women. Obesity-related inflammation and psychosocial stressors are contributing factors.⁴
• Anxiety: Research links obesity to increased anxiety levels, potentially due to social stigma and the psychological burden of managing weight.⁵
• Social isolation: Obesity-related mental health issues can result in withdrawal from social interactions and physical activity, further compounding psychological distress.⁶

The Challenges of Weight Gain

Hormonal Imbalances and Weight Gain

Hormonal imbalances can significantly impact weight gain, especially in women. Here are some common hormonal issues that can lead to weight changes:

• Polycystic Ovary Syndrome (PCOS): This condition is associated with weight gain, particularly around the abdomen, due to insulin resistance and elevated androgen levels. Managing PCOS often requires a combination of medication and lifestyle changes.^7-8  Find out more about PCOS here. // Link to PCOS article //
• Thyroid Hormone Imbalance: An overactive thyroid (hyperthyroidism) can cause weight loss. While an underactive thyroid (hypothyroidism) can slow metabolism and lead to weight gain. However, in most cases, this increase is limited to 3–5 kg, unlikely to have a significant impact.^7,9 Thyroid imbalances can be managed with medication and regular monitoring. Find out more about hypothyroidism here // Link to article about hypothyroidism //
• Menopause: During menopause, the decline in estrogen levels, in combination with other factors, can contribute to weight gain, particularly in the abdominal area. This change in body fat distribution can be managed with a combination of diet, exercise, and sometimes hormone replacement therapy.^7,10
• Cushing’s Syndrome: This rare disorder, characterized by high levels of cortisol, can cause significant weight gain, particularly in the abdominal area. Treatment often involves addressing the underlying cause of cortisol overproduction.⁷

If you suspect that hormonal imbalances are affecting your weight, it’s crucial to consult with a healthcare professional. They can help diagnose the issue and recommend appropriate treatments, whether through medication, lifestyle changes, or a combination of both. Understanding and addressing these hormonal challenges can be a key step in achieving and maintaining a healthy weight.

Pregnancy and Menopause

Pregnancy and menopause are significant life events that can profoundly impact weight management. Here’s what you need to know:

• Pregnancy: Weight gain during pregnancy is natural and necessary for the growing fetus. However, post-pregnancy, many women find it challenging to lose weight due to hormonal changes and increased body fat. Breastfeeding can aid in weight loss, but it’s crucial to maintain a balanced diet and regular physical activity. Focus on nutrient-dense foods and gentle exercises like walking or postpartum yoga to support your body during this time.
• Menopause: Menopause typically occurs between the ages of 45 and 55 and brings about hormonal changes that can lead to weight gain, especially around the abdomen. This shift in body fat distribution can increase the risk of chronic diseases. To combat this, maintain a healthy diet rich in fruits, vegetables, and lean proteins, and engage in regular physical activity, including both aerobic exercises and resistance training, to preserve muscle mass and support metabolic health.

Understanding these changes and adopting a proactive approach to diet and exercise can help manage weight effectively during these pivotal stages of life.

Unhealthy eating behaviours and their roots

Many women with overweight or obesity struggle with unhealthy eating patterns, which can be rooted in psychological issues such as stress, trauma or disordered eating. Emotional eating is a common coping mechanism, where food can be used to manage feelings of sadness, anger or stress. For some, these patterns may be linked to underlying eating disorders:

• Emotional eating has been widely recognised as a coping mechanism for negative emotions and stress.¹¹
• Binge eating disorder (BED) is more prevalent in individuals with obesity and is linked to mental health issues such as depression and anxiety.¹²

Losing weight can be particularly challenging due to differences in caloric needs between men and women. Genetic factors can create additional hurdles for women, making it essential to find a personalised eating plan that is balanced and suits individual health requirements.

Addressing these patterns requires compassionate, non-judgemental support and often, professional intervention to uncover and heal the root causes.

Medication and weight loss management challenges

Medications prescribed for mental health conditions, including depression, anxiety, and sleep disorders, can pose additional challenges for those trying to lose weight, particularly for women. Common side effects include:

• Increased appetite: Certain antidepressants, such as selective serotonin re-uptake inhibitors (SSRIs), and antipsychotics, like olanzapine, are known to cause weight gain through appetite stimulation.¹³
• Metabolic changes: Some medications can affect metabolic rate and insulin sensitivity, contributing to increased fat storage.¹⁴
• Fatigue and reduced physical activity: Sedative effects from medications, such as benzodiazepines or certain sleep aids, can lower energy levels, reducing physical activity.^15-16

These side effects create a complex feedback loop where weight gain worsens mental health challenges, and vice versa.

Innovative solutions: medications for obesity

One promising avenue in managing obesity is the use of GLP-1 and GLP-1/GIP analogues, a class of medications designed to support weight loss. These medications offer several advantages:

• Compatibility with other treatments: GLP-1 and GLP-1/GIP analogues, such as liraglutide semaglutide and tirzepatide, show minimal interaction with most mental health medications, making them safe options for individuals managing multiple conditions.¹⁷
• Appetite regulation: GLP-1 and GLP-1/GIP  analogues work by modulating hunger signals, promoting satiety and supporting sustainable weight loss.¹⁸
• Psychological benefits: Weight loss achieved through these medications often leads to improved self-esteem and mood, reducing the psychological burden associated with obesity.¹⁹

While medications can play a vital role, they are most effective when combined with lifestyle changes and psychological support.

Physical Activity and Weight Management

In addition to medication, having more muscle mass is crucial for boosting metabolic rate and overall health. Building muscle mass through resistance and weight training not only enhances metabolism but also provides significant health benefits, such as mitigating the effects of aging and reducing insulin resistance.Regular physical activity is a cornerstone of effective weight management. Here are some essential points to consider:

• Physical Activity Guidelines: The World Health Organization recommends at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity per week. This can include activities like brisk walking, cycling, or swimming.
• Importance of Regular Exercise: Engaging in regular exercise helps you lose weight, maintain weight loss, and reduce the risk of chronic diseases such as heart disease and diabetes. It also improves mental health by reducing symptoms of depression and anxiety.
• Types of Physical Activity: Incorporate a mix of aerobic exercises and resistance training into your routine. Aerobic exercises, such as running or dancing, improve cardiovascular health and help burn calories. Resistance training, including weightlifting or bodyweight exercises, is crucial for building muscle mass, which boosts metabolism and supports long-term weight management. Research indicates that both endurance and resistance-type exercises help preserve muscle mass during weight loss, with resistance training also improving muscle strength. For individuals on weight loss medications, resistance training is particularly beneficial in preventing muscle mass loss, allowing for the preservation of lean muscle while promoting fat loss. This is vital for overall health and metabolic function.²²

By following these guidelines and incorporating a variety of physical activities into your routine, you can achieve and maintain a healthy weight while enhancing your overall well-being.

A Holistic approach to better health and Well-Being

Weight loss alone does not resolve all mental health challenges, but it can be a crucial part of improving physical and emotional well-being. Holistic support systems are essential for sustainable progress. At Yazen, individuals can get comprehensive support, including:

• Yazen coaching: Personalised guidance from trained coaches to help set and achieve realistic health goals.
• Psychological support: Access to professional psychologists who can address emotional and mental health barriers.
• Community and resources: A supportive network and tools to encourage healthy behaviours and long-term success.

Tailored Care for Women’s Health Challenges

For women, the interplay between overweight, obesity and mental health is complex and multifaceted. Addressing these issues requires more than a one-size-fits-all solution. A combination of medical treatment, psychological support and lifestyle changes can empower women to reclaim their health and enhance their quality of life. By recognising the unique challenges they face and providing compassionate, tailored care, we can help women navigate the path towards both physical and emotional well-being.

References

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2. Nevill et al. 2022. NICE's recent guidelines on "the size of your waist" unfairly penalizes shorter people. Obesity research & clinical practice. (16) 4:277-280. https://doi.org/10.1016/j.orcp.2022.08.002
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