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waist?

      Because the geographical location of your abdominal fat cells is most conducive to producing oestrogen. These fat cells surround the liver and adrenal glands, which lend a helping hand to produce oestrogen. The adrenal glands produce a form of testosterone, the liver produces the enzyme necessary to convert the testosterone to oestrogen, and the fat cells surrounding the liver and adrenal glands provide the laboratory to get the job done. It’s a highly efficient system.

      A year ago or ten years ago (depending on your age), you were more likely to store fat in your buttocks, hips and thighs. Today, it’s most likely to be in your stomach and waist. Your thighs have done their job, now it’s time to rest. And while they are recuperating from years of hard work, they relax a bit too much and lose some of their structure, collapsing in certain areas and plumping out in others. Cellulite starts to become more noticeable and is often described as ‘dimples on your fat cells’. Could it be that your thirty something fat cells are so happy to be in midlife that they are smiling at you?

      It wouldn’t surprise me. This is their heyday, and they are also ecstatic about your loss of muscle mass. Muscle loss works in tandem with fat gain. Muscle is your metabolism, and when you lose muscle you lose your ability to burn calories. So from age 35 on, the average woman loses about half a pound of muscle a year while she’s gaining 1½ pounds of fat. When you lose a half pound of muscle, you burn about 40 fewer calories a day. The more muscle you lose, the fewer calories your body needs, and the extra calories are rerouted to your fat cells to store.

      In addition to muscle loss, food cravings also join in to give fat cells a helping hand. A slight decrease in oestrogen and progesterone intensifies your PMS, mood changes and food cravings. When oestrogen levels diminish, the levels of certain brain chemicals follow suit. One of the most influential is serotonin. When serotonin levels drop below normal, you feel tired and moody, and your brain cells cry out for sugar, starch and chocolate as a natural way to bring this important brain chemical back into balance and make you feel better. In addition, the ice cream, hot fudge and whipped cream also help to make your fat cells feel better. Your cravings for high-calorie foods ensure that you are eating sufficient calories for your fat cells to store. During the perimenopause, everything seems to work in the fat cells’ favour.

      From the combination of lower oestrogen levels, less muscle mass, increased food cravings and increased fat storage enzymes, this is what your 35-year-old fat cells look like:

      When you were in your twenties you may have cursed your female fat cells, but with the right approach to eating and exercising, you did see results. But by the time you celebrate your 40th birthday, you may have had a child or two, you are clinical evidence that gravity does exist, your waist is no longer the size of Scarlett O’Hara’s – and you’ve lost 2½ pounds of muscle, gained 7½ pounds of fat, and need 200 fewer calories a day.

      With each subsequent birthday, your fat cells are having more of a celebration with the jelly and ice cream than you are.

      When you reach your mid-forties, your oestrogen levels are declining more significantly, your body changes are no longer subtle, and there is no question in your mind that you are in the perimenopause.

      • Your periods have changed – sometimes longer, other times shorter; sometimes heavier, other times lighter.

      • You are craving chocolate all month long and keeping chocolate everywhere – in your bag, briefcase, desk drawer and anywhere else that’s feasible. You may be forgetting people’s names and appointment times, but chocolate is excluded from your memory loss.

      • You continue to lose half a pound of muscle a year, and your caloric needs drop by as much as 400 calories a day. If you are eating the same amount, you are storing most of those 400 calories in your waist.

      • You have gained up to 10 pounds of fat and are more frustrated with your weight than ever before.

      • One-size-fits-all labels have crept into your cupboard, along with elastic-waisted trousers and skirts.

      • You are considering liposuction or any other procedure to get rid of this unwanted fat.

      • Your fat cells start reproducing and multiplying to make sure there is plenty of room to store fat and produce the oestrogen you need. In other words, you may not be able to give birth any longer, but your fat cells still can.

      Fat cells giving birth? Many women aren’t happy to hear that their fat cells are reproducing, but it’s another one of their highly evolved functions during the perimenopause. Because your ovaries’ output of oestrogen is now below normal, fat cells start dividing as a safeguard for oestrogen production. Their new motto is ‘divide and conquer.’

      When you are in your mid-to late forties, your menopausal fat cells are working together like an ant colony, some dividing, others expanding, and all managing to store unbelievable amounts of calories in their microscopic containers. All of this hard work is to make sure you are gaining ample weight in your waist so that your abdominal fat cells can provide a natural source of oestrogen.

      By now, your fat cells have been so successful in stimulating weight gain in your upper body that a change in body shape is apparent. Your waist has increased by 2 inches, and your pear-shaped body has become noticeably more apple-shaped. This shift in body shape is pleasing to some women. It was to my friend Stephanie. After being pear-shaped since puberty and having to buy smaller-size tops than bottoms for the previous 30 years, she welcomed a more even weight distribution. She came walking out of a room one day modelling her new apple-shaped body for appraisal and asked, ‘What do you think? Red delicious or Granny Smith?’ We all agreed she was red delicious – and proud of it.

      This is what Stephanie’s and your 45-year-old fat cells look like:

      As you approach the 50-year mark, your body and fat cells continue to change, and you are reading everything that you can get your hands on about the menopause. It becomes the number one topic of conversation with your friends and the number one concern with your doctor. Then as you round your fifth decade, your fat cells reach a new equilibrium. Their job is done.

      When you celebrate your 55th birthday, you’ll most likely fit the clinical definition of postmenopause: no periods for at least a year. This is a relief for most women, and it’s a sign that the transition is coming to a close. In addition, you’ll also be relieved by other positive changes that mark the end of your perimenopausal years.

      • Your moods even out. Your son is no longer murmuring under his breath ‘mean-o-pause’.

      • Your memory is making a comeback. You actually remember your daughter-in-law’s name again.

      • You may still have a few hot flushes, but they no longer keep you awake all night or drench you during business meetings. Your emergency portable fan is no longer necessary.

      • Your weight has stabilized on its own, and you are pleasantly surprised to find that you’ve lost a couple of pounds without really trying.

      Finally some good news! Once you stop menstruating and become postmenopausal, your fat cells have successfully accomplished their mission. The storage enzymes deactivate,


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