The Professional Hypochondriac recently spoke with Dr. Shana Weiss, an internist in private practice in Vernon Hills with specialty training in bariatric medicine. Previously, she was part of the team at NorthShore University Health System’s Center for Weight Management.

TPH: When do women most commonly gain weight?
Dr. Weiss: I usually see it around age 40. Women are most at risk between the ages of 45 to 55.

TPH: What’s happening to our bodies?
Dr. Weiss: Nobody’s really pinned down the metabolic reason for weight gain. It’s an oversimplification to simply say that metabolism slows down. Lots of chemical signals get altered between the brain, gut and body fat. A few years ago nobody thought fat did much of anything but it does act as an organ. Some part of the biochemical pathways and signaling mechanisms become altered. It’s likely tied to hormones as well. As those pathways shift, in some women we see weight gain right around the middle, rather than in the hips and thighs.

TPH: How can we prevent this weight gain?
Dr. Weiss: Focus on exercise as opposed to watching what you’re eating, assuming you eat a fairly healthy diet and watch your portion sizes. The majority of women are frustrated because they’ve already tightened up their diet and haven’t seen a big difference. The change has to come from more exercise. Working out on an elliptical trainer three times a week for 20 minutes is not enough. Usually the rule of thumb is you need to work out five to six days a week for 60 minutes to achieve weight loss. Some combination of cardiovascular and weight training works best.
Weight training improves your muscle mass and boosts metabolism. The more muscle mass you have, the higher your metabolic rate, so you can burn more calories at rest. Also, the more you exercise the more you’re mobilizing blood sugar and getting it to where it should be to help prevent diabetes, too.

TPH: Should I weigh what I did in my 20s and 30s?
Dr. Weiss: For the majority of women, it’s unrealistic to weigh what you did in your 20s. You want to maintain a healthy weight. Ask your doctor what’s right for you. I use the body mass index (BMI) with my patients as opposed to the old height and weight guidelines. Your healthy weight also depends on how much weight training you do and what size frame you have. There’s lot of misinformation out there about weight and where people should be but just interpret this information with common sense.

TPH: Do antidepressants cause weight gain?
Dr. Weiss: This is a very complicated question and even more complicated answer. Briefly, the serotonin reuptake inhibitor group of medications (SSRIs) have the potential to cause weight gain. However, in many perimenopausal women, their mood symptoms are contributing to fatigue, apathy, or irritability, all of which may be tied in to different eating habits. So if women feel better, they are able to better correct their behaviors, and possibly avoid weight gain or even lose a few pounds. Each individual circumstance is different.
Dr. Weiss can be reached at 850 N. Milwaukee Ave., Suite 210, Vernon Hills, IL 60061 (847) 573-9663.

For a protein-packed breakfast sure to keep you going all morning long, try this:

Protein Pancakes
1 cup uncooked old fashioned oatmeal (not instant)
1 cup 1% cottage cheese
1 cup egg whites (use liquid egg whites from carton)
A dash of cinnamon
A dash of vanilla
Mix it all in a blender and voila! Be sure to spray the griddle with non-fat cooking spray between pancakes. Serve with fruit or sugar-free syrup.
Yields 10 pancakes.

Nutritional Information
Serving size – 2 pancakes

Calories: 227
Fat: 1.5 grams
Carbs: 11 grams
Protein: 12.5 grams