Hi, I'm Dr. Bianca!


I’m a menopausal woman. I write about what it's like to get through the hormonal transition we’ve come to know as menopause. My intent is to help us all age together in the best and healthiest way possible. Let’s not suffer in silence. Let’s normalize the conversation. 


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“My bloat is gone!”

“I’m sleeping so much better!”

“My pants are looser!”

“This program is life-changing!”

“My coat is easier to zip!”

“I lost 12 pounds!”

“I love what this program is doing for me!”

Research reports that menopause weight gain averages 5-10 pounds regardless of food intake or energy expenditure.

In fact, over 43% of menopausal women have obesity.

The menopause transition is a time of fluctuating hormone levels, lasting up to 8-10 years. 

As a result, most middle age women battle body weight changes, an increase in abdominal fat, and an ever-growing waist circumference.

Hormonal changes, especially a drop in estrogen levels, cause lean body mass to decrease and fat mass to increase.

Fluctuations can also cause a woman's metabolism to change.

Therefore, leaving her with increasing insulin sensitivity and more adipose tissue along the midsection, non-lovingly called the MENOPOT.

Every premenopausal woman has the chance to come into menopause with a healthy weight and being metabolically efficient, if they are conscientious in their years preceding.

Whereas, being overweight before menopause can make losing weight once you are in the menopause process much harder.


At 25, I was diagnosed with Polycystic Ovarian Syndrome (PCOS).

This condition is linked to insulin resistance, increasing one's chances of developing type 2 diabetes.

I didn't take it very seriously in my 30s, even with horrible period cramps, an irregular menstrual cycle and feeling shaky when I went too long without eating (a common symptom of blood sugar imbalance).

At 43 years of age, I was 25 pounds overweight, even though I followed a reasonably healthy diet.

Yet, quantity was ALWAYS my problem. I tend to eat like a 200 pound man.

Risk Factors of Menopause Weight Gain

My blood panels showed high stress hormone levels, and total body fat was way over what it should be for a 5'3" female.

In addition, I had low levels of testosterone, increased belly fat, and a slower metabolism.

At this time, I chose to take a long, hard look at my risk factors

I set out on researching the significant changes that needed to be made to derail the possible oncoming diagnosis of metabolic syndrome.

I bought a kitchen scale and a gym membership and adopted a new mantra: "patience". 

Discipline is choosing between what you want now and what you want most.

abraham lincoln

This change was going to take time.

Undoing bad habits is never easy.

The good news, the amount of time it took to offset the adverse changes was less than one year.

For some that might seem long, but to me, I had to undo a lifetime of bad habits.

During that period, my quality of life improved tremendously, including:

  • weight loss
  • an increase in muscle mass
  • a new found love of exercise in the form of competitive triathlon
  • a consistent 28-day period cycle
  • an improved emotional relationship with food

What Is Metabolism

Metabolism results from the chemical reaction of taking what you ingest and turning it into fuel or energy.

The metabolic process begins in the mouth. 

The mouth's saliva is a liquid, filled with enzymes, that work like little Pacmen to begin digestion before the food reaches the stomach.

When you do not chew your food correctly or introduce enough salivary enzymes to the food in your mouth, you miss the first part of digestion.

This critical physical activity is vital in the eventual unlocking of nutrients from your food. 

The more nutrients extracted from good food, the more efficient our metabolism becomes.

The mere act of chewing can be a significant contributor in improving our overall metabolism, called diet-induced thermogenesis:

  1. Chewing expends energy
  2. Causing the intestines to contract more quickly
  3. Leading to heat being generated within the body

So, in a nutshell, eating actually raises your metabolism!!

Diet Induced Thermogenesis

Menopause Weight Gain

There are 3 possible reasons that women gain weight during the menopausal and post menopausal transition:

Hormonal Fluctuations

Hormonal fluctuations, particularly the decline of estrogen, can contribute to weight gain.

Estrogen, an important female sex hormone, directly affects how fat is deposited.

When we are younger, we accumulate fat more evenly throughout our bodies.

When we have low estrogen, we get visceral fat accumulation, which is fat in the abdomen, aka "muffin top" or "menobelly".

In fact, abdominal obesity increases the risk of heart disease in both women and men.

When fat accumulates in the abdomen, it creates inflammation around internal organs, such as the liver and the heart, which can lead directly to cardiovascular disease and high cholesterol levels.


The rate at which our bodies break down and digest food decreases by 10% each decade after 20 years old. 

We have our highest metabolic rate during our infancy and our young growing years, 50% higher, due to the need for energy to help our system develop. 

A study published in Science reported that total energy expenditure begins its most significant decline at 63 + years old. 

Leaving the question of whether or not the menopausal years really contribute to weight gain from an aging perspective. 

Daily energy needs vary significantly from childhood to late adulthood.

Whereas the BMR and TEE decline by almost 1% per year after age 63


Effects of Deep Abdominal Fat On the Body

Excess weight and abdominal fat distribution are high predictors for heart disease for post-menopausal women.

In fact, abdominal fat or "central adiposity" can cause a significant increase in the following for women during and after menopause:

  • stroke
  • hypertension
  • diabetes

The risk of death due to heart disease increases 8-fold in women with fat distribution around their midsection. 

Abdominal fat also can predict the amount of insulin sensitivity in postmenopausal women.

This can eventually lead to fatty plaque buildup in the arteries causing metabolic syndrome. 

study of postmenopausal twins concluded that total abdominal fat accumulation is 60% genetic.

Even though one might have the genes for abdominal fat or heart disease, expressing that gene is dependent on the following:

  • other hormones (or lack of hormones)
  • environmental conditions

A woman might have a genetic predisposition for many health concerns, including heart disease risk and metabolic changes. 

However, strength training, lifestyle changes, weight management, and healthy choices can considerably slow or even stop genetic expression altogether.

How I Hit My Daily Macros

At the date of this post, I have not run in 24 weeks due to a stress fracture in my heel. 

Not an ideal situation for a triathlete but a typical one nonetheless of a woman in menopause doing what she did in her 40s thinking it would be ok in her 50s. 

I am not saying that as we age, we should not push ourselves athletically. 

We need to push our bodies differently

As I am not able to utilize a run cardio as much as I used to (addiction to adrenaline is a very real thing...why do you think its called the "runners high")...I needed to take a hard look at my macros to see where I could tweak my eating to offset potential weight gain and muscle loss. 

Lumen: Teaching the Body To Become Metabolically Flexible

Fat Burning Lumen

Welcome to the Lumen.

(Use the discount code BIANCAB for an additional $50 off)

The Lumen is a handheld device that resembles a breathalyzer. 

I describe the Lumen as a cross between MyFitnessPal, my own macro calculator and a personal nutritionist at any given moment throughout my day. 

A cartridge inside the Lumen acts like a breathalyzer measuring the amount of fat and carbohydrates being exhaled in CO2. 

High levels of CO2 means more carbs are being burned.

Low levels of CO2 indicates that I am burning fats for fuel. 

Being in a state of fat burn means that the body is utilizing fat stores for an energy source. 

This is great news because it is targeting the excess fat surrounding  our organs...the exact fat that needs to be melted in order to rid the menopot for women and the beer belly for men. 

As we know, this abdominal fat is the most detrimental to our health and heart. 

The Lumen app registers the breath and immediately shows how it impacts the macros you need for that day to keep yourself metabolically balanced. 

Metabolic flexibility is the key to staying healthy, maintaining an optimal weight and a confirmation that you are using your macros efficiently.

A History of Dieting In America

The Timeline of Dieting in America

If you are of the menopausal weight gain age, you probably have gone through the myriad of dieting programs on the market since you were in your early 20s.

Your mom took Dexatrim and went fat-free in the 70s.

You learned that eating bread and proteins together was a no-no with the Fit For Life diet in the 80s. 

Jenny Craig and Weight Watchers had you counting points and eating packaged foods.

Blood tests told you that you were an A, B, or O, and you went on the Eat Right For Your Type diet in the 90s.

On the contrary, eating only fast food Subway sandwiches with Jared was the way to go to lose a few pant sizes then.

Juice cleansing and The Master Cleanse (of which I made it through for 12 whole days and had a detox reaction that almost put me in the hospital) was mid-2012 for all the liquid lovers.

Plant-based and Vegan vs Paleo continue battling it out.

Keto, Intermittent Fasting and boxed meal plans are the new "It" kids. 

Lastly, all the multi-level pyramid programs selling "health coaching" and pre-packaged foods  seem to be the biggest rage in 2020.

When you stick to a plan and include positive lifestyle factors, almost all of these "fads" will cause weight loss.

Great! Accountability works, for sure! 

But what actually works in the long run and keeps off the weight during the hardest times of weight loss in a woman's lifespan?

Metabolic Flexibility

You are "metabolically flexible" if your body can use all macronutrients for fuel. 

The Standard American Diet (SAD) encourages the overconsumption of sugar, typically carbohydrates eaten 3-6 times per day encouraging the menopause weight gain! 

Think bread, cookies, pasta, and baked goods. 

When we continue to eat an overabundance of sugar, our bodies become saturated with glucose (sugar) and uses it primarily for food. 

Whatever we do not use, gets stored.

Guess where it is goes? 


If we rely only on one form of a macronutrient or completely cut one out, as in the case of the "fat-free" craze, we can cause some severe imbalances which can contribute to:

  • extra weight
  • difficulties with lipid metabolism (e.g. high cholesterol)
  • an overactive hunger hormone (Ghrelin is the hormone that stimulates appetite)
  • high blood pressure
  • neurological issues
  • sleep disturbances
  • the list goes on

Knowing what macronutrients to eat and in what amount can be a key to unlocking the confusion in the weight gain puzzle.

Becoming Metabolically Flexible

When I was 43, I saw a friend, who I hadn't seen in a while, come into my office looking incredibly fit.

Besides the Olympic lifting she had been doing, she mentioned that she was following a "Flexible Diet Plan." 

So naturally, I wanted in if it meant looking like her!

I began my research and dove head first into the "counting macros" world and not the world of Olympic weight lifting! 

If I wanted to change my body and metabolism, I had to do something and take full responsibility for the extra 25 pounds I was carrying. 

Using an online calculator, I found the approximate macros needed for weight loss and signed up for a free version of MyFitnessPal to begin my food journaling. 

Kitchen time grew as I logged grams and weighed my food.  

Hearing my mother's voice in my head as she would say to me when I was younger..."Pay now or pay later". 

The results were astounding, albeit slow to any serial dieter. 

I was in this for the long haul and the pre-emptive setup for menopause. 

Paying now means putting in the time and effort

Paying later meant a real struggle with fat loss and good solid chance for insulin resistance, a condition that most studies point to for many menopausal women. 

Macronutrients vs Micronutrients

It can get pretty confusing when you hear the term "counting macros".

To simplify, there are macronutrients and micronutrients and we need them both.

Macronutrients are foods that we need in "larger" amounts, such as:

  • proteins
  • carbohydrates
  • fats

Whereas, micronutrients are needed in small dosages:

  • vitamins
  • minerals

When you strive to become metabolically flexible, you want your body to utilize the appropriate fuel source for your activity. 

For example, if you are super active and need a quick energy hit, you need to use up some fast carbs

However, fats are your friend when you are going the distance or looking for fuel to endure the long haul. 

Think of it as "burning the midnight oil."  

Consuming too much protein can be stored as fat if you don't utilize all that you need, so knowing how much to eat is essential to help build muscle mass especially when combined with strength training


If you are still confused as to what each macronutrient is responsible for, here is a brief overview...


A 6-12 month clinical trial published in 2020 reported that eating more than the recommended dietary allowance of protein reduced body weight and lowered overall fat mass. 

This trial showed that a high protein diet not only had weight loss effects but also prevented weight gain after weight loss

According to the outcome, there were no adverse effects on the kidneys or bone density. 

The amino acids that makeup protein are the essential building blocks for building muscle tissue

Studies also show that dietary protein is an essential nutrient for bone health, an important consideration for menopausal women with osteoporosis.

Power up your protein with this copycat Starbucks Egg Bite recipe!

How protein Reduces Menopause Weight Gain

  • increases the hormone called Leptin, which is responsible for appetite suppression
  • makes you feel satiated or full for more extended periods of time, reducing your impulse to eat more food
  • increases metabolism through dietary-induced thermogenesis (creating heat through the act of chewing and digesting)
benefits of protein graphic

Animal Protein

Plant Protein

  1. 1
    White meat poultry
  2. 2
    Eggs and egg whites
  3. 3
    Lean cuts of beef
  4. 4
    Greek yogurt, cottage cheese, milk
  1. 1
    Chia seeds
  2. 2
  3. 3
    Peanut butter powder
  4. 4


About 15 years ago, I sat in on a lecture in NYC given by a pioneer in the field of nutrition, Sally Fallon, author of the famous book "Nourishing Traditions." 

She brought the bone broth to the forefront before it became cool in the mid-2000s. 

She gave a talk called "The Oiling of America," which transformed my warped fear of fat from the 80s. 

During that time, the AMA and the FDA made us believe that too much fat makes you fat. 

The wrong type of fat can do more than make you fat; it can wreak havoc on anyone's health, especially as it pertains to the menopausal woman.

It's actually a vicious cycle for women. Excess estrogen is stored in fat cells. Fat cells then produce even more estrogen. The excess estrogen then triggers the body to store even more fat

Welcome, menopot!

High-quality, healthy fats promote weight loss, as seen in the Mediterranean diet

Fats got a bad rap in the 60s and 70s due to fast food processing. 

When packaged foods became the rage, processed fats were being used to help improve their taste and shelf life. 

Hydrogenation converts liquid fats into a partially or full-solid consistency. 

The Worst Type Of Fat

Trans fats emerge from the hydrogenation process, which aids in raising the bad and lowering the good cholesterol. 

Trans fats can also contribute to diseases such as:

  • cardiovascular disease
  • breast and colon cancer
  • interference in the uptake of necessary essential fatty acids
  • diabetes
  • obesity
  • allergies (asthma and eczema)

Fats, Insulin Resistance and Digestion

In all the research I've read, it appears that as we age, we become more insulin-resistant due to the decline in the protective nature of our sex hormones

This statement also includes men in their aging years and the reduction of testosterone.

When we overeat fat, even good fat, we can slow up our digestion too much.

Even though, fat doesn't directly affect blood sugar levels, it can slow our rate of digestion. 

Therefore, making it difficult for insulin to work correctly.  

Furthering a potential to develop pre-diabetic conditions as we age.

Previous studies suggest that some fats are worse at promoting insulin resistance, inflammation, and fat storage.

However, other fats can encourage weight loss, reduce the risk of cardiovascular disease and improve glucose metabolism.

Choosing the Right Fats

When choosing your fats, the best ways are to go for foods high in MUFA (monounsaturated fatty acids) and foods high in Omega 6 PUFA (polyunsaturated fatty acids).

These can improve your total cholesterol levels, decrease your menobelly and possibly help to lessen some menopause symptoms.

Foods high in MUFA and Omega 6 PUFA:

  • olive oil
  • peanut oil
  • safflower oil
  • sesame oil
  • cashews
  • almonds
  • pistachios
  • macadamia
  • hazelnuts 
  • avocados

How Fat Reduces Menopause Weight Gain

  • Fat takes longer to digest than carbohydrates or protein, which can help you control your appetite
  • Fat, such as that found in avocado, promotes an increase in metabolic heat (diet-induced thermogenesis) which "stokes" the internal metabolic flame
  • When carbohydrates are minimized, the body will utilize fat for fuel and stop "storing adipose."
  • Helps the body to "burn fat" by signaling the brain to suppress the appetite
  • benefits of fat graph


    Fats were demonized in the latter part of the last century.

    Whereas carbohydrates have now taken on the role of the unwanted macro.

    Let's get one thing straight, carbohydrates are needed; however, just like the correct type of fat, knowing the proper carbohydrate is also essential.

    Extra pounds can come from over-eating proteins, fats, or carbs; therefore, blacklisting one macro isn't fair or accurate.

    The brain heavily relies on glucose, a simple sugar broken down from carbohydrates, for its energy source!

    Muscles utilize the sugar broken down from carbs to quickly release energy.

    In fact, glycogen is essential for muscle repair after heavy resistance training.

    Eating all macros in the right amounts can contribute to building lean muscle mass and shedding body fat.

    Try this delicious healthy zucchini "zoodle" side dish for a healthy carb!

    Effects of Carbohydrates on Blood Sugar

    It is important to consider how carbohydrates affect our blood sugar

    Carbohydrates are the only macro that directly raises our glucose

    We become more sensitive to glucose as we age.

    Therefore, eating the right carbohydrates becomes even more critical moving into the menopausal years.

    • Adding in a 1/2 tsp of Apple Cider Vinegar (ACV) to your drink and consuming either before or after a high carb meal, will slow the rate of glucose spike!

    Productive vs Unproductive Carbs

    I don't like to demonize food, so I won't use the words "good" or "bad."

    Instead, I look at food as fuel

    Analogy: If you owned a pristine vehicle, like a Ferrari or a Porsche, would you opt for the highest or lowest quality of gas? 

    The same goes for the carbs that you can choose for yourself. 

    Do they give you oomph and energy? 

    Or do they deplete you and cause inflammation and disease? 

    How Does Food Make You Feel?

    Taking notice of how you feel after you eat can tell you a lot how a particular food is affecting you:

    1. Does your stomach bloat or do you get gassy? 
    2. Do you get congested or stuffy? I have a slight gluten sensitivity, so when I eat pasta, I notice that I can't breathe well through my nose. 
    3. Do you notice your muscles or joints feeling heavy, tired or painful?
    4. Does your mood change? I notice that after drinking alcohol, I tend to get a little down in the dumps. A patient of mine, from China, says that when she drinks wine her face gets red and she calls it the "Asian flush". I brought to her attention that this is a histamine reaction. A sensitivity to the sulfites can cause a hive like reactions on the skin. 

    Productive Carbohydrates

    Also known as "whole", these carbohydrates are minimally processed and typically contain their natural fiber content. 

    Fiber directly affects how quickly sugar spikes after eating a carbohydrate, so eating carbs higher in fiber helps to keep the glucose levels from rising too soon after a meal. 

    This is important for diabetics, pre-diabetics, and aging women with insulin sensitivity!

    Productive carbs are also called "slow carbs" because they slowly release glucose into the bloodstream.

    Examples include: 

    • quinoa
    • barley
    • vegetables
    • legumes
    • potatoes
    • oats
    • beans
    • whole grains

    Unproductive Carbohydrates

    Unproductive carbs are known to be "refined."

    This means that they have been processed and stripped of their fiber content.

    They typically lack nutrients and can contribute to "empty" calories.

    These carbohydrates cause a spike in glucose and quickly push sugar into the bloodstream.

    Unfortunately, this fast climb leads to a fast crash, causing one to become hungry more quickly. Easily causing the cycle of overeating and feeling "hangry". 

    Refined and processed carbs can also contain added sugar, further contributing to pre-diabetic conditions and difficulties in balancing sugar levels.

    Examples include:

    • white bread
    • pastries, pretzels, cookies
    • beverages with "sugar" added 
    • white flour

    How Carbohydrate Reduces Menopause Weight Gain

    • whole or good carbohydrates maintain their fiber content supports satiety aka making you feel fuller faster
    • high fiber carbohydrates from vegetables improves bowel movements
    • the glucose from carbs fuels active muscles...higher lean muscle mass means the less overall body fat mass
    • carbohydrates with prebiotic fiber (root vegetables for example) supports the gut microbiome which improves overall digestion 
    benefits of carbohydrate

    My Personal Lumen Examples

    This is the Lumen measurement 30 minutes after eating pretzels as an evening snack. Not something I do often but I was in a salty, crunchy craving type of moment and couldn't resist. 

    FYI, cravings typically mean an imbalance in a nutrient.

    It was clear that I was in full on carb zone, not good for my waistline or blood sugar! 

    Lumen Carbohydrate

    This is the Lumen measurement before I head out on a 1 hour 30 minute mountain bike ride at a moderate intensity. 

    You can see that my "personal nutritionist" is telling me that the carbohydrate stores (needed to fuel my muscles to ride for that long) are optimal.

    So, just like a gas tank, there is no need for me to "top off" my fuel!

    Optimally, I will use up the carbs and dip into the fat stores to continue to melt that abdominal fat during this ride!  

    Lumen measurement before a workout

    Lumen level is showing that I am burning fat when I took this measurement 30 minutes after the mountain bike ride. 

    The ride was spent in a fairly moderate exertion.

    I was able to talk while riding and my breath wasn't labored. 

    This is a clear indication that hard, long endurance workouts with heavy exertion aren't necessarily the best ways to exercise for fat loss. Negating the need to always "go hard or go home" mentality. 

    Saving big exertions for heavy lifting will do your muscles and bones better in menopause. 

    Lumen Fat Burning Level

    The Weight Loss Macro Conclusion

    If you can take anything away from this post...

    1. Protein will help you build lean muscle and help to repair tissue. 

    2. Fat will keep you feeling full

    3. Carbohydrates will fill up your tank and provide you with energy

    There is no one size fits all when it comes to calculating macros. 

    Every BODY is different, with different energy needs and energy expenditure

    However, there are a few certainties:

    • omitting one full macro group will leave your system unbalanced and can set you up for future health problems or disease
    • contrary to popular belief, cutting back too many calories can put you into a state of RED (relative energy deficiency) especially in menopause when energy stores are already being depleted by the decline of sex hormones 
    • working out too strenuously for too long can tax your adrenals causing chronically high cortisol leaving you "wired and tired"
    • choosing the healthiest forms of proteins, carbs and fats will keep you at an optimal weight 

    Products I Use

    Nourishing Traditions Cookbook

    Nourishing Traditions

    Braggs Apple Cider Vinegar with mother

    Apple Cider Vinegar

    Lumen Hack Your Metabolism Device

    Use discount code BiancaB for an extra $50 off!

    Lumen: Hack Your Metabolism


    Menopause Weight Gain: Striving for Metabolic Flexibility

    Menopause Weight Gain Striving for Metabolic Flexibility


    November 13, 2022


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    Dr. Bianca Beldini

    I’m your Doctor of Physical Therapy, Acupuncturist, Master Dry Needler, and Triathlon and Running Coach. I’ve been in the health, wellness and fitness industry for over 25 years, and I’m here to help you reach your optimal health.