From the Guidelines
To effectively manage your weight during perimenopause, it is crucial to create an energy deficit of ≥500 kcal/d through a combination of dietary restriction and increased physical activity, as recommended by the 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults 1. Given your current BMI of 38 and daily exercise time of 30-60 minutes, consider the following adjustments:
- Increase the intensity of your exercise by incorporating 2-3 sessions of high-intensity interval training (HIIT) per week, which can boost metabolism more effectively than light exercise alone.
- Incorporate strength training at least twice weekly to build muscle mass, which naturally decreases during perimenopause.
- Focus on protein quality in your diet, aiming for 25-30% of calories from lean sources, and reduce refined carbohydrates while maintaining your 1800-2000 calorie range.
- As you are in the class II obesity category (BMI of 35.0 –39.9 kg/m2), aim for a more aggressive energy deficit of 500 –1000 kcal/d, which can produce approximately a 1- to 2-pound weight loss per week and approximately a 10% weight loss at 6 months, as suggested by the American Gastroenterological Association medical position statement on obesity 1.
- Consider consulting with a nutrition professional for personalized dietary advice, especially since you are taking Lexapro, which can contribute to weight maintenance challenges for some people.
- Prioritize sleep quality (7-8 hours nightly) and stress management through practices like meditation, as both cortisol elevation and sleep disruption common in perimenopause can hinder weight loss.
- Discuss with your doctor the potential benefits of pharmacotherapy for obesity, considering your unique behaviors and comorbidities, as well as the potential interactions with your current medication, Lexapro 1.
From the Research
Weight Management with Lexapro
- Lexapro (escitalopram) is an SSRI that can affect weight, but the impact is generally minimal 2.
- A study comparing escitalopram and nortriptyline found that escitalopram resulted in little weight change, with an average increase of 0.14 kg over 12 weeks of treatment 3.
- However, individual results may vary, and some people may experience weight gain or loss while taking Lexapro.
Exercise and Caloric Intake
- With a daily exercise routine of 30-60 minutes and a caloric intake of 1800-2000 calories, you may want to consider adjusting your diet or exercise plan to promote weight loss.
- Increasing physical activity or reducing caloric intake can help with weight management, but it's essential to consult with a healthcare professional before making any significant changes.
Obesity and Depression
- There is a significant correlation between obesity and depression, with each condition increasing the risk of developing the other by about 50%-60% 4.
- A study on the global prevalence of adult overweight and obesity found that the number of adults living with overweight and obesity is forecasted to reach 3.80 billion by 2050, with no country successfully curbing the rising rates of adult overweight and obesity 5.
Potential Next Steps
- Consult with your healthcare provider to discuss potential adjustments to your treatment plan, including diet, exercise, or medication.
- Consider seeking guidance from a registered dietitian or a fitness professional to create a personalized weight management plan.
- Monitor your progress and adjust your plan as needed to achieve a healthy weight and improve overall well-being.