Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

Last week, Dr. Pat created a “Lesson Plan” for Caren, a 45-year-old sixth-grade teacher who is beginning menopause, with “irregular cycles and really heavy periods and rare hot flashes.” Caren noted that she is 30 pounds overweight and beginning to have blood pressure problems, though she takes no medication. She acknowledged that she has a “wonderful marriage,” with an appreciative husband, but she is worried about her lack of stamina and her weight gain. Most of all, though, she dreads becoming “really fat, nasty-tempered, and depressed with menopause,” like some of her fellow teachers.

Dr. Pat’s Lesson Plan for Caren comprises six steps. Step One addresses the issue of Caren’s reported “very heavy bleeding.” Step Two recommends getting medical clearance for a weight loss and exercise program. Step Three details the basics of a sensible exercise plan, including advice on where to find videos and individual exercises and stretches that one can do at home, in addition to structured workouts. You will find these steps detailed in last week’s column.
 
Below are Steps 4 to 6 of Dr. Pat’s Lesson Plan for a Smooth Menopausal Transition.

4. Reaching your goal requires the same rules whether you choose to go back to a class for weight loss or do it alone: Re-frame the issues that cause you to choose the wrong foods, eat at the wrong times, and overeat.  You can see a weight-loss specialist or nutritionist, you can join a weight-loss group such as Weight Watchers, or choose an online weight loss program (see “Selecting a Weight Loss Programon the National Heart, Lung and Blood Institute’s website).

RELATED: “Medical Monday: Weight Loss Medications

If your weight loss program is working, then you should lose one pound a week. The most important thing about diets is that most diets fail, and they all fail for the same reason—diets are for life, not just for the period when weight loss occurs.

When you return to teaching in the fall, you can control what to eat for energy between classes; just prepare and bring to school small portions of food that won’t affect your energy in a seesaw fashion.  Protein and vegetables, apples and cottage cheese are great snacks to keep energy steady.

Food at work is for fuel, not fun.  Take a walk and eat your lunch at the same time, to avoid the temptation of being around the other teachers, who may be relishing food that you should not eat.   When you reach your weight loss goal, it will be helpful to continue to keep a journal that helps you be aware of your food choices.  When you choose to have a fabulous meal, control the portions and go back to stricter food control for a week.  Weight loss is a national obsession in this country where obesity is epidemic. Obesity is the root cause of many diseases and disorders, and has spawned a multi-billion-dollar industry, recently joined by Oprah!  Your choice to lose weight may be the most important choice you make in terms of lifelong health.

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