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The Connection Between Weight Loss and Hot Flashes

Fitday Editor

If you've had one, there's no mistaking it: the sudden, intense, hot feeling in your upper body, perhaps accompanied by a rapid heartbeat, sweating, dizziness, nausea or headache. The initial rush is followed by a warm flush, leaving you red and sweaty.

Up to 85 percent of women in the United States experience hot flashes of some kind as they approach menopause and for the first year or two after their periods stop. Between 20 and 50 percent of women continue to have them for many years after as well.

But, to the delight of women everywhere, research focused on alleviating these troublesome symptoms is growing.

The Link Between Weight and Hot Flashes

Studies have found that obese and overweight women, in general, report more severe and more frequent hot flash symptoms. However, the mechanisms underlying this association are not well understood.

Hot flashes are mostly caused by the hormonal changes of menopause, but can also be affected by lifestyle and medications. A diminished level of estrogen (seen during menopause) has a direct effect on the hypothalamus, the part of the brain responsible for controlling your body temperature (as well as appetite, sleep cycles and sex hormones). By some physiological mechanism, the drop in estrogen confuses the hypothalamus - which has been called the body's "thermostat" - making it read "too hot."

In a recent study, 40 overweight or obese women who were experiencing four or more hot flashes a day were randomized to either behavioral weight loss intervention or a wait-list control. Using physiologic monitoring, a diary and questionnaire, hot flashes were assessed before and after the intervention.

The results? Women who were randomized to the intensive intervention reported a significantly greater improvement in hot flashes compared with controls. The average weight loss in these women was about 19.5 lbs.

Two Theories About What This Means

Connecting the results of this study and others similar to it, experts have proposed two different explanations. The first is that fat could be acting as an insulator. Excess adiposity could make heat dissipation harder for your body. The second is that overweight and obese women may suffer from recurrent diet-binge or yo-yo diet cycles. This back-and-forth can impact your body's estrogen levels, making it harder for your hypothalamus to regulate your internal temperature.

It is important to note a few shortcomings of these studies. Most women (74.1 percent) reported that hot flash reduction was a major motivator for losing weight. Given that the intent of the intervention could not necessarily be hidden, there is a possibility that participants' recording of their symptoms was influenced by their prior knowledge of their treatment group. The fact that hot flashes were also assessed by single self-report measures, which can fall victim to memory and reporting bias should also be noted.

While the results still need to be confirmed in a larger study, these current findings provide women who suffer from hot flashes an added option in controlling their symptoms. Since many of the women in this pilot study indicated their primary motivator for losing weight was hot flash reduction, this could be a strong incentive for women to engage in a healthier lifestyle, which provides numerous other health benefits beyond just hot flash management.


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Sarah Dreifke is a freelance writer based in DeKalb, IL with a passion for nutrition education and the prevention of chronic disease. She holds a Bachelor of Science in both Dietetics and Life Sciences Communication from the University of Wisconsin-Madison. Currently, she is working towards a combined Master's Degree in Nutrition and Dietetics as well as a dietetic internship at Northern Illinois University.

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