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For high-performing women who are exhausted by weight gain, hormonal chaos, and vanishing energy — this is your reset. I’m Dr. Ade Akindipe, a DNP, obesity + hormone specialist, and health coach.
On this show, we demystify metabolism, gut health, hormone balance, longevity, and the root-cause mindset behind lasting transformation.
If you’re ready to stop fighting your body and start living with more clarity, energy, and confidence — this is your space.
Dr. Ade Akindipe, DNP (00:02.996)
Let's talk about belly fat. So this is something that's very common among all women, especially women that are navigating these hormonal changes. And the biggest issue is what is this around my midsection? It feels like it just happened overnight. I didn't have this problem before and here I am. I can't fit in my clothes. I feel bloated. I feel awful. I just want to lose this belly fat.
So if you are listening to this and you can relate, I want you to understand that this is not something that you are the only one that's experiencing this. This is another shift that tends to happen in midlife. So that kind of belly fat is not necessarily because it's not just going to respond to just you eating less. That kind of fat makes you feel like your body changed without asking permission. It's like, how come this is happening right now?
So I want you to understand that this is physiology. It isn't about vanity. I don't want you to feel guilty for, know, feeling like, why am I even worried about this? It's something that really you should be worried about. In fact, not just cosmetically or just the way you live or the way you look in your clothes, but also in terms of metabolic health. That is one of the big markers of how healthy you are. Okay. So you could be
120 pounds, you can be 200 pounds, the more belly fat you have, the more risk for chronic conditions like insulin resistance and diabetes and things like that. So today I want us to really talk about why belly fat increases specifically during perimenopause, the role estrogen plays in fat distribution, how insulin resistance
drives abdominal storage, the metabolic role of testosterone in muscle and fat loss, how hormone therapy, when appropriate, may help reduce belly fat, and then helping us connect the dots around everything. All right, let's get into it.
Dr. Ade Akindipe, DNP (02:16.718)
So when you were in your 20s and 30s, estrogen was this hormone that you make a whole lot of. And you made a lot of it. And of course, it depends on your time of the month, how high it is and how low it is. But the way you store fat then was also different. Now the pattern is protective and it tends to be in the hips and the thighs then. But in parity menopause,
estrogen becomes kind of erratic. So fluctuating month to month and eventually trending downwards. So women will start to notice as estrogen declines, fat storage shifting from the hips and the thighs to the stomach area. And then the amount of fat around the organs in the belly area also increases. And that's why there's that almost identical kind of thing happening with insulin resistance going up at the same time.
And then coupled with that, as you get older, you have all the different life stressors, right? That happens, which intensifies this belly fat. So it's not just your hormone levels that are dropping, but also everything else that you may or may not be managing outside, all the external things that might be impacting that. So visceral fat is the deep abdominal fat and it's hormonally active. So it responds.
strongly to insulin and stress. Okay? So when your estrogen drops, your body becomes more prone to storing fat centrally. So if this is hormonal distribution, it's not necessarily just about eating. estrogen, let's go into a little bit more into what estrogen does. Estrogen helps regulate glucose uptake into muscles. It helps regulate insulin.
It helps with inflammation, so reducing inflammation. It helps regulate fat storage patterns. When estrogen levels are good enough and adequate, your blood sugar is more stable, your insulin works appropriately, fat is less likely to accumulate around the midsection. But when estrogen declines, insulin resistance increases, blood sugar spikes more easily, fat storage increases,
Dr. Ade Akindipe, DNP (04:42.378)
especially in the abdominal area. So estrogen therapy when started appropriately in early menopause and supervised by a qualified provider has been shown to improve insulin sensitivity, reduce belly fat accumulation, improve body composition, lower inflammation, but it doesn't melt fat. It improves the metabolic terrain. So it kind of gives you a nice
foundation along with everything else in your life, lifestyle, stress management, and things like that. So if insulin is elevated frequently due to blood sugar spikes, it's, you know, fat burning is suppressed. So you may notice now when you're in perimenopause that you have stronger carb cravings.
Women just say they just feel like they just don't know how to get away from the carbs, all the different things in the break room. They feel more hungrier. They're having afternoon crashes. They have rapid weight gain. I know one lady that says, it seems like I just gained like 20 pounds in a few months. So, you know, when women say that, usually I will recommend estrogen replacement, which can improve how your cells respond to insulin.
So when insulin sensitivity improves, fat storage decreases, energy stabilizes, and then cravings can also reduce. But this works best alongside fueling your body appropriately. So that means you're eating enough protein, strength training, blood sugar, carb balance meals, right? So let's talk a little bit more about the hormones women rarely hear about, which is testosterone. Yes.
you need testosterone. It supports lean muscle mass. you're doing the work. Just a small amount of testosterone can really, testosterone replacement can improve women's energy levels, increase your ability to build muscle, and in some ways also improve your motivation and drive to even want to do those things. Because sometimes that's what, when you lose all those hormones,
Dr. Ade Akindipe, DNP (07:06.508)
Women will say, just don't have the motivation. I don't have the energy. I know that I want, need to do, but I can't do it. just, I used to be able to work out five days a week. I'll work out one day and then I'm all sore all over. getting, checked for hormones to see how this might be a good fit for you might be the first step. If that's something that you're thinking about, I will recommend that you book a personalized wellness assessment. the link is in the show notes. Okay.
Dr. Ade Akindipe, DNP (07:35.949)
Let's talk about cortisol and low estrogen. Lower estrogen actually in a progesterone. So lower progesterone and fluctuating estrogen levels can make your nervous system more stress sensitive. And that's why women are irritable. The things that used to bother you not so much, or it bothers you but you were able to cope, women have a very short fuse now. So they're more moody.
So, know, and that alone can also compound on the stress. So a higher cortisol level will also lead to belly fat. Higher cortisol level will disrupt your sleep and of course your blood sugars. Okay. So who might benefit from hormone support? So if you're a woman and all of these different things I said to you is happening, especially the belly fat, which is one thing that women will complain about,
You're trying different diets, or maybe you're losing weight, but the belly fat continues, then you might be a good fit for that. You have moderate to severe symptoms of like vasomotor symptoms, hot flashes, night sweats, joint issues. You notice significant metabolic changes. And what do I mean? Maybe you've gone to your doctor, and your doctor's already noticing your blood sugar is climbing up, and they're telling you, just watch it, just watch it.
It's okay to watch it, but also you need to know what's happening. That's why a lot of women, when they come into our clinic, if we see that your hemoglobin A1c is climbing up, and your hemoglobin A1c is essentially monitoring your blood sugars over the last three months, and if that number starts to creep up, then we don't want to wait until it starts to get into the diabetes range. You don't want to just keep watching it. At some point, you need to do something about it.
in the early phases is where you need to get curious about what's spiking your blood sugars. So oftentimes it is what you are eating, it's stress, it's sleep, all of those issues. So I highly recommend a woman who is stuck and you just can't get rid of that belly fat is to start a continuous glucose monitor. You need to gain clarity on what is raising your sugar levels because again, remember we said when you're losing estrogen,
Dr. Ade Akindipe, DNP (10:02.636)
right? You are more insulin resistant. That means your body doesn't tolerate sugar like as well as it used to. So there are certain foods that will trigger that blood sugar spike. You need to know what those foods are. And it may not necessarily be what you think it is. It might be, it might not be that white rice. For those of you who have already tried this, you know exactly what I'm talking about where, where you think it's the, what we
considered not healthy, but everybody's metabolism is different. It could be the green tea that you're drinking on your way to work that's spiking your blood sugar. It could be that mocha that you have every day. Whatever it is, you need to gain clarity. So I highly recommend getting a continuous glucose monitor, put it on for a couple of weeks. Let's see what's happening with your blood sugar. And you might get clarity and maybe that's one thing you need to reduce or remove from your diet.
If you have no contraindications to hormone replacement therapy, meaning you don't have a history of breast cancer or active mass, which is why you always want to make sure you're getting all your screenings done, your mammograms done, your pap smears done, and all of that colonoscopy. And of course, you need to work with a qualified healthcare provider. So if you've been eating less, you're doing more cardio, you're avoiding carbs completely, you are blaming yourself.
pause, you cannot starve declining estrogen ladies. That's just something that happens with us naturally, but you need to be more educated on your body to know how to fix it for you personally. You cannot out cardio your way out of hormone shifts. Your body responds to signals. And when you listen to your body, instead of trying to fight it, that's when the healing starts. And that's when weight loss becomes a side effect. That's when belly fat reduction becomes a side effect.
because we're dealing with all of those things. So hormones will not replace strength training. So you still have to continue strength training, lifting and really working on building those muscles, fixing chronic stress, identifying the patterns that keeps you chronically stressed, removing, again, removing and replacing the appropriate nutrition for you and creating fat loss
Dr. Ade Akindipe, DNP (12:29.068)
without effort. When I personally realized what those were for me, because I had those symptoms back when I entered perimenopause five, six years ago, was the bloating and the gas and the things that I used to be able to tolerate, I couldn't tolerate anymore. And it's not easy to replace those things, right? Because those are things that you enjoyed. That's what is palatable to you, but you may...
need to shift and what I recommend doing is giving it a try. Try maybe one new vegetable per week. Try a new recipe. Try something new and then over time you start to build a plate that not only nourishes you but also feeds the gut because I've talked about gut health all the time. Your gut has
millions if not billions, maybe trillions who knows of bacteria that live in there. And they're very powerful. There's good ones and there's bad ones. What could happen over time if you've had poor gut health related to so many different things and you have overgrowth of the bad bacteria, you may actually be feeding the bad bacteria and
What happens? That bad bacteria wants to stay alive, right? So it can actually send signals to your brain to crave the food that's going to feed it. Isn't that crazy? Yeah. So what you're essentially doing when you change your palette, when you change your nutrition, is basically killing off the bad bacteria by eating healthier.
So then you start to crave the good ones, the one that's feeding the good bacteria in your gut. You start to feel better. You can tell, I can tell even now if I eat certain things that might taste good, I know I'm going to feel it later. I'm gonna feel awful, sometimes almost immediately. It's interesting how our bodies just adjust. I'll start eating that thing and immediately it's not an allergy, but you start to feel like this isn't good for me. I do not want this again.
Dr. Ade Akindipe, DNP (14:48.382)
I put it down. So again, this takes time. It's trial and error. If you're obviously allergic or sensitive to something, you don't need to go force yourself to eat it. But if you're used to eating the same meals every single day, you know, maybe you're just doing caffeine till 3pm and then you eat. But by the time that you're eating, you're eating pretty much whatever is available. That's also causing belly fat.
And then also you're not feeding your gut with a diverse forms of nourishing meals. So you kind of have one strain of bacteria possibly in your gut. So you want to diversify the good bacteria in your gut. So I hope that all makes sense to you that what you feed yourself is really who are. I guess in fact what you eat. And if you are not feeding your gut with the right foods,
that can also lead to high belly fat. Okay, so we covered a lot here, how estrogen influences fat distribution, the role of insulin resistance in abdominal storage, hormone replacement, how that can be a good fit for you. So if you are looking for a way to get started, whether it's hormone replacement, whether it's looking at your nutrition, whether it's mapping out what's causing your insulin to spike, that is where we come in. I recommend
Strongly recommend you to book a personalized wellness assessment. That's the entryway into working with us. Whether you're remote or in person, that's absolutely okay. In that assessment, you know, we'll look at your symptoms, hormone stage, your metabolic panels, your stress load, everything in between, because sometimes when you're stuck, you might just not know. If you don't, don't know what you don't know. So it's good to go to someone that's well-versed.
on midlife health and see how we might be able to help you. And if this episode resonates with you, please send it to another midlife woman who needs this today and make sure you are following us for more midlife hormones, metabolism, and gut health education. Until next time, stay elevated.