The Truth About Weight Gain During Menopause

By Josephine Yurcaba
Photo credit: Getty Images

From Woman's Day

Menopause is a game changer for a lot of women. Even if you eat the same way you ate when you were younger and exercise every day, you might gain weight during menopause, and that’s because, according to Dr. Ekta Kapoor of Mayo Clinic, “the rules of the game are different” once you hit menopausal age.

A woman is said to be in menopause once she has gone a year since her last period, and it comes with a host of hormonal changes. Contrary to what many people might think, menopause doesn’t directly cause weight gain. Most weight gain that women experience during and after menopause is the result of aging, according to Dr. Kapoor. But the hormonal changes that happen because of menopause can contribute to weight gain.

For example, levels of the main female hormone estradiol drop significantly after menopause, which directly affects the way women carry fat, Dr. Kapoor says. Before menopause, most women carry fat in their lower body, but after menopause, they will start to carry it around their bellies, more like men. So though many women might think they’re gaining weight after menopause, in some cases, "what might really be happening is that they may weigh the same as they did before, but they're seeing it in an area where they've never seen it before,” Dr. Kapoor says.

Additionally, as people age, their physical activity will often change, and they lose muscle mass, which affects their basal metabolic rate (that is, how much energy the body uses while it is at rest). “Muscle is the part of your body where most of the energy is burned in the resting state,” Dr. Kapoor says. So as you age and lose muscle mass, you’re burning fewer calories while you’re in a resting state, for example, while you’re sitting at your desk at work.

“All in all, you're burning fewer calories at rest, you're burning fewer calories in activity,” Dr. Kapoor says, so it would make sense that your diet would need to change along with the changes brought on by menopause in order to keep the same weight or lose weight.

Women who are going through menopause face some unique challenges, too. They face all the usual symptoms of menopause - hot flashes, night sweats, insomnia and trouble sleeping, and changes in libido, for example - while also dealing with the stress caused by raising kids, or, if they’re of menopausal age, maybe raising teenagers (who are going through a host of hormonal changes themselves). “All of this can also contribute to suboptimal lifestyle choices because, the truth is, a mind that is upset or that is stressed, that is preoccupied, there's not really the time to focus their energy on eating healthy or exercising,” Dr. Kapoor explains. And, if women are overwhelmed with too many things, they might also seek comfort in food, and with the changes that menopause brings on, those comfort foods can contribute to weight gain.

Excessive weight gain around the belly can increase the risk of high blood pressure, heart disease, high cholesterol, and diabetes. “The risk of all these problems goes up for postmenopausal women to the point that heart disease becomes the number one killer of women after menopause,” Dr. Kapoor says. Obesity is also linked to a number of cancers, such as breast cancer and uterus cancer.

Most of the time, though, a small amount of weight gain after menopause isn’t something to worry about, according to Dr. Cheryl Onwuchuruba of Novant Health Randolph OB-GYN. She tells Woman’s Day that a marked change in weight could indicate a bigger health problem, but a change of a couple of pounds over a few months might just mean that you need to make a few lifestyle adjustments to avoid an increased risk of heart disease or other issues. “Once you've gone through menopause, I find that you have to make some changes that you've not really had to make in the last three decades,” Dr. Onwuchuruba says.

Though women often turn to cardiovascular exercise as their exercise of choice, Dr. Onwuchuruba says they should do more weight-bearing and strength-training exercises, both to help prevent some of the loss of muscle mass and also to help improve their bone health as they enter their 60s and osteoporosis becomes more of a concern. She says that, ideally, women should try to exercise five days a week for at least 45 minutes a day, and Dr. Kapoor suggests keeping a body mass index (BMI) of 22 to 24, though she notes that BMI is not a perfect measure of someone's body fat.

Women should also take a big-picture approach to their health if they’re worried about weight gain during or after menopause, Dr. Onwuchuruba says. For example, if you’re having night sweats during menopause, then you might not be getting enough sleep, which could make you less motivated to exercise the next day. “Trying to look at your health from the whole wellness picture to see, where can we intervene to really help you to be at your best and to be at your healthiest.”


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