Weight gain is a very common occurrence seen in middle-aged women. While many attribute this weight gain to menopause there are equally those who call it a consequence of menopause. These two schools of thought have been in the picture for decades. It can be compared to the chicken and the egg as to which came earlier.
This debate needs to be tackled before addressing the underlying issue of obesity and the other risk factors associated with the same. Let us have a look at this aspect in the following article and understand the association between menopause and weight gain.
Causes of Weight Gain in Menopause
Hormonal fluctuations– Fluctuating and falling hormone levels around menopause can affect the way women’s bodies store fat during menopause. estrogen is a major hormone that regulates metabolic rate. during menopause, the level of this hormone reduces. This is because the bodies want to store fat for later – a bit like “puppy fat” at puberty. Women develop “insulin resistance” making the bodies store, rather than burn, calories.
How the body handles food also changes- For example, if you eat 1000 calories before menopause you will burn 700 and maybe store 300. After menopause, you will store 700 and burn only 300.
Alteration of weight distribution- An extra pound before the pre-menopause will settle evenly over the hips, bottom, thighs, and arms. After menopause, it all goes around the middle! This leads to more of an apple than a pear shape – hence the term “middle age spread”. So, even a small weight gain can result in a change of clothing size.
Less energy requirement- During this phase the women’s body needs less energy. Studies suggest that women may need around 200 calories a day less than they did in the past.
Women tend to move less too- aches and pains and stiffer joints as well as fatigue make exercise seem impossible. Menopause can also play havoc with bladder control which can put some women off exercising. All of which means we burn up less energy.
Sarcopenia- Women lose muscle mass during menopause known as sarcopenia. It sets in at around 8% per decade after age 40. Muscle is more metabolically active, meaning it burns more energy, helping women to lose weight even when they are sitting still. So, less muscle = fewer calories burned = more weight gain.
Sleep deprivation- Sleep is adversely affected by menopause for many women. This may be due to night flushing and sweating, and random waking in the early hours of the morning. Sleep deprivation is associated with fatigue and lower levels of physical activity. Studies have also shown a clear association between low levels of sleep and greater weight gain (1).
Psychological impact- The psychological impact of menopause can also lead to weight gain – getting demoralized about our changing/aging appearance, anxieties about relationships, finances, or our own or a loved one’s health, as well as caring for elderly relatives or grandchildren and possibly feeling overwhelmed in work due to brain fog all cause extra pressure and stress which can lead to comfort eating – and drinking (2).
Effect of increased weight during menopause on menopausal symptoms
As women gain weight during the menopausal phase the menopausal symptoms may also aggravate in severity. Studies have shown that obesity is a risk factor for more severe menopausal symptoms.
Impact on menopausal bone loss
Initial studies concluded that obese women appear to lose bone at a lower rate than non-obese women during menopause. But this view was later challenged by the results provided by a Global study of osteoporosis in women.
This study included women from ten countries and assessed patient characteristics, fracture history, fracture risk factors, and anti-osteoporosis medications. The data suggested that obesity was not protective against fracture in postmenopausal women (3).
Impact on psychosexual well-being at menopause
Apart from being at increased risk for various chronic diseases, overweight women may suffer psychosocial consequences, with a significant impact on one’s self-esteem and general well-being. Given the evidence that mood disorders are one of the most important co-morbid conditions of sexual dysfunction in postmenopausal women, it is plausible that weight gain and obesity at menopause may be risk factors for poor sexual functioning (4).
Impact on cardiovascular conditions.
Obesity is a major risk factor for heart-related conditions. Hormone estrogen has a protective effect on the heart as it boosts ‘good’ blood cholesterol (high-density lipoproteins, or HDL) and lowers ‘bad’ blood cholesterol (low-density lipoproteins, or LDL). But this cover reduces during menopause. Weight gain and less estrogen in the woman’s body during menopause puts them at a greater risk of these diseases.
Effect of weight loss on menopausal symptoms
Reductions in weight, BMI, and abdominal circumference have been associated with a reduction in menopausal symptoms in overweight and obese women. The combination of dietary modification and exercise also have shown positive effects on the general quality of life and psychological health. In addition, dietary weight loss and exercise have also been shown to exert a positive effect on insulin resistance in postmenopausal women, which together with a decrease in menopausal symptoms may potentially decrease the risk of cardiovascular diseases too (2).
How to handle menopausal weight gain? (1)
Eat smaller portions– as stated earlier women during this phase need less food than they used to. Every year over the age of 40 years the Basal Metabolic Rate (BMR – the rate at which we burn off calories) slows down. Make sure that meal portion is full of good nutritious food that will protect health as well as help weight. Reduce the intake of sugar and processed foods– enemies of weight loss and more likely to increase abdominal fat.
Be mindful of alcohol intake – Alcohol gives empty calories! Avoid alcohol consumption or keep it to a minimum.
Keep active- Studies show that exercise increases fat burning. And, the more you exercise the more you strengthen your muscles and bones. Women’s muscle mass declines around menopause.
Muscle is efficient at burning calories – doing resistance work and lifting weights will increase muscle. An increase of 2kg of muscle = a 10% increase in BMR. Developing strong and toned muscles will make clothes fit better, as well as increase self-confidence.
Wherever possible, address stress- Cortisol, the stress hormone, encourages abdominal fat deposition. Talk to friends, family, work colleagues, and your healthcare professional about ways of reducing commitments, worries, and menopause symptoms.
Choose menopause as a time of life to try and bring out the best in yourself. Take more out for yourself, exercise, and eat a healthier diet, this will have the added benefit of helping you cope better with menopausal symptoms. And, don’t forget that the risk of breast cancer, heart disease, diabetes, and other issues are also increased by our weight.
So, losing excess weight will not only keep you healthy but also protect you from all other lifestyle-associated diseases and conditions.
Author: Dr Pooja Nilgar (Content writer and editor)
References
- Liverpool Women’s NHS Foundation Trust. (2020). Menopause and Weight Gain.
- Davis, S.R., Castelo-Branco, C., Chedraui, P., Lumsden, M.A., Nappi, R.E., Shah, D., Villaseca, P. and Writing Group of the International Menopause Society for World Menopause Day 2012, 2012. Understanding weight gain at menopause. Climacteric, 15(5), pp.419-429.
- Compston, J.E., Watts, N.B., Chapurlat, R., Cooper, C., Boonen, S., Greenspan, S., Pfeilschifter, J., Silverman, S., Díez-Pérez, A., Lindsay, R. and Saag, K.G., 2011. Obesity is not protective against fracture in postmenopausal women: GLOW. The American journal of medicine, 124(11), pp.1043-1050.
- Shah, M.B., 2009. Obesity and sexuality in women. Obstetrics and Gynecology Clinics, 36(2), pp.347-360.
