Menopausal Weight Gain

Weight gain is one of the most common health concerns for women.  Over 68.1% of women aged 40-59 are either overweight or obese.  It is also twice as likely that a middle-aged woman becomes obese compared to a man.  Women gain 5-8% of their baseline body weight during menopause, but the average 5 lb weight gain during the first year is often sudden, unexpected, and concerning, occurring despite no changes to lifestyle, whatsoever.  This article addresses the importance of treating weight gain, with a focus on menopause.   Below, I outline how menopause can impact health, why weight gain occurs during menopause, and steps to prevent weight gain.

Changes during menopause may negatively impact women’s health in many ways.  The dramatic decrease in estrogen increases LDL (bad cholesterol), decreases HDL (good cholesterol),  and increases bone loss and risk of osteoporosis.  Weight gain causes an increase in blood pressure and blood sugar, heightened risk of cardiovascular and metabolic disease, and a significant decrease in satisfaction with quality of life and sexual function.  Weight gain brought on by menopause can result in a lower self-esteem, and many women report feeling judged unfavorably by society. This reduced self-worth can lead to psychological disorders, such as anxiety or depression.

Several changes occur during perimenopause and menopause that make it more likely for women to gain weight. Factors include aging, hormones, lifestyle choices such as diet and exercise, and genetic predisposition.  The loss of muscle mass as we age slows the rate at which our body uses calories, which makes it more challenging to maintain a healthy weight.  The natural decrease of estradiol contributes to redistribution of weight particularly in the abdomen and underlying organs.  Hot flashes also play a role as disrupted sleep cycles cause imbalance to the satiety hormone (leptin), the hunger hormone (ghrelin), the stress hormone (cortisol), and the thyroid hormone.

Guidelines have shifted in recent years to promote lifestyle behaviors during menopause that prevent weight gain rather than promote weight loss.  In 2016, The Women’s Preventive Services Initiative (WPSI) recommended counseling be offered to help women maintain a healthy weight or limit weight gain. Studies have shown that an eating pattern consisting of 1300 kcal/day and increasing physical activity expenditure (1000–1500 kcal/week) can lead to weight loss.  While it is more difficult to maintain the same level of physical activity due to aging, a combination of balance exercises, weight bearing exercises, cardio and strength training is effective. Bottom line: If women continue the same pattern of eating and exercise from their 20s and 30s, unfortunately they are very likely to gain weight.

Lifestyle changes are the mainstay of treatment in helping reduce symptoms of menopause, such as hot flashes.  A regular sleep schedule, limiting alcohol and caffeine, quiting tobacco, and adding extra soy can help reduce symptoms of menopause such as hot flashes.  While menopause is a natural decline in reproductive hormones when a woman reaches her 40s and 50s, it often has uncomfortable and unpleasant symptoms, which can be treated medically by a health care provider.  Oral estrogen therapy is the most effective treatment option for relieving menopausal hot flashes, but long-term use of hormone therapy may increase cardiovascular and breast cancer risks.  Antidepressants can be used for management of hot flashes for women who can’t take estrogen.

Pivotal Weight Loss provides comprehensive weight management including focus on management of related health-issues like menopause, hot flashes, insomnia, hypothyroidism, osteoporosis, fatty liver, etc.    Our program implements behavioral strategies to identify an individual’s own motivations which are proven to make behavior change last.  Also, new weight loss medicines called GLP-1s represent an exciting breakthrough in using hormonal pathways to treat weight gain. GLP-1s, for example Semaglutide, treat hormonal imbalance, blood sugar and help suppress appetite to assist patients to cut back on calories.  Women are not destined for weight gain.