Weight gain, or a difficulty in losing weight, among women in midlife has been a common complaint among clients over the years. Research shows that while this is common, it is more likely a result of aging and lifestyle changes, but menopause does play a role (1). So, let's break that down a little bit.
It's true that estrogen deprivation happens after menopause, which can lead to an increase in body fat combined with a decrease in lean body mass (2). Women do have a tendency to gain weight with age irrespective of their menopausal status, which is typically associated with less physical activity which leads to a decrease in bone mineral density and muscle mass. This is typically true of men too. The older people get, they tend to be less physically active, which decreases energy expenditure. When combined with a similar caloric intake, this decreased energy expenditure leads to weight gain.
You may be surprised to hear it, but sleep loss is also attributed to weight gain in midlife women. We've been preaching it for years, but sleep does have a substantial effect on your weight. Many potential issues contribute to sleep loss in women including night sweats, mood problems, obstructive sleep apnea, and low estrogen (3). As we all know very well, little sleep can lead to less physical activity, sugar cravings, decreased insulin sensitivity, and less caloric output (4).
While we can't point to menopause entirely for the increase in weight, it does affect the distribution of fat on the body. Menopausal women tend to have a greater percentage of body fat on the organs (visceral fat) as compared to women in the premenopausal state (5). This is a big deal. Obese postmenopausal women have higher overall mortality risk with as high as a 4-fold increase in cardiovascular deaths and it raises the risk of type 2 diabetes, dyslipidemia, high blood pressure, and some cancers including uterine and breast (6).
So, what do we do about all of this? The research points to lifestyle factors such as exercise, nutrition, stress, and sleep (big surprise!) as being critical stave off much of the health risks associated with weight gain and health issues with women as they approach menopause (7). For you, this means:
* some kind of caloric reduction
* a diet including meat, plant-based foods like fruits, vegetables, whole grains, nuts, and legumes with a moderate fat intake
* resistance training to improve lean body mass, which will increase basal metabolic rate and energy expenditure
* 7-9.5 hours of sleep per night
Our best advice is to start with one of these areas at a time. Specifically, pick one task you can do that will touch on an aspect of one of the lifestyle factors mentioned. For instance, a great option for increasing the quality of your sleep could be no screens one hour prior going to bed. You would then systematically go through a task or two for each of these, and before you know it, you would be in a dramatically better place.
1. Karvonen-Gutierrez, C. & Kim, C. (2016). Association of mid-life changes in body size, body composition and obesity status with the menopausal transition. Healthcare, 4(3).
2. Leeners, B., Geary, N., Tobler, P., & Asarian, L. (2017). Ovarian hormones and obesity [published online ahead of print March 2, 2017]. Human Reproduction, 23(3), p.300-321.
3. Eichling, P. & Sahni, J. (2005). Menopause related sleep disorders. Journal of Clinical Sleep Medicine, 1(3), p.291-300.
4. Wiley, T. & Formby, B. (2000). *Lights Out*. New York: Simon & Schuster.
5. Milewicz, A., Tworowska, U., & Demissie, M. (2001). Menopausal obesity: myth or fact? Climacteric, 4(4), p.273-283.
6. Thurston, R., Sowers, M., Sternfeld, B., et al. (2009). Gains in body fat and vasomotor symptom reporting over the menopausal transition: the study of womenâ€™s health across the nation. American Journal of Epidemiology, 170(6), p.766-774.
7. Kapoor, E., Collazo-Clavell, M., & Faubion, S. (2017). Weight gain in women at midlife: a concise review of the pathophysiology and strategies for management. Mayo Clinic Proceedings, 92(10), p. 1552-1558.