Menopause and Weight Gain – is it inevitable?

Menopause is a natural biological process that every woman experiences, typically occurring in their late 40s to early 50s. While the end of menstruation is the most familiar marker of menopause, this transition comes with a range of physiological and metabolic changes, one of the most common and frustrating being weight gain.

Studies suggest that more than half of women experience weight gain during menopause, and anecdotally, many menopause specialists, including myself, observe that the number could be even higher. This blog explores why weight gain happens during menopause, what the science says, and how women can manage their weight during this challenging life phase.

What causes menopause weight gain?

The transition into menopause, known as perimenopause, triggers numerous hormonal changes. Oestrogen declines significantly during this time and it’s a major factor behind weight gain during menopause.

Before menopause, women typically store fat more evenly across their bodies, often in the hips and thighs – the so-called ‘pear shape’ distribution. However, as oestrogen levels fall, fat distribution shifts predominantly to the abdominal area, creating more of an ‘apple’ body shape. This type of fat, known as visceral fat, is stored deeper within the body, around vital organs such as the liver and intestines.

Visceral fat is not only aesthetically concerning; it is also associated with increased risks of serious health conditions, such as insulin resistance, type 2 diabetes, cardiovascular disease, and metabolic syndrome. Weight gain during menopause isn’t just about appearance or a change in dress size; it has significant implications for long-term health.

The Role of Metabolism and Muscle Mass

Alongside the reduction in oestrogen, women also experience a decline in muscle mass as they age. Muscle tissue is metabolically active, meaning it burns more calories at rest than fat tissue. As muscle mass decreases, the body’s metabolic rate slows down, resulting in fewer calories being burned throughout the day. This slower metabolism makes it easier to gain weight and harder to lose it, even if eating habits remain the same.

The SWAN (Study of Women’s Health Across the Nation) research has provided valuable insights into how weight gain progresses during the menopausal transition. The study reports that, on average, women gain 1.5 kilograms per year during this period, leading to an average total weight gain of approximately 10 kilograms by the time they reach menopause. In my experience, many women report significantly greater weight gain, and struggle with the increase in weight around their tummies.

The Impact of Lifestyle: Stress, Sleep, and Activity

Weight gain during menopause is not solely due to biological changes; lifestyle factors also play a crucial role. Many women find that they become more sedentary during menopause, often due to joint pain, fatigue, or simply the ageing process. A high-pressured job, combined with looking after children and elderly parents may mean it’s difficult for women to carve out time for exercise. Combined with a slower metabolism, a decrease in physical activity can exacerbate weight gain.

Stress is another major contributor to weight gain during menopause. Chronic stress leads to elevated levels of cortisol, the “stress hormone”, which is known to promote fat storage, particularly around the abdomen. Moreover, stress can lead to emotional eating or unhealthy food choices, as many women may turn to convenient, high-calorie processed foods when feeling overwhelmed.

Sleep disturbances are also common during menopause, often due to symptoms like night sweats and insomnia. Unfortunately, poor sleep is linked to weight gain, as lack of rest disrupts hunger hormones such as ghrelin and leptin, increasing appetite and cravings for unhealthy foods. Many women find themselves trapped in a vicious cycle of poor sleep, low energy, and weight gain.

The Myth of Hormone Replacement Therapy (HRT) Leading to Weight Gain

There is a widespread misconception that Hormone Replacement Therapy (HRT) causes weight gain. However, research does not support this view. While HRT may lead to side effects such as bloating and fluid retention in some women, these typically subside over time. In fact, HRT can often aid in weight management indirectly by improving sleep, reducing stress, and alleviating other menopausal symptoms that may contribute to weight gain. By restoring hormonal balance, HRT can help reduce the accumulation of visceral fat.

Strategies for Managing Weight Gain During Menopause

Managing weight gain during menopause requires a comprehensive approach that includes attention to diet, exercise, stress management, and sleep. Below are some key strategies that can help:

• Adopt a Balanced Diet
When it comes to diet, the focus should be on balance rather than restriction. Extreme diets, such as those that severely limit calories or cut out entire food groups, are not sustainable and can make long-term weight management more difficult. Instead, aim for a well-rounded diet rich in fruits, vegetables, lean proteins, and whole grains.

• Portion Control
Be mindful of portion sizes, as overeating, even with healthy foods, can contribute to weight gain. Keeping a food diary can be a useful tool to identify areas where calorie reductions can be made.

• Reduce Processed Foods
Processed foods tend to be high in sugars, unhealthy fats, and salt, all of which can contribute to weight gain. Focusing on whole foods and preparing meals at home can help reduce the intake of these empty calories.

• Carbohydrates and Protein
Carbohydrates are often demonised in discussions about weight loss, but they are essential for energy, especially when exercising. Low-glycaemic carbohydrates such as sweet potatoes, whole grains, and legumes can help maintain energy levels and promote muscle preservation. Protein helps with satiety and muscle maintenance, making it an important part of any weight management plan.

• Incorporate Resistance Training
Exercise is critical for managing weight during menopause, particularly resistance training. Building muscle helps increase metabolic rate, which can counteract the natural decline in metabolism that occurs with age. Resistance training exercises such as squats, lunges, and weightlifting can help preserve and build muscle mass.

In addition to resistance training, incorporating regular cardiovascular exercise, such as brisk walking or cycling, can further support weight management. Aim for at least 150 minutes of moderate-intensity aerobic exercise per week.

• Manage Stress and Sleep
Stress management techniques such as mindfulness, yoga, and meditation can help reduce cortisol levels and prevent stress-related weight gain. Mindfulness apps like Headspace and Calm can be valuable tools in managing daily stress and improving overall mental health.

Improving sleep quality is also essential. Establishing good sleep hygiene, such as going to bed at the same time each night, reducing alcohol and caffeine intake, and creating a relaxing bedtime routine, can help alleviate sleep disturbances and support weight management.

A Holistic Approach to Weight Management During Menopause

Weight gain during menopause is a common and complex issue that arises from both biological and lifestyle changes. While the transition into menopause can be challenging, it’s important to approach weight management holistically. By adopting a balanced diet, incorporating regular exercise, managing stress, and improving sleep, women can not only manage their weight but also enhance their overall health and well-being.

While there is no quick fix, small, sustainable changes can make a significant difference over time, allowing women to navigate menopause with greater confidence and control.

If you’re struggling with weight gain during menopause, book an appointment today.