Menopause can be tricky to navigate. Was “that’s an understatement” your first thought while reading that sentence? If so, this article is for you.
One of the more challenging aspects of menopause, aside from all the hormones that do a complete 180, may be weight gain. Whether it crept up on you slowly or seemed to happen almost overnight, menopause (or even perimenopause) related weight gain can be challenging to lose.
But it’s not impossible. In fact, with the right tools and support, you can lose weight and keep further menopausal weight gain at bay without all the frustration you’re probably feeling right now.
Read on to learn more about what causes weight gain during menopause and review some science-backed tips to help you with weight loss, weight management, and overall wellness during menopausal transitions.
What Causes Menopausal Weight Gain
During menopause, your body undergoes many changes, and there may be various reasons you may be gaining weight during this time (as well as during perimenopause). One main reason is all the hormonal changes that occur during this time, especially with lowered estrogen levels.
As the North American Menopause Society notes, although menopause may not be directly related to weight gain, it does have associations with changes in body composition and fat distribution. As women age, they may start to exercise less, their metabolism slows down, and they’re more prone to issues like wider waistlines and abdominal fat.
So you may find that along with the night sweats, mood changes, and other symptoms of menopause, you’re also putting on weight. It can happen even if you stick to a healthy diet and keep up with physical activity. There are a few reasons for this. A review of research on menopause and weight gain found that hormonal changes during menopause were associated with increased abdominal fat.
The authors also conclude that hormone therapy with estrogen and estrogen-progestin may help prevent excess weight gain during menopause. Again, this suggests that the weight change is hormone-related (for example, due to declining estrogen levels).
Another study illustrated that it’s not necessarily that menopause leads to general weight gain, but more specifically, abdominal obesity. The researchers in this study found that women in menopause had a greater waist circumference and waist-to-hip ratio during this period.
Like the other study, these researchers found that women on hormone therapy did not experience an increase in waist circumference or waist-to-hip ratio. While more research is needed on the direct associations between menopause and weight gain, it’s a good idea to spend a little more time on weight management if you do find yourself gaining weight during this time.
How Menopausal Weight Gain Affects Women’s Health
All that excess weight you’re putting on during menopause can be challenging to deal with emotionally, but there’s more to consider here. Unchecked menopause weight gain can impact your health, and excess body mass can cause a range of health issues, including but not limited to:
- Heart disease
- Type 2 diabetes
- Various types of cancer
So, for overall health and wellness, focusing on weight management as you go through these natural changes is a good idea. Consider a few tweaks to an already healthy lifestyle, like making dietary changes and getting enough sleep. Here are a few tips to help you out:
1) Consider Hormone Therapy
The next logical train of thought would be to wonder whether hormone therapy is the key to managing weight gain during menopause (or preventing it altogether). It's a controversial topic. And while it’s something you should always discuss with your doctor, it isn’t as black or white as some think.
The verdict from early 2000 studies on hormone replacement therapy, or HRT, was that there was more harm than benefits for HRT. Later re-analysis said the opposite: when done properly and in early menopause, HRT can help with menopausal symptoms and improve cardiovascular health and all-cause mortality.
If you work with a functional medicine doctor, you may know HRT is one option for menopause support. If you don’t, you can bring this topic up with your healthcare provider and determine if this would be a beneficial option for you.
2) Focus on Whole Foods
While we don’t recommend specific diets, you can work with a healthcare professional to find foods that can help you during menopause. For some, research finds that the Mediterranean diet may be beneficial for managing menopause-related weight gain. If it suits you, it may be a good idea to work with a dietitian to incorporate it into your lifestyle.
One study investigated how a Mediterranean diet (MD) would affect weight and other health markers in menopausal women. In this study, they had menopausal women follow the MD, mimicking the diet of people living in Nicotera, a southern Italian town. It included lots of fruits and vegetables, whole grains, legumes, protein, and (of course) good quality olive oil.
Specifically, the macronutrient breakdown was:
- 50-60 percent of calories from carbohydrates
- 10-15 percent of calories from protein
- And less than 30 percent of calories from fat
There were variations in how much each person ate of what. Everyone is different, so work with your nutritionist to find the right ratios for your needs.
The authors found this diet may benefit more than just menopausal women’s waist circumference. These women experienced significantly improved body mass index or BMI (read our article on BMI to learn why this may not be the most reliable marker) and reduced overall body weight and fat mass. They also improved metabolic health markers such as LDL, HDL, triglycerides, and total cholesterol.
Improved metabolic health may have helped these women lose weight and become healthier, as that improvement has helped their bodies turn off their fat-storing mode. If you’ve found it challenging to manage your weight so far (especially belly fat), incorporating foods from the Mediterranean diet may help give your body a gentle nudge.
3) Engage in Aerobic Exercise and Strength Training
Physical activity is another great way to lose weight and build muscle mass. However, some women exercise less and less as they enter menopause, which can also contribute to weight gain during this phase.
Metabolism also decreases, as does muscle mass. And when there’s less muscle mass, your body may burn fewer calories, and you find yourself putting on body fat more quickly than you did before. The answer is to get a little more exercise. But you want to ensure you’re doing a mix of different workouts.
Aerobic exercise can be beneficial, and so can strength training. Aerobic exercise, or cardio, includes running, swimming, jogging, and even walking. It gets your heart rate up, pumps feel-good hormones in your body, builds endurance, and burns calories. Aerobic exercise can also be good for the heart.
Strength training includes using weight training (including your own body weight) for different exercises such as squats or deadlifts. It can help increase muscle mass, which we lose as we age (age-related muscle loss is known as sarcopenia).
You can always start small, for example, by getting in those 10k steps daily. And if you already get enough steps in and are running or jogging weekly, it may be time to incorporate a little bit of strength training into your regime.
Physical exercise helps manage menopausal (and general midlife) weight gain and menopause-related symptoms like back pain and hot flashes. A general recommendation is to get in at least two hours of combined exercise each week for menopausal and postmenopausal women.
A word of caution: high-impact repetitive exercises like running are not recommended for those who have osteoporosis. Also, activities that may make one prone to falling or injury are not recommended since they can lead to bone fracture. This is why a bone mineral scan can be important for women in menopause.
Adding some low repetition jumping exercises to your routine can actually help maintain bone mineral density and prevent progression to osteoporosis.
4) Reach Out For Support
Last but certainly not least, here’s a tip that’s a little less science-focused but more heart-centered. Even though it feels like you’re on a mission, you’re not alone. Women around the world feel the same way. So don’t be afraid to reach out to your community or loved ones for support.
If you don’t relate to those in your immediate surroundings or they find it difficult to understand what you’re going through, you can join a support group that resonates with you. Some great menopause support groups include:
Finding one may take time, but you can search for support groups in your local area that meet up in person. Or, if you’d like to keep things virtual, there are some great ones on social media platforms (like the ones linked above). You can even create your very own menopause support circle!
Another great idea is to have a workout buddy or accountability group where you can check each other’s progress and cheer each other on. You can also lean into your healthcare team or nutritionist for support. Many people find that nutritionists, functional medicine doctors, or other alternative medicine practitioners can offer motivation and behavioral support for longer-lasting change and health benefits.
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With over 11 years of experience as a dietitian in many areas of nutrition, Katie has worked as a clinical dietitian within a hospital, as well as in the fields of diabetes, sports and performance nutrition, recovery from addiction, and general wellness. She’s also an athlete and has run 8 marathons, including the Boston Marathon.