Change of Life, Change in Weight?

Gaining weight as a consequence of going through menopause seems to be inevitable. Talk to a group of women in their mid-to-late 50s and onward and they will ruefully point to their expanding middle section and explain that their extra 10-15 pounds are due to the “change.” The waistline seems to disappear, blouses are worn over the waistband of a skirt or pants (not tucked in), and sometimes billowy scarfs or jackets are used to bring the eye away from the midriff.

But is it true? Is menopausal weight gain real? Is the perception that the pounds have gathered front and center on the body accurate? Is the decline of estrogen, which characterizes menopause, the reason for the weight gain? Does the absence of this hormone cause fat to migrate from wherever it was stored prior to menopause to sit on top of what was a waist? Is an age-related decline in muscle mass being replaced rapidly by fat in the menopausal woman?

Many weight-loss products advertise themselves as an intervention that will stop menopausal weight gain. If they are to believed, any woman approaching her 50s has good reason to consider buying clothes in a larger size unless she buys these pills or follows a special diet. One product promises to “naturally block weight gain after 40.” Another offers a diet for a “menopausal belly.” So many images of menopausal rolls of belly fat are on the Internet that it is a wonder that advertisements for girdles (those undergarments that supposedly pushed belly fat toward the neck) do not accompany the pictures. And yet, the scientific literature doesn’t support the connection between menopausal status, increased midsection fat deposits, and weight gain.

In one such study, Australian-born women aged 46-57 were followed for five years to record changes in their weight. The average weight gain was 2.1 kg (4.6 lbs.). (This amount of weight could be gained on a weeklong cruise.)

In another study, over 3,000 racially and ethnically diverse American women were followed during their menopausal transition; that is, the years in which they went through an ending of their periods and decrease in estrogen production. The study tracked changes in weight, the ratio of waist to hip circumference, and physical activity of women as they entered their menopause. Their ages ranged from 42-52, and they were followed for three years.

Interestingly, their weight did increase, but by the same amount—2.1kg—as found in the study of Australian women. Their waists became slightly wider, but again the change was small, a 2.8% increase in waist circumference. And those women who engaged in regular physical activity such as walking displayed a decrease in weight and waist size. The survey did not reveal any relationship between menopausal status, gain in weight, or the supposed migration of fat into the mid-section.

These data seem to contradict the general perception that, “... of course one thickens around the middle!” during menopause, and should expect to be in a larger size soon after menopause occurs.

But in truth, the transition into menopause can bring a fair amount of physical and mental discomfort leading to the consumption of excess calories. Sleep quality may deteriorate because of frequent awakenings, especially if hot flushes are experienced during the night. Daytime fatigue can lead to overeating and, when sleep disruption goes on night after night, it may be hard to resist eating to feel more alert or combat tiredness. And fatigue will make it harder to maintain an exercise routine, or commit to starting one.

Mood changes, some of which resemble PMS, can also show up during the transition into menopause and make it harder to resist comfort eating. Unfortunately, the foods often chosen to comfort are high in fat and sugar. Cauliflower, tofu, and cottage cheese are rarely sought-after foods when stressed.

Coincidentally, menopause occurs at an age when the normal loss of muscle with aging may be having an effect on physical stamina, balance, rate of walking, and the ability to stand up easily from a sitting position. According to the article by Volpi and her associates, there is an involuntary loss of muscle mass of about 3-8% per decade in men and women starting in their thirties, and the rate of loss increases after the age of 60. Menopausal decrease in estrogen may contribute to this process. (See the reference cite at the bottom of this post.)

But this doesn’t mean that muscle will be replaced by fat, and the fat mass will prevent the menopausal woman from buttoning the jeans that fit before she entered menopause. Regular exercise that increases muscle mass, and a diet providing enough protein to build up that muscle mass, should significantly compensate for the age and menopausal decline in muscle. Women are told to eat at least 0.8 – 1.2 grams of protein per kg of body weight. (Convert lbs. to kilograms by dividing weight in pounds by 2.2.)

Menopausal symptoms are not pleasant. Vigorously fanning oneself when everyone else is shivering, or experiencing mood swings that are reminiscent of the early days of PMS, is annoying at best and certainly can affect the quality of life. But these symptoms do disappear, eventually. Gaining weight or fat in the wrong places need be not added to the woes of going through menopause. Indeed, for many women, entering the sixth decade of life means more time for themselves as their household empties of children (or their children are more independent). It may mean time to go to a gym or yoga class, spend time with friends, and take on a job or volunteer opportunity that was impossible with young children. Menopause gives most women more time to pay attention to their diet, eating sufficient protein, and engaging in daily physical activity. And if this is done, a stronger, slimmer body may be the consequence of the change.