Around midlife, women (and men) lose lean muscle tissue and gain body fat—and weight. In fact, research suggests that most women gain about a pound per year between the premenopausal and postmenopausal periods. What causes this menopause weight gain?
Both declining activity levels and the hormonal changes women experience at midlife are likely contributors. Hormonal shifts have been shown to contribute to abdominal obesity: Declining levels of estrogen allow the male hormone testosterone to predominate, which prompts body fat to migrate away from the hips and outer sections of the body and spread toward the abdomen and around the internal organs.
Even curvy women’s bodies tend to lose their waists after menopause, taking on the straight up-and-down profile of male bodies, and many women develop “menopots.” This accumulation of fat in the abdominal area, heralded by an expanding waist, is not just a cosmetic concern; abdominal (visceral) fat, more so than lower-body fat, increases the risk of developing type 2 diabetes and cardiovascular disease.
Although menopause weight gain is common, perhaps even inevitable, that doesn’t mean there’s nothing you can do to beat the odds and keep your weight (and waist) within healthy limits. Recent studies show that the key is changing your lifestyle—and it’s never too early or too late to start.
Premenopause: A good time to get a head start
Important guidance comes from the Women’s Healthy Lifestyle Project (WHLP). This study, published more than a decade ago in the Annals of Behavioral Medicine, followed 535 healthy premenopausal women (ages 44-50) for five years. At the start of the study, the participants’ baseline weights were obtained and the women were randomly assigned to a control group or to a lifestyle intervention group charged with making behavioral, dietary, and physical activity changes to their daily routines. Their goal: To lose five to 15 pounds to prevent subsequent gain above their baseline weight before the end of the study. To do so, and to lower their LDL (bad) cholesterol levels, the women were instructed to consume 1,300 calories each day (25 percent from total fat, 7 percent from saturated fat, 100 mg of dietary cholesterol) and increase their physical activity enough to burn 1,000 to 1,500 calories a week. The control group received no special instructions.
At the end of the five-year study, 55 percent of the women in the lifestyle intervention group were at or below their baseline weight compared with 26 percent of the control group. Waist circumference also decreased significantly more and blood glucose levels increased less in the lifestyle group than in the control group—even among women who had no significant change in weight.
Brisk walking was recommended as a good form of exercise to women in the WHLP lifestyle intervention group, and with good reason. Brisk walking is an excellent weight management strategy, it’s heart healthy and, for most people, is easy to incorporate into one’s daily routine. Another good option to consider, according to a study in the Archives of Internal Medicine, is bicycling. Investigators followed 18,000 premenopausal female nurses for 16 years and found that most women gained about 20 pounds over that time. But the women who rode their bicycles more frequently—especially those who were overweight or obese— gained less weight than their more sedentary counterparts.
It’s not too late to change: That’s one of the important messages from a year-long study published in 2012 in the journal Obesity. Investigators recruited 439 overweight or obese sedentary postmenopausal women (ages 50–75) and assigned them to one of four groups:
• Group 1 focused only on diet. Participants were instructed to consume 1,200 to 2,000 calories a day.
• Group 2 concentrated on exercise only—45 minutes of moderate to vigorous aerobic exercise five days a week.
• Group 3 addressed both diet and exercise.
• Group 4, the control group, made no lifestyle changes.
After one year, the diet-and-exercise group lost an average of 20 pounds, the diet-only group dropped 16 pounds and the exercise-only group, 4 pounds. By contrast, the control group lost less than a pound. Body mass index (BMI), waist circumference and percentage of body fat also declined significantly in the intervention groups.
When it comes to weight loss, most studies show that the best results are obtained from watching your diet and increasing physical activity. Findings from two recent studies shed light on the health benefits of exercise and why it may be particularly valuable for postmenopausal women.
Danish researchers enrolled 13 premenopausal and 10 recently postmenopausal (defined as having had their last menstrual period within 3 years) women in a 12-week exercise training program. The program consisted of playing floorball twice a week for 30 minutes along with warm- up and cool-down exercises. (Floorball is a team sport similar to hockey, but it is played indoors with plastic sticks.) The investigators found adverse changes in several biomarkers associated with the development of atherosclerosis, or hardening of the arteries—a major risk factor for heart attack or stroke—in both groups of women, but the rate of change was accelerated in the postmenopausal women. This accelerated change, which was indicative of a more rapid decline in vascular function, may help explain the sudden rise in heart disease risk that occurs in women after menopause.
Exercise appeared to have a positive impact, however. Before training, diastolic blood pressure and the biomarkers of cardiovascular disease risk were higher in postmenopausal women than in those who were premenopausal, but both groups demonstrated marked improvements after exercise training. Similar findings were reported last year in the Journal of the American Geriatrics Society. Investigators recruited 77 overweight or obese sedentary postmenopausal women to participate in an aerobic exercise program three times a week for six months. At the end of the study, markers of systemic and vascular inflammation and insulin sensitivity—indicators of cardiovascular disease and diabetes risk— had improved.
Ask for help at any age
Most people—regardless of their age—have trouble sticking with a weight-loss plan unless they receive expert help. Rather than going it alone, you may want to consider enrolling in a commercial weight-loss plan such as Weight Watchers, TOPS, Jenny Craig or programs such as the kind offered at community or university hospitals.
And don’t overlook your primary care provider as a source of help with menopause weight gain. A two-year study followed 390 obese adults who were trying to lose weight. According to the results, which were reported in 2013 in the International Journal of Obesity, those who received intensive weight-loss and exercise counseling at their primary care provider’s office lost more weight than people who did not receive counseling (10 pounds versus 4 pounds).
For more information on menopause, see Menopause May Speed Up Aging and 6 Ways to Manage Hot Flashes.