Menopausal Weight Gain May Hamper Brain Function

Patient Expert

It's really easy for the pounds to creep on to our frames on as women go through menopause. There are several reasons for this, including hormonal changes, lifestyle and genetic factors. In addition, muscle mass often decreases as we age and fat increases. Losing muscle mass lowers the rate that the body uses calories, thus making it more difficult to stay at the same weight as you did in your 20s and 30s. Stress also can play a factor, as can life changes such as elder care or divorce. It's really easy to put off exercising when life takes over and it seems a lot faster to grab take-out than to cook when we're faced with regular time crunches.

However, gaining weight at this time in life may not only make it difficult to fit into your clothes, but it also may do a number on your brain.   For instance, studies have shown that people who are overweight are 26 percent more likely to develop dementia while people who are obese have a 64-percent likelihood of developing this condition.

So if you've added a few (or more) pounds, can losing it make a difference? A new study out of Brazil that looked at brain function before and after weight-loss surgery sheds some light on the difference it can make. The study involved 17 severely obese women who had an average body mass index of 50.1 and 16 women who were at a normal weight. None of the participants had diabetes or a family history of dementia.

Prior to the surgery, the women took an IQ test as well as six other assessments to determine their memory and executive function. Researchers also took blood samples from the women and asked them to undergo PET scans to measure the brain's metabolic activity. The researchers' analysis found prior to surgery that the obese women had increased metabolism levels in their brains when compared with women who were lean.

These participants then had Roux-en-Y gastric bypass, an operation that shrinks the stomach to the size of an egg. In addition, this surgery diverts food past a significant portion of the small intestine, thus reducing the nutrients and calories the body absorbs. Six months after the surgery, the women's body mass index measured an average of 37.2, which meant they were still classified as severely obese.

Weight loss due to bariatric surgery appeared to reverse the higher metabolism and these women also showed improved executive function, which is tied to planning and organization. In addition, the differences in brain scans pre- and post-surgery were pronounced. Prior to surgery, the obese women's brains seemed to work harder than the brains of the leaner women, especially in areas of the right hemisphere that become active to compensate for cognitive decline. After the surgery, these differences were no longer noticed.

Additionally, the tests indicated that the surgeries made the women more sensitive to insulin. The women also had reduced levels of proteins that are associated with inflammation. Their levels of a hormone GLP-1 -- which is believed to reduce inflammation as well as the number of beta-amyloid plaques that are seen in Alzheimer's disease - also increased.

The researchers hypothesized that the way that the brain processes sugar leads to structural damage in people who are obese. This damage may contribute to cognitive decline or cause it to accelerate. Therefore, it's important to try to maintain a healthy weight as we age.

So how can you prevent weight gain after menopause? The Mayo Clinic recommends doing moderate exercise at least 150 minutes a week or vigorous aerobic exercise at least 75 minutes a weekly, in addition to strength training exercises twice weekly. Additionally, you will need to eat about 200 fewer calories when you reach your 50s than you did when you were 40. To do this, try to eat a nutritious diet that focuses on fruits, vegetables, whole grains and lean protein so that you can get as many vitamins and nutrients from your diet as possible.

Primary Sources for This Sharepost:

Kaplan, K. (2014). L_ower weight, get smarter?_ Well, maybe. Houston Chronicle.

Margues, E.L., et al. (2014). Changes in neuropsychological tests and brain metabolism after bariatric surgery. The Journal of Clinical Endocrinology & Metabolism.

Mayo Clinic. (2013). How risk is weight gain after menopause?

Sifferlin, A. (2014). This is what weight loss does to your brain.