While it may seem that weight gain during the menopausal transition and beyond is inevitable, the truth is that, while it is a common phenomenon, it can be manageable. It makes sense that we want to blame hormone fluctuations for weight gain during menopause. 

Although hormones do play a significant role in body fat distribution, menopause alone may not only be the direct cause of weight gain. The good news is that hormonal fluctuations are only partly responsible, and switching focus to other lifestyle adjustments may minimize or even reverse extra weight gain in midlife¹.

1.    Hormonal Changes

Estrogen plays a role in inhibiting hunger signals, preventing excessive calorie consumption. A theory for menopausal weight gain relating to estrogen fluctuation is that its effectiveness in modulating hunger hormones is reduced. In turn, menopausal women may experience a more intense hunger signal which could lead to increased food intake, causing weight gain².

2.    Body Fat Storage Shifts

Fluctuations in hormones resulting from menopause can increase the likelihood of you gaining weight around your middle versus around your hips and thighs¹. In addition, the aging process is associated with changes in adipose (fat) tissue metabolism. 

An increase in body fat, specifically around the abdomen, results from this change in metabolism combined with hormonal changes associated with menopause. Research shows that postmenopausal women have a higher amount of intra-abdominal fat compared to premenopausal women. Belly fat in postmenopausal women accounts for 15-20% of their total body weight versus only 5-8% in premenopausal women³. 

Consistent findings in the research point to the fact that age is the main determinant of weight gain in midlife, but the hormonal changes during perimenopause substantially contribute to a fat increase in the abdomen⁴. With this shift in body fat storage, you may notice a shift from a pear-shaped body to an apple-shaped body⁵.

3.    Slowing Metabolism

In conjunction with altered fat storage patterns, metabolism naturally slows with age. The combined loss of lean body mass and body fat accumulation contributes to a slowing metabolism⁵. However, a new international study conducted on over 6,000 individuals aged 8 days to 95 years found that metabolism was stable from ages 20-60 and that a decline in metabolism wasn’t seen until age 60⁶. More research is needed, but the good news is that our metabolisms may not be slowing down as early as previously thought.

Menopause Diet Plan: Tips for Combatting Weight Gain

4.    Loss of Muscle Mass

After age 30, muscle mass decreases by approximately 3-8% per decade - that rate of decline quickens after age 60⁷. At rest, muscle tissue is more metabolically active than fat tissue, so losing muscle mass slows the rate at which your body burns calories¹. This lower calorie-burning capacity may make weight gain more likely and make it harder to lose weight.

5.    Genetic Factors

Genetics are not to be overlooked when it comes to weight gain. It’s likely that if your parents or close relatives carry extra weight in the abdominal area, you will too. There are many ways that genes contribute to obesity, including appetite effects, satiety, metabolism, food cravings, distribution of body fat, and the tendency to cope with stress by eating⁸. The good news is that genes alone can’t determine waist size, and keeping on track with a healthy diet and regular exercise can combat weight gain.

6.    Decreased Physical Activity/Less Exercise

In general, physical activity tends to decrease as women age. Coupled with other factors such as diet and muscle mass loss, weight management is more challenging. At any age, weight and fat mass will increase if we burn fewer calories because we’re less active. 

The CDC defines physical activity as “anything that gets your body moving” and recommends incorporating 150 minutes of moderately intensive activity and muscle-strengthening activities twice per week⁹. 

The benefits of strength training include helping you build and maintain muscle and bone mass that you lose as you age. As mentioned earlier, muscle burns more calories at rest than fat. So the more muscle mass you have, the more calories you burn¹⁰.

Tried and True Fitness Tips for Women in Menopause

7.    Lack of Sleep

Research suggests that adults who log more sleep consume significantly fewer calories than those who are chronically sleep-deprived¹¹. Sleep deprivation can disrupt the balance of hormones that regulate appetite, specifically ghrelin, which stimulates the appetite, and leptin, which suppresses the appetite. Individuals who slept less were shown to have reduced leptin levels and elevated ghrelin levels¹². Prioritizing sufficient sleep is an underrated yet crucial aspect of maintaining a healthy lifestyle, regardless of age or weight.

Emphasizing Health in the Aging Process

While some causes of weight gain during menopause can be mitigated through lifestyle changes, and some remain out of our control, such as genetics and hormonal changes, weight gain during menopause is not inevitable. Staying informed about these changes and making daily healthy choices to optimize your well-being should be at the top of your mind. Menopause may introduce new challenges, but lifestyle changes can go a long way toward helping you maintain a healthy weight - during the menopausal transition and beyond.

This information is for educational purposes and is not medical advice or intended as a recommendation of any specific products. Consult your health care provider for more information.

References

1. Mayo Foundation for Medical Education and Research. (2021a, March 12). Menopause weight gain: Stop the middle age spread. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menopause-weight-gain/art-20046058 
2. Chopra S, Sharma KA, Ranjan P, Malhotra A, Vikram NK, Kumari A. Weight Management Module for Perimenopausal Women: A Practical Guide for Gynecologists. J Midlife Health. 2019 Oct-Dec;10(4):165-172. doi: 10.4103/jmh.JMH_155_19. PMID: 31942151; PMCID: PMC6947726.
3. Victoria State Government . (2002, January 16). Menopause and weight gain. Department of Health & Human Services. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menopause-and-weight-gain 
4. S. R. Davis, C. Castelo-Branco, P. Chedraui, M. A. Lumsden, R. E. Nappi, D. Shah, P. Villaseca & as the Writing Group of the International Menopause Society for World Menopause Day 2012 (2012) Understanding weight gain at menopause, Climacteric, 15:5, 419-429, DOI: 10.3109/13697137.2012.707385
5. The North American Menopause Society, NAMS. (n.d.). Changes in weight and fat distribution. https://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife/changes-in-weight-and-fat-distribution 
6. Herman Pontzer et al.,Daily energy expenditure through the human life course.Science373,808-812(2021).DOI:10.1126/science.abe5017
7. Volpi E, Nazemi R, Fujita S. Muscle tissue changes with aging. Curr Opin Clin Nutr Metab Care. 2004 Jul;7(4):405-10. doi: 10.1097/01.mco.0000134362.76653.b2. PMID: 15192443; PMCID: PMC2804956.
8. Harvard Health Publishing. (2019, June 24). Why people become overweight. https://www.health.harvard.edu/staying-healthy/why-people-become-overweight 
9. Centers for Disease Control and Prevention. (2022, June 2). How much physical activity do adults need? https://www.cdc.gov/physicalactivity/basics/adults/index.htm 
10. Scripps Health. (2022, January 7). How to lose menopause weight gain. https://www.scripps.org/news_items/5432-5-tips-to-fight-weight-gain-after-menopause 
11. Salamon, M. (2022, April 4). Snooze more, eat less? sleep deprivation may hamper weight control. https://www.health.harvard.edu/blog/snooze-more-eat-less-sleep-deprivation-may-hamper-weight-control-202204042718#
12. Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med. 2004 Dec;1(3):e62. doi: 10.1371/journal.pmed.0010062. Epub 2004 Dec 7. PMID: 15602591; PMCID: PMC535701.