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Is Menopause to Blame for My Weight Gain?

Female measuring waist size
Women going through menopause may notice a shift from a pear-shaped body during childbearing years, to more of an apple-shaped body during midlife.

Published on August 12, 2022

Read Time: 4 Minutes

Nathan Ratchford, MD, a gynecologist with Phelps Health, defines menopause as the natural end of menstrual periods and ovulation. Typically, this is clinically defined as no menstrual cycles for 12 months in a patient with no other cause. Most women experience menopause between the ages of 45 and 55, with the average being age 51.

Women are often aware that hot flashes and mood swings can accompany this transition, but is menopause also to blame for midlife weight gain?

“Weight gain is common during midlife for both men and women,” Dr. Ratchford said. “Menopause is typically not attributed to weight gain, however many women experience weight gain and menopause coincidentally due to both occurring at the same stage of life.”

Dr. Ratchford also explained that a decrease in the hormone estrogen, occurring during menopause, isn’t directly to blame for weight gain.  

“We know this because menopausal women who are overweight don’t lose their weight when they’re placed on estrogen,” Dr. Ratchford said. “And there are many menopausal women who are a normal weight with low estrogen. More so, weight gain – or lack of weight loss – is multifactorial – [caused by] genetics, age, lifestyle, behavioral habits, diet, etc. Since most women experiencing menopause often have a disruption in these factors, weight gain is also more common. [In summary,] many of these factors are timed or influenced by menopause and the decrease in estrogen [that goes along with it].”

How Can I Combat This Weight Gain?

“If someone is approaching menopause with a normal or near-normal weight already, it’s important to remember that the diet and exercise they’re used to in maintaining that weight, will likely not be sufficient going forward,” Dr. Ratchford said. “As they age, their body will require fewer calories, and they should adjust their diet accordingly. For women entering menopause already overweight, it’s important to remember that losing weight is possible – but it takes early and consistent determination.”

Diet plays the biggest role in weight gain or loss, according to Dr. Ratchford, who recommends a long-term diet strategy. Fad diets can help someone lose weight in the short run, but it’s best to develop healthy eating habits that women can maintain permanently. When considering any new diet, it’s best to ask your doctor first to determine if it’s safe for you.

Exercise also has many benefits, when it comes to combatting weight loss.

“There’s so many different exercises to choose from – it’s impossible to make a recommendation that’s applicable to everyone,” Dr. Ratchford said. “To be fair, any exercise that can be safely and consistently completed is going to be a great place to start. The American Heart Association recommends at least 150 minutes per week of moderate aerobic activity. Additionally, weight training will not only help increase metabolism, but it plays a role in bone strength.”

Sleep, which can harder to come by during menopause, is also important. Sleep disturbances can affect weight, blood pressure, digestion, mood and more, according to Dr. Ratchford. Adults need at least 7 hours of sleep per night.

From a Pear to an Apple

Women going through menopause may notice a shift from a pear-shaped body during childbearing years, to more of an apple-shaped body during midlife. This increase in belly (or visceral) fat is not only frustrating, but should be taken seriously. Visceral fat increases the risk of cholesterol, type 2 diabetes, stroke and heart disease. And weight gain – especially obesity – at any age can lead to other health conditions and a reduction in overall health, Dr. Ratchford added.

Caused by elevated cortisol levels? Why the change?

I’m Stuck; What Gives?

If a patient has made healthy lifestyle changes, and the scale still isn’t budging, Dr. Ratchford advised speaking to one’s doctor about other possible causes of weight gain, as it most likely has multiple causes. Hormone replacement therapy (HRT) may also be a consideration.

“In my practice, I typically focus the conversation of whether or not to take hormone replacement therapy (HRT) around the patient’s quality of life,” Dr. Ratchford said. “Hot flashes, night sweats, irritability, mood changes and decreased libido can all contribute to quality of life. The pros and cons of starting HRT should be discussed in detail, so my patients can make the right choice for themselves.” 

To determine your healthy weight, Dr. Ratchford encourages looking at body mass index (BMI), which is calculated by dividing the body weight in kilograms by the square of height in meters. There are free apps and online calculators that are easy to use, which automatically convert feet and pounds. A normal BMI is between 18 and 25.

Plagued by Midlife Weight Gain?

If you are struggling with and not finding a resolution for midlife weight gain, contact your primary care provider or OB/GYN today.

Found in: Health Menopause Services Wellness