Menopause & Weight Gain

01/05/2021


Women often wrongly assume that they are the problem when it comes to losing weight during and after menopause.

You faithfully eat almost nothing but grilled fish and lettuce leaves and you diligently power walk for at least 30 minutes every day. But your clothes keep getting tighter around the waist and the numbers on the scale don't go down - sometimes they can nudge upwards, along with your waistline.

 Welcome to:

Menopause, Hormones and Weight Gain

What Causes Weight Gain During and After Menopause?

There are a number of factors that are responsible for increasing weight during and after menopause.

  • Normal ageing - slowing down of our normal metabolism
  • Reduced physical activity à Lower kJ/calorie requirements
  • Reduced physical activity à Loss of muscle mass à Lower metabolic rate
  • Maintaining or increasing food and alcohol intake without a corresponding increase in physical activity
  • Stress
  • Disruption to normal sleep patterns - not helped by hot flushes and night sweats!!
  • Use of certain medications including steroids, anti-depressants and some pain medications
  • Declining levels of the hormone, Oestrogen

"My weight hasn't changed, but my pants are getting tighter around the waist!            What's Going On?"

General medical consensus is that menopause does not cause weight gain on the scales.

But changes to our overall body shape is where the hormones really kick in. Lower levels of the hormone Oestrogen are an important but often overlooked factor in changes to body composition during and after menopause.

These hormone related changes include:

  •  increased loss of muscle mass
  • difficulty in building muscle mass
  • redistribution of body fat from our hips and thighs to the abdomen as the more dangerous 'visceral' fat
  • increased storage of body fat in unusual places e.g. in muscle tissue

From puberty until just before the onset of menopause, women tend to store fat in their hips and thighs as subcutaneous fat (pear / gynoid shape). Although this fat can be stubborn and hard to shift it doesn't increase disease risk very much.

However, during menopause, low estrogen levels promote fat storage in the belly area as the more dangerous visceral fat (apple / android shape). Many women don't put on weight on the scales but their waistlines get bigger. This used to be known as "the middle aged spread". This type of fat is linked to an increased risk of disease and other health problems.

Lower levels of Oestrogen can also affect other hormones which are linked to an increase in appetite. Many women undergoing menopause often felt driven to eat more. These changes to appetite related hormones include:

  • Increased levels of the 'hunger' hormone, ghrelin
  • Decreased levels of the satiety (feeling full) hormones, leptin and neuropeptide Y

Lack of sleep and high levels of stress can also really knock your metabolism and your hormone levels around - and that's not good news for managing your weight.


Health Risks Associated with These Changes

Weight gain at the waist doesn't just affect appearance. It contributes to women's increasing risk of some chronic diseases after menopause.

  • Cardiovascular Disease
  • Type 2 Diabetes
  • Insulin Resistance
  • Osteoporosis
  • Frailty
  • Falls and Fracture

There is also emerging evidence related to increased risk of some cancers - including colon and breast cancer.

As women get older, their risk of cardiovascular (heart and blood vessel) disease increases. This is partly due to the tendency to put on weight around the abdomen. Oestrogen boosts 'good' blood cholesterol (HDL) and lowers 'bad' blood cholesterol (LDL) - when oestrogen levels decline these protective mechanisms fade

The loss of lean muscle mass can also contribute to Insulin Resistance and Type 2 diabetes. Additionally , there is also a direct link between low levels of oestrogen and the development of osteoporosis.  

Managing Weight During and After Menopause

Dieting is NOT the answer

To lose weight during and after menopause the basics still apply - we need to eat less calories than we burn. This is often summed up as "eat less and move more". However, as we age, this message is oversimplified. When we diet, we not only lose body fat, but we also lose precious muscle mass, which is dangerous for our long-term health. We encourage our clients to avoid fad diets. Maintaining a healthy weight, even if it is related to an Oestrogen imbalance, begins with eating well and staying active.

Although we need to be careful with our calorie intake, we also need to pay special attention to the key nutrients listed below. Rather than just restricting calories, it's important to understand that it's now really about ...

"Eating With Purpose"

Whilst all the healthy eating guidelines still apply, making sure we get enough of the following key nutrients is essential.

  • Protein - to help maintain and increase muscle mass
  • Calcium - to protect bone health
  • Healthy Fats - to protect our blood vessels and heart
  • Fibre - to help control our blood sugar, satiety (feeling full), and also gut health

At Pulse we can help to ensure that you are getting all the nutrients you need to maintain great health and manage your weight during and after menopause by offering nutrition advice tailored to you and your lifestyle.

Exercise

Many people find that they gradually reduce their physical activity as they age, without being aware of the vital role of exercise to their long-term health. Physical activity not only helps people to manage their weight, but also maintains muscle mass and strength, and promotes bone health. It also reduces the risk of falls and fractures and can help keep people connected within their communities. There are some forms of exercise that are particularly helpful and combining these will multiply the health benefits.

It's a good idea to check in with your doctor if you plan to undertake strenuous activity. Remember, it doesn't need to be all or nothing- just start small and build up as you get stronger and fitter.


Resistance / Strength Training

Lifting weights and other types of resistance training helps to build muscle mass and prevent the age-related loss of muscle and strength. Muscle is more metabolically active than fat and burns more calories - this helps to control weight and decreases the risk of insulin resistance and Type 2 diabetes.

If you haven't done strength training before getting a professional to show you the ropes can help you get the most out of your sessions and avoid injury.


Aerobic Exercise

Getting your heart rate up is good for cardiovascular health (heart and lungs) and it gives your metabolism a boost which also helps to control weight.

It doesn't have a be a run or other high intensity exercise. Weight bearing exercise such as walking or dancing, or low impact exercise such as swimming or cycling is ideal.


Flexibility and Balance

The importance of being flexible and having good balance as we age is often overlooked as an important factor in preventing falls and fractures.

Yoga, Pilates, Tai Chi are great examples of gentle, low impact exercises with many health benefits.



Incidental Activity

Engaging in activities such as gardening, washing the car, chasing your children or grandchildren, taking the stairs instead of the lift, parking further away from your destination all contributes to keeping you fit and healthy.


Other Benefits of Exercise

Exercise also helps us to:

  • Relax and lower our stress levels
  • Lower our blood pressure
  • Increase our "Good" HDL - cholesterol levels which is important for heart health
  • Maintain good bowel function
  • Improve our mood and mental health
  • Improve our brain function, memory and cognition


This Bit Is Important

We don't want you to get the wrong idea. Evidence shows that carrying some extra weight is protective for our health as we age. Healthy weight ranges change as we get older and carrying some extra weight around your middle is ok.

Throughout our lives our bodies are in a constant state of physical change. From infancy to childhood to puberty to adulthood to menopause. Of these changes the last one is often the most difficult for us to accept. The changes that menopause brings can be very challenging and frustrating.

That doesn't mean that we throw our hands up in the air and say "I give up". Far from it! We should absolutely do what we can to protect our health.

At Pulse, helping women to embrace the changes of menopause and age well is our passion. If you would like to find out how we can help you navigate this new stage of life we would love to hear from you.