Ask the Coaches: Is Menopause Causing My Weight Gain?

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Dear Coaches,

Now that I’m 52 years old, I am beginning to adjust to menopause. I’ve heard so many stories from friends who have basically given up on their health and weight-loss goals since they’re past a “certain age.” Despite being consistent with my nutrition and exercise routine, I, too, have felt like I’ve been slowing down a bit and gaining weight. It’s especially noticeable around my midsection. Is this an inevitable effect of menopause? Is there anything I can do to prevent or, better yet, reverse the weight gain? And, are menopause and weight gain related? Or, do I just need to learn to deal with yet another aspect of this “new normal.”

I’d love to reclaim my former waistline. Please tell me it’s still possible!

-Cindy

A: Listen, Cindy, I get it. I mean, I don’t “get it” in the sense that I’ve gone through exactly what you’re going through. I haven’t nor will I ever (although men most certainly experience a similar transition with andropause). But I get your frustration, and from a physiology standpoint and practical experience, I understand what you’re going through.

You’re experiencing a tremendous metamorphosis—as the body you previously knew is transforming into what you’ve referred to as the “new normal.” Heck, at times it probably feels like it’s turning against you. And when it comes to menopause and weight gain, I completely understand how you can feel it’s inevitable.

While you may feel like you’re fighting an uphill battle, I assure that it’s completely possible to prevent weight gain—better yet, lose weight—and keep your waistline in check.

I’m not saying it’s going to be a walk in the park, Cindy. What I am saying is I’m going to shed some light on how to lose weight during menopause based on scientific evidence and real-world experience with hundreds of women just like you!

What is the “New Normal”

For starters, I think it’s important to have a brief discussion on the life transition known as menopause, which is made up of several stages. Of course, this biological transition is defined by changes in a woman’s reproductive cycle:

  1. The early menopause transition stage is specifically defined by menstrual cycles varying by seven or more days from regular cycles.
  2. The next stage is defined by intervals of skipped cycles or a missed cycle of at least 60 days.
  3. The third stage, defined as the end of perimenopause, begins following the first year without menstruation.
  4. This is followed by a stage of early postmenopause, which lasts up to six years.

There are multiple reasons for laying it out like this. The most salient is that while menopause is often referred to as a “state,” it’s actually a process. It takes time. In fact, while the hallmark of menopause is the final menstrual period (defined as the last menstrual period followed by 12 months of amenorrhea), the menopausal transition begins 5 – 10 years prior to that.

Also, it’s critical to highlight that this transition revolves around changes in levels of reproductive hormones. We’ll come back to that in a moment.

The transition is known for symptoms such as hot flashes, night sweats, reduced quality of life, sleep problems, and depressed mood. And to your point, Cindy, menopause and weight gain do seem to be associated. For instance, one study showed that a large group of menopausal women gained an average of 5 pounds over a 3-year period. And after 8 years post-menopause, the women gained 12 pounds.1

Certainly more notable than weight gain itself, just like you talked about, Cindy, menopause is associated with an increase in abdominal fat, which is particularly concerning because it increases one’s risk of cardiovascular diseases (e.g., coronary heart disease, infarction, stroke), high blood pressure, type 2 diabetes, osteoarthritis, certain cancers, sleep apnea, mental health problems, and more. But there is not an exact relationship between menopause and weight gain2

It’s All About the Hormones…Or Is It?

It’s commonly accepted that the weight gain experienced during menopause can be attributed to changes in reproductive hormones. Believe it or not, this actually does not seem to be the case. Rather, research suggests that the relationship between menopause and weight gain is due to factors associated with aging.3

For instance, postmenopausal women typically experience reductions in resting metabolic rate and calorie-burning lean muscle. And while these age-related changes may seem equally grim and inevitable, they’re not. In fact, as you’ll see, they provide some key insights into how to lose weight during menopause. Take, for example, the fact that the most consistent behavioral factor contributing to weight gain during menopause is decreased physical activity.1,4 I bet you have an inkling of where I’ll be going with that.

While menopause per se may not lead to weight gain, the hormonal changes associated with it—particularly the fall in estrogen—favor an increase in abdominal fat.5,6 Of course, these hormonal changes may also contribute to some of the other symptoms associated with menopause, such as sleep loss and mood-related issues, which may certainly impact lifestyle factors such as eating behaviors.

The Solution to Menopause and Weight Gain

With the proverbial table set, we can now dig into exactly how to lose weight during menopause by implementing some key strategies. To break the cycle (no pun intended) of menopause and weight gain, you have to recognize that successful weight-loss maintenance involves lifestyle interventions and long-term behavior change. In other words, even though the changes you’re experiencing may be out of your hands, there are several variables well within your control that we can put to good use.

  • Set appropriate goals and expectations. While it’s not a stretch to lose weight during menopause, it is a time when you may have to consider revising your priorities. In other words, maybe it’s no longer time to think about getting in the best shape of your life. Instead, maybe it’s time to focus on losing a little bit of weight (or even preventing weight gain), getting stronger, having more energy, sleeping better, and/or having less pain. All I’m saying here is that it’s important to make sure your target is realistic and appropriately in sight.
  • Get Moving. As mentioned, during menopause, we typically see a reduction in metabolic rate. This is at least in part explained by a significant decrease in physical activity. Indeed, in a study of nearly 300 menopausal Brazilian women, researchers found that being sedentary—not menopause—was associated with an increased risk of being overweight/obese, abdominal obesity, and metabolic syndrome, which is characterized by excess belly fat, high blood pressure, high blood sugar, and high blood lipids.7The researchers found that even a very modest increase in physical activity—walking 6,000 or more steps per day—was associated with a decreased risk of cardiovascular disease and type 2 diabetes. Additionally, studies have shown that a lifestyle intervention combining a reduced-calorie diet and increased physical activity (such as brisk walking for a total of 10 – 15 miles or 100 – 300 minutes per week) prevents weight gain and may even lead to weight loss (and reductions in hot flashes) during menopause.8,9
  • Lift weights. Now, if you really want to step your game up, then you’ll want to add resistance training to your exercise routine. When it comes to protecting your calorie-burning lean muscle, lifting weights is a surefire solution. In fact, it’s the most effective tool for combating the age-related decline in muscle mass.The great news is you don’t have to be a bodybuilder or lift super-heavy weights to benefit. The most recent research shows that lifting lighter weights 2 – 3 times a week (using full-body exercises like squats, presses, and rows) is just as effective as lifting heavy weights when it comes to building muscle.10,11
  • Practice yoga. Yoga has been shown to lead to a host of health benefits, including improvements in metabolic parameters, weight management, waist circumference, and quality of life in postmenopausal women.12 What’s more, there’s evidence that yoga can also reduce the occurrence of hot flashes in menopausal women.13
  • Watch what you eat. Regardless of age or hormonal status, there’s no question that a calorie-controlled diet is a linchpin for weight loss. And better yet, when you combine a reduced-calorie diet with exercise, you can typically expect even better results.14 There are many effective options. Really, the “best” diet is going to be the one that you can stick to (and will help with worry of menopause and weight gain).
  • Power up with protein. Along with resistance training, one of the single-most-effective strategies to protect and build calorie-burning lean muscle as we age is consuming enough dietary protein.16,17 In fact, as we get older, our protein needs actually increase. Consuming about 0.7 grams of protein per pound of body weight per day (along with a well-rounded exercise routine, of course) is a good general guideline for most. One of the best ways to make sure you’re getting enough protein is to use a high-quality protein supplement such as BioTrust Low Carb.
  • Watch how you eat. As mentioned above, the hormonal changes associated with menopause may also contribute to issues such as sleep loss and mood-related issues, which may certainly impact lifestyle factors such as eating behaviors.Along those lines, do your best to eat mindfully. Are you eating because you’re hungry? Or, are you eating because you’re stressed and tired? When you eat, are you eating slowly just until you’re satisfied? Or, are you eating quickly and mindlessly until the point of discomfort? Are you noticing any triggers for overeating or poor food choices?
  • Get some sleep. Speaking of sleep, getting plenty of it can help improve your resiliency, ability to cope with stress, blood sugar regulation, cognitive function, and overall health. When it comes to getting restorative sleep, we have to consider things like stress management, sleep hygiene, and circadian rhythms.
  • Watch when you eat. Above, I mentioned the significance of a reduced-calorie diet when it comes to weight loss. Along those lines, people traditionally gravitate toward daily calorie restriction. However, there’s an emerging and growing body of research showing that various forms of intermittent fasting (IF) may be equally—if not more—effective for weight loss. For example, one form of IF called alternate-day fasting, which incorporates caloric restriction only on “fast” days (ranging from 1 – 3 times per week), has been shown to be both safe and effective for weight loss.18,19
  • Consider hormone replacement therapy. I’m neither an endocrinologist nor do I play one here on the blog. However, I do want to point out that it’s also worth having a conversation with your healthcare provider about balancing your hormones. Despite what some have been led to believe, hormone therapy does not appear to contribute to weight gain. On the contrary, there’s evidence that hormone therapy may prevent the accumulation of abdominal fat during menopause.5,6

Embrace the Process

Finally, consider women’s health expert Dr. Christiane Northrup’s insightful take on the topic, “After working with thousands of women who have gone through this process, as well as experiencing it myself, I can say with great assurance that menopause is an exciting developmental stage—one that, when participated in consciously, holds enormous promise for transforming and healing our bodies, minds, and spirits at the deepest levels.”

This is YOU. The NEW you. Take time to figure out who you are, what’s important to you, who’s important to you. It’s not just your body that’s changing; your life is changing during this transition period. Maybe you’re nearing retirement. Maybe your kids have all flown the coop. This is YOUR time. Explore. Be creative. Take time to bridge the gap between where you were and where you want to be—and dream BIG.

I hope you find this helpful, Cindy!

-Coach Tim

References

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  • Dennis KE. Postmenopausal women and the health consequences of obesity. J Obstet Gynecol Neonatal Nurs JOGNN. 2007;36(5):511-517-519. doi:10.1111/j.1552-6909.2007.00180.x.
  • Simkin-Silverman LR, Wing RR. Weight gain during menopause. Is it inevitable or can it be prevented? Postgrad Med. 2000;108(3):47-50, 53-56. doi:10.3810/pgm.2000.09.1.1204.
  • Poehlman ET, Toth MJ, Gardner AW. Changes in energy balance and body composition at menopause: A controlled longitudinal study. Ann Intern Med. 1995;123(9):673-675.
  • Donato GB, Fuchs SC, Oppermann K, Bastos C, Spritzer PM. Association between menopause status and central adiposity measured at different cutoffs of waist circumference and waist-to-hip ratio. Menopause N Y N. 2006;13(2):280-285. doi:10.1097/01.gme.0000177907.32634.ae.
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  • Colpani V, Oppermann K, Spritzer PM. Association between habitual physical activity and lower cardiovascular risk in premenopausal, perimenopausal, and postmenopausal women: A population-based study. Menopause N Y N. 2013;20(5):525-531. doi:10.1097/GME.0b013e318271b388.
  • Simkin-Silverman LR, Wing RR, Boraz MA, Kuller LH. Lifestyle intervention can prevent weight gain during menopause: Results from a 5-year randomized clinical trial. Ann Behav Med Publ Soc Behav Med. 2003;26(3):212-220.
  • Thurston RC, Ewing LJ, Low CA, Christie AJ, Levine MD. Behavioral weight loss for the management of menopausal hot flashes: A pilot study. Menopause N Y N. 2015;22(1):59-65. doi:10.1097/GME.0000000000000274.
  • Schoenfeld BJ, Contreras B, Vigotsky AD, Peterson M. Differential effects of heavy versus moderate loads on measures of strength and hypertrophy in resistance-trained men. J Sports Sci Med. 2016;15(4):715-722.
  • Phillips SM. Nutritional supplements in support of resistance exercise to counter age-related sarcopenia. Adv Nutr Int Rev J. 2015;6(4):452-460. doi:10.3945/an.115.008367.
  • Lee J-A, Kim J-W, Kim D-Y. Effects of yoga exercise on serum adiponectin and metabolic syndrome factors in obese postmenopausal women. Menopause N Y N. 2012;19(3):296-301. doi:10.1097/gme.0b013e31822d59a2.
  • Avis NE, Legault C, Russell G, Weaver K, Danhauer SC. A pilot study of integral yoga for menopausal hot flashes. Menopause N Y N. 2014;21(8):846-854. doi:10.1097/GME.0000000000000191.
  • Franz MJ, VanWormer JJ, Crain AL, et al. Weight-loss outcomes: A systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc. 2007;107(10):1755-1767. doi:10.1016/j.jada.2007.07.017.
  • Sumithran P, Prendergast LA, Delbridge E, et al. Ketosis and appetite-mediating nutrients and hormones after weight loss. Eur J Clin Nutr. 2013;67(7):759-764. doi:10.1038/ejcn.2013.90.
  • Martone AM, Marzetti E, Calvani R, et al. Exercise and protein intake: A synergistic approach against sarcopenia. BioMed Res Int. 2017;2017. doi:10.1155/2017/2672435.
  • Winett RA, Davy BM, Marinik E, et al. Developing a new treatment paradigm for disease prevention and healthy aging. Transl Behav Med. 2014;4(1):117-123. doi:10.1007/s13142-013-0225-0.
  • Catenacci VA, Pan Z, Ostendorf D, et al. A randomized pilot study comparing zero-calorie alternate-day fasting to daily caloric restriction in adults with obesity: Alternate-day fasting versus caloric restriction. Obesity. 2016;24(9):1874-1883. doi:10.1002/oby.21581.
  • Trepanowski JF, Kroeger CM, Barnosky A, et al. Effect of alternate-day fasting on weight loss, weight maintenance, and cardioprotection among metabolically healthy obese adults: A randomized clinical trial. JAMA Intern Med. May 2017. doi:10.1001/jamainternmed.2017.0936.
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