The body changes before and during the menopause. One significant change, due to a fall in female hormone levels, is a drop in the metabolic rate by about 10%. This fall can lead to notable weight gain (2 to 2.5 kg over three years on average) unless compensated by taking in fewer calories.
This article was included in issue 102 (Autumn 2024) of The Menopause Exchange newsletter.
The reasons for this weight gain include:
- falling muscle mass that’s metabolically very active just by sitting on the body
- falling hormone levels, leading to a fall in metabolic rate
- generally being less active and slowing down, such as pace of walking
Central adiposity
Weight gain before, during and after the menopause tends to be around the tummy, which is the area where men put on weight (the so-called beer belly). This is because of declining female hormones, such as oestrogen, and increases in the male hormone, androgen. This is the dangerous area to put on weight. It increases the risk of metabolic syndrome, which is a cluster of conditions including high cholesterol, high blood pressure, prediabetes and diabetes, and cardiovascular diseases.
Excess weight carries other risks during the menopause. It can exacerbate painful joints and increase the risk of heart disease and certain cancers, such as breast and colorectal cancer. A lower BMI is associated with a 20% reduced risk of breast cancer. Weight gain can also exacerbate hot flushes and night sweats, especially if the weight is carried centrally, and contribute to poor self-esteem and low moods.
What’s the solution?
The menopause needs to be accompanied with decreasing caloric intake and doing both aerobic exercise and resistance training. The aim is to try and maintain as much metabolically active tissue (muscle mass) as possible. Physical activity is associated with fewer menopause symptoms and may help to reduce central adiposity, even if little weight is lost overall.
What’s the best diet?
It’s likely that around the menopause some sort of diet will need to be maintained for life. It’s not really a case of ‘going on’ and ‘coming off’ a diet. Certainly, when weight is initially lost, there can be a little relaxing of the calorie restriction, but returning to the previous way of eating will lead to weight gain again.
Strict dieting isn’t recommended, as it may lead to a reduction in even more metabolic weight. It’s unlikely that your appetite will have reduced, so the answer is to eat bulky, filling food containing fewer calories. Vegetables are bulky and filling so, for example, when having a meal ensure half the plate is covered with the veg (as long as you don’t add loads of oil/cheese/butter to them). Try and have high-fibre carbs, as these will also be filling and ensure your gut bacteria are happy.
The Mediterranean diet
There’s evidence that the Mediterranean diet is a beneficial one to follow during the menopause. It’s a great all-round diet for health, helping to ward off heart disease and cancers, as well as keeping weight in check. Originally inspired by traditional dietary patterns of Mediterranean countries, the main characteristics are the relatively high consumption of olive oil (preferably virgin), legumes, unrefined cereals, a variety of colourful fruits and vegetables, moderate to high consumption of fish, moderate consumption of nuts and dairy products (mostly cheese and yogurt), and a low consumption of meat and meat products.
The benefits are believed to come from the high levels of polyphenols (substances in oils, fruits and vegetables that give them their flavour and colour), the low level of saturated fat and relatively higher levels of polyunsaturated and monosaturated fats.
Measuring weight
Because of the risk of weight held centrally (belly fat) and a range of metabolic diseases, a good indicator of needing to lose weight is to measure waist circumference. To do this accurately:
- Stand and place a tape measure around your middle, just above your hip bones.
- Make sure the tape is horizontal around your waist
- Keep the tape snug around your waist but not compressing your skin
- Measure your waist just after you breathe out
For a healthy measurement, all women need to aim to be less than 80 cm (31.5 in).
Downside of being underweight/losing too much weight
Unfortunately weight loss of as little as 5% of body weight is associated with increased bone turnover, meaning calcium is lost from bones quite rapidly. To minimise bone loss, eat a bone-healthy diet (getting sufficient calcium and other nutrients), combining this with some high impact exercise, if possible.
Being underweight can carry health risks too. It can lead to an increased rate of calcium loss from the bone due to very low levels of circulating oestrogen. This is because some oestrogen is still produced after the menopause in the adipose (fat) tissue, so being too thin means that the tissue won’t be able to fulfil this role.
Keeping active
It’s hard to lose weight just by increasing activity, but the benefits of physical activity go beyond just weight loss at this age. It can:
- help with mental wellbeing
- help maintain muscle mass
- help offset fat from building up around the belly, even if little weight is reduced overall
- help offset falling metabolic rate to a certain extent
- help reduce menopause symptoms, including hot flushes
High impact exercise can offset calcium loss from the bones, but it’s wise to get professional advice first to prevent injury.
About the author
After working as a dietitian for over 30 years, Gaynor Bussell now works as a nutritionist and writer, specialising in women’s health and weight issues.
Created Autumn 2024
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