Think weight gain is unavoidable during and after menopause? Not true. Don’t believe the defeatists—there’s much you can do to maintain an ideal weight and stay healthy as you age.
Although obesity statistics in most Western countries may indicate otherwise, and women do tend to gain an average of one pound per year between the ages of 40 and 65 (some gain 10 pounds or more), women aren’t doomed to obesity as they get older.
It takes vigilance for middle-aged women to maintain a healthy weight, but it can be done. You can beat the odds if you head into menopause aware and prepared with a reasonable nutrition plan.
Is Menopause or Aging to Blame?
According to The Menopause Society, there is no scientific evidence that menopause itself (or the hormone therapy some women use during menopause) is responsible for midlife weight gain. But confounding variables make this determination difficult, according to endocrinologist Maria Daniela Hurtado Andrade, M.D., of the Mayo Clinic. It is challenging even for experts to discern which process—aging or menopause—affects weight most during this time, she says. Many factors are at play.
“Throughout midlife, we go through physical, psychological, and social changes. And importantly in women, this midlife stage is when aging and menopause coincide,” said Dr. Hurtado Andrade, who has a doctorate in physiology and pharmacology. About two-thirds of middle-aged American women are now overweight or obese, she told The Epoch Times.
Metabolism slows with age, and during menopause, estrogen decreases and causes women’s body fat distribution to shift so that it tends to deposit around the middle, rather than at the hips, as in younger women. Excess fat in this area, called “central adiposity,” can increase the risk of cardiovascular and metabolic conditions in women.
Along with these changes, aging naturally causes muscle mass to decrease, and most people are less active as they get older, which may weaken muscles further and make weight management more difficult.
Additionally, some aspects of menopause can be indirect factors in weight gain, Dr. Hurtado Andrade told The Epoch Times. Vasomotor symptoms (that is, hot flashes and night sweats) can lead to poor sleep quality, which can in turn affect mood and overall quality of life, she said. This can lead to women making not-so-healthy choices regarding diet and exercise.
“Maybe [due to sleep and mood issues] you don’t have the energy to exercise,” Dr. Hurtado Andrade said, “so indirectly the consequences of menopause could certainly be a factor in exacerbating those changes that occur already with aging. Menopause itself is not a direct effect on weight, but vasomotor symptoms and their negative ramifications could certainly be a risk factor.”
Some studies report that in early menopause, excess body fat can make vasomotor symptoms worse, whereas later in menopause excess adiposity could mitigate these symptoms, Dr. Hurtado Andrade said. Researchers do not understand why this dynamic seems to be dependent on the stage of menopause a woman is in.
Despite all this, weight gain is not inevitable during menopause, according to Dr. Hurtado Andrade.
At this year’s annual meeting of The Menopause Society, she talked to women’s health professionals about their patients’ weight management in midlife, discussing the value of early guidance on dietary changes and physical activity.
How to Beat the Odds and Stay Thin—Or Lose Weight
Dr. Hurtado Andrade advised her audience of health professionals to proactively approach the issue of weight gain. “This issue is very commonly reported in women, and we must recognize it,” she told The Epoch Times.
“There is a holistic approach to this. If women do not make lifestyle changes throughout the midlife stage—we’re not just talking about menopause, but throughout the midlife stage—there is a very high likelihood that they are going to gain weight. And we need to prevent that.”
Women need to be aware that weight gain is a possibility and to start making changes, she said.
While increasing physical activity is helpful in weight control, research shows dietary changes are more important than exercise.
Calorie restriction is the key to losing and controlling weight, Dr. Hurtado Andrade said. “The reality is, for people to lose weight—whether it is women or men—we need to create a caloric deficit, meaning consuming fewer calories than what our body is able to burn. And that can be done either by consuming fewer calories or trying to burn more calories.”
Calorie Restriction, Rather Than Diet Regimen, Is What Matters
Creating a 500-calorie deficit daily equals a weight loss of one pound per week, she said, and this is more effective than trying to exercise away that pound: “Restricting 500 calories from what you consume is much easier than burning 500 calories. To burn 500 calories, you need to walk [approximately] 5 miles a day, which is very hard not only from a fitness perspective but also from a timing perspective. Creating that caloric deficit by restricting calories is easier,” she said.
As the saying goes, you can’t outrun a bad diet.
Exactly how many calories should a middle-aged woman consume? Dr. Hurtado Andrade generally recommends between 1,300 and 1,500 calories a day. She also recommends women make sure they’re getting enough protein to stave off muscle loss: “Protein can help prevent the muscle mass loss that occurs not only with any weight loss intervention, but that also occurs in midlife and as we go through the menopausal transition,” she said. She recommends that protein make up 30 percent of calories consumed—or at least 1.2 grams per kilogram of body weight.
This sounds complicated, but Dr. Hurtado Andrade said what matters most is simply being consistent about restricting calories. Whatever diet or eating plan you choose, it must be something you can follow for the rest of your life, she said, so it should be one that is well-balanced and easy to follow, such as a Mediterranean diet or a low-carb diet. Keto and intermittent fasting may work for a bit, but are not good long-term solutions, she advised.