So you’ve gained weight during menopause and can’t seem to shift it? Don’t worry, you are not alone. It is currently thought that postmenopausal status is associated with a higher prevalence of obesity with nearly half of postmenopausal women overweight, among whom it is estimated a quarter are obese. It is thought that declines of endogenous oestrogen, together with physical inactivity, are probably the major contributors to this phenomenon. During early menopause, research indicates that this withdrawal of oestrogen may reduce lean body mass while increasing fat mass.
But is this fat distribution really attributed to menopause or is it simply “middle age spread”? It is well established that body weight increases with age both in women and in men, and that this change is observed in both lean/normal weight and overweight subjects. Studies have also shown that a change in body weight over the same age period is no greater in women who became post-menopausal than pre-menopausal control subjects. Both groups gain weight independent of menopausal status.
In contrast to the common opinion, studies such as these indicate that there is no distinct independent increase in the rate of weight gain at the time of menopause. Instead the development of weight problems is most likely attributed to middle age. The redistribution of fat can however be attributed to “the change”, menopausal women often experience a shift in fat mass that results in a greater ratio of upper body fat to lower body fat. Independent of weight gain, significant modifications of body morphology such as an increase in abdominal fat deposition have been demonstrated in several studies. While body composition changes with age: fat mass increases, bone and lean body mass and body protein decrease, the decline in fat-free mass is the major characteristic of menopause-related changes in body composition.
So where can we intervene? While as we mentioned oestrogen deficiency seems to play a role in menopause-related changes in body composition, lifestyle factors such as diet, exercise, smoking habits and alcohol consumption are also involved. Studies have shown that hormonal replacement therapy cannot offset postmenopausal weight gain or fat accumulation but appears to diminish the shift of fat from hip to waist. Studies have also shown dietary fibre intake may have a protective effect on such weight gain but more research is needed to determine it’s exact role.
The worrying part about weight gain during the middle stages of life is that it often co-exists with other diseases, the most important being diabetes, dyslipidemia and hypertension. Furthermore, it can lead to an increased risk of hormone dependant cancers, cardiovascular disease, gallstones and osteoarthritis. The good news is that weight loss can reverse many of these complications, reduce the number and dosages of medications used, and improve longevity and quality of life. To do so requires lifestyle modification, a 360 degree approach such as ours here at Motivation Weight Management.