Pamela Malo, MHS, RD, Arivale Coach
“I’m not doing anything different with diet or exercise, but my pants don’t fit any more–help!”
This was a common complaint I heard from women in their late 40s and early 50s when I began researching the effects of menopause on body weight and fat distribution. What our research showed was that, while there is some reality to the dreaded “meno-pot”–the increase in waist size that coincides with menopause–there are also aspects of body weight and size that mid-life women can control if they understand what is happening biologically.
Menopause is medically defined as the time when a woman has been without a menstrual period for 12 consecutive months. However, midlife hormonal changes begin long before the monthly cycle stops, so menopausal symptoms and body weight changes can start before this time, too.
Our study–the Healthy Transitions Study–recruited 158 premenopausal women in their mid-40s and followed them for seven years as they transitioned into menopause. Each year, we collected data on body weight, body fat distribution, hormonal status, diet, exercise, and health-related biomarkers, so we had a longitudinal record of how these factors changed in relation to the onset of menopause.
Our results showed that both body weight and abdominal fat increased significantly with menopause. What was particularly striking was the change in deep abdominal fat tissue–called visceral fat–which increased every year up to the onset of menopause and then plateaued during the first few postmenopausal years as hormones stabilized. These changes in body fat distribution before menopause paralleled the drop in estrogen levels in the blood.
In short, the increase in weight and waist circumference women notice at menopause is real!
We also observed some very interesting results with regard to diet, activity, and energy expenditure (number of calories you burn). With regard to diet, in general women didn’t change their food intake too much over the course of the study–if anything, they were eating a little bit less the older they got. However, physical activity measured by a wearable device dropped dramatically: average daily activity was cut in half when we compared four years prior to menopause to post-menopause.
In addition, 24-hour energy expenditure–the number of calories burned during a day, including resting metabolism–dropped by 9 percent with menopause, resulting in approximately 200 fewer calories being burned each day. We also observed a 32 percent drop with menopause in women’s ability to burn dietary fat. This resulted in 26 fewer fat grams per day, on average, being burned after menopause compared to pre-menopause.
What it means for women going through menopause
So, what does this mean for menopausal weight gain and “waist gain”?
When women understand that their metabolism is going to drop by about 200 calories around menopause, they can engage in behaviors to help offset this. The women in our study seemed to spontaneously decrease their food intake–which is one way to offset the metabolism drop–although it wasn’t enough to completely prevent weight gain because their physical activity levels also dropped significantly.
Increasing your physical activity as much as possible during the perimenopausal years, while watching your diet, can help compensate for the drop in metabolism that occurs as estrogen levels decline, as well as build muscle which can help boost metabolism to some extent.
It’s also important to understand that your ability to burn dietary fat will drop–so choosing lower-fat foods may be important to maintaining a healthy weight after menopause since the fat you eat will be more likely to be stored than when you were younger.
While these strategies can help offset weight gain–or facilitate weight loss–there’s less that can be done about the increased waist size, which appears to be largely controlled by hormones. This is where self-compassion and body acceptance come in. As long as you are leading a healthy lifestyle and controlling overall weight gain at menopause, you’ll help reduce your risk for heart disease, diabetes, and other health conditions that are more common in postmenopausal women, even if your waist size does increase an inch or two.
A systems approach to menopause
How does the systems approach fit in?
Understanding your genetic predisposition to exercise-related tendon and ligament injuries can be important for prevention if you change up your exercise program–especially once you’re over 50. And, knowing your genetic predisposition for weight gain from dietary fat–your “baseline” over which the hormonal changes at menopause will impact–can be helpful for weight management.
Midlife is a good time to begin regularly tracking risk factors for heart disease, diabetes, and bone loss–vitamin D and blood markers like lipids, blood sugar, and insulin. And, of course, tracking your activity and sleep can help you see whether you’re reaching your targets or–inadvertently–starting to go the other direction.