Gaining weight is a common occurrence during menopause. On an average of women gain 1-2kg during the peri-menopausal period, or more than this if a woman is overweight or obese before menopause. This week’s blog post focuses on managing weight gain in menopause.

Why Do We Gain Weight?

When a woman starts peri-menopause, progesterone levels start to decrease slowly and oestrogen levels fluctuate day-to-day. In the early stages of peri-menopause, oestrogen levels are often very high, whereas later in the perimenopausal stage the ovaries produce very small amounts of oestrogen [1]. 

Studies suggest that high oestrogen levels can promote fat gain [2], explaining the increases in weight. Women also tend to store more weight in their hips and thighs as they age, leading to a pear shape body type. It is stored as subcutaneous fat which can be hard to lose but isn’t thought to increase the risk of disease much. However, low oestrogen levels throughout the menopause can cause visceral fat to be stored in the lower abdomen area, which can increase the risk of insulin resistance, type 2 diabetes, and heart disease [3].  

Another factor thought to influence weight gain in peri-menopause is hormonal changes that increase appetite and overall calorie intake. One study found that levels of ghrelin in peri-menopausal level were significantly higher than pre- and post-menopausal women. Ghrelin is a hormone produced mainly by the stomach and is known as the ‘hunger hormone’. This is because it stimulates appetite, encourages fat storage, and can increase food intake. High levels of this hormone in peri-menopausal women could explain weight gain [4].

Additionally, low oestrogen levels experienced during menopause can diminish the function of neuropeptide Y and leptin. Neuropeptide Y is a protein, responsible for stimulating food intake, with a preference for carbohydrates. Leptin is a hormone released by fat cells that contributes to the regulation of body weight. This suggests that women with low oestrogen, seen in the later stages of peri-menopause may be likely to increase their caloric intake [5,6]. 

Why is it Hard to Lose Weight?

With all these hormonal changes it can be hard for you to lose the weight that is gained during the menopause. The reductions in oestrogen during the menopause can lead to the slowing of your metabolism, which explains why it is even harder to lose weight. A good first step of tackling weight gain in menopause is to prevent further weight gain.

The menopause can also come with symptoms such as mood swings. This is another barrier when trying to lose weight as mood swings may cause you to feel less motivated or more critical of weight changes. It is important to focus on mental health during this stage as well as physical health.

How Can We Manage Weight Gain in Menopause?

There are a number of ways that you can manage your weight throughout the menopause:

1. Increase your physical activity – the NHS recommends doing at least 150 minutes of moderate intensity per week or 75 minutes of vigorous activity a week. Physical activity can be anything from hiking to cycling to carrying heavy shopping bags.
2. Eat well – all adults should aim to eat a healthy, balanced diet. 
3. Try a Mediterranean-style diet – this can help to reduce the risk of heart disease. This diet consists of a variety of fruit, vegetables, whole grains, and unsaturated fats. You can read our blog post on the mediterranean diet here.
4. Try alternative therapies such as yoga, herbal treatments, and meditation – these treatments may help with the any negative mood symptoms you experience.
5. Control portion sizes – try measuring out your snacks, check the recommended serving sizes on everyday foods, and practice mindful eating to ensure you are eating when you are hungry, not because you are bored or for comfort.
6. Plan meals – this can help you to make healthy decisions when preparing meals.
7. Keep yourself accountable – try exercising with friends or making healthy meals for your whole family to stay motivated.
8. Don’t do too much at once – make small lifestyle changes, instead of drastic ones, to make it more likely for you to stick to the changes you have made [7]. 

There is little evidence on the link between hormone replacement therapy (HRT) and weight. However, from the evidence that is there, HRT doesn’t seem to cause weight gain. HRT may be an option to consider for managing other symptoms of the menopause, but it doesn’t work for everyone [8]. 

Top Tips for Managing Weight During the Menopause

1. Try the Mediterranean diet to reduce the risk of heart disease
2. Check serving sizes on everyday foods to ensure you’re not over-consuming
3. Plan meals to make it easier to make decisions when choosing what to eat
4. Keep yourself accountable by getting support from friends and family
5. Don’t try to make huge changes overnight, it’s much more sustainable to make smaller lifestyle changes

References

[1] https://pubmed.ncbi.nlm.nih.gov/9929857/ 

[2] https://pubmed.ncbi.nlm.nih.gov/19021869/

[3] https://pubmed.ncbi.nlm.nih.gov/23460719/  

[4] https://pubmed.ncbi.nlm.nih.gov/18280066/ 

[5] https://pubmed.ncbi.nlm.nih.gov/25866757/ 

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964739/ 

[7] https://www.healthline.com/nutrition/lose-weight-in-menopause#effects-of-menopause-on-weight

8] https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/side-effects/