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Habit Change

Menopause and weight gain

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Many women report noticing weight gain during menopause. Menopause is a natural change that affects all women at some point in their lives. 

During menopause, the body undergoes many different changes and hormonal shifts. These shifts, combined with sleeplessness and increased stress levels, can lead to weight gain. 

However, there are strategies we can put in place to try and minimise the effect of these changes on our weight. This guide explores evidence-based information on what causes menopause-related weight gain and ways to manage it.

The body goes through significant changes during menopause, so it’s important to be kind to ourselves and focus on self-care. Although weight is one marker of health, our mental health, fitness, and happiness are equally important. Focusing on those factors will make managing any potential weight gain easier. 

What is menopause?

Menopause is part of the natural ageing process for women. It starts occurring when your supply of ovarian eggs gets low. This decrease in the number of eggs causes irregularity of menstrual periods and lower levels of female sex hormones (oestrogen and progesterone).

However, the body doesn’t stop producing these hormones overnight. In fact, it can take many years for this to happen. 

During this process, hormone levels can continue to fluctuate, which often causes an imbalance. This imbalance can result in our bodies behaving differently and is responsible for the menopausal symptoms many women experience. This phase is called ‘perimenopause’ and starts at different times for women. 

‘Menopause’ occurs when a female has had no periods consecutively for twelve months. Usually at around the age of 50-55 years (the average age is 51 in the UK). However, this can occur earlier or later. 

During menopause, women report many different side effects, such as hot flushes, sleep disturbances, mood changes, and decreased libido. Weight gain is also a common side effect

 

Key points:

  • Menopause is part of the natural ageing process for women, usually between the ages of 50-55
  • Symptoms include hot flushes, sleep changes, mood disturbances, and weight gain

 

What causes weight gain during menopause?

Scientists have debated whether weight gain during menopause occurs due to the menopausal transition or is secondary to the ageing process itself. 

However, it’s widely accepted that hormonal changes during perimenopause (the transition in the years leading up to menopause) can play a role in changes to our weight, both where we gain weight and how much we gain

Below are some of the different factors that could be responsible for weight gain during menopause.

Hormonal changes

In the transition to menopause, it’s common to see an increase in cortisol (the ‘stress hormone’) levels in our body. This can result in additional visceral fat storage (the fat that’s stored around our organs), noticeable as ‘belly fat’. 

Research suggests that high amounts of visceral fat are an independent predictor of increased blood pressure, cardiovascular disease, and insulin resistance.

Since insulin is one of the main hormones responsible for lowering your blood sugar levels, being insulin resistant typically means that your blood sugar levels are higher than they should be. It also means that you store fat a lot more easily because insulin promotes fat storage.

Whether or not the changes in female sex hormones, such as oestrogen and progesterone, directly affect insulin and other hormones is unclear, as the evidence is conflicting.

Sleep disruption

Many women experience disrupted sleep during perimenopause and menopause, either due to other symptoms, such as hot flushes, or from hormonal changes. Good quality, regular sleep is extremely important for managing our weight and preventing many other chronic conditions, such as heart disease, obesity, and type 2 diabetes. 

If we don’t sleep well, it can have many direct and indirect effects on our weight and wellbeing. Being sleep deprived means that we’re much less likely to exercise and more likely to crave snacks that are high in refined sugars and carbohydrates

Plus, evidence suggests that disruptions to our sleep cycle can, at least in the short term, impact our metabolism, leading to less energy expenditure. 

Sleep deprivation can also significantly impact the ability of our brain to process emotions. This can lead to us experiencing a lack of empathy towards others and mood swings and increase our stress levels. 

Increased stress levels

On top of the potential indirect sleep-related increase in stress, the hormonal changes that lead to a rise in cortisol levels can directly impact our stress levels. This can lead to the cycle of experiencing sleep disturbances, higher levels of stress and, in turn, more trouble sleeping.

In addition, some women might find it harder to engage in physical activity because of the other symptoms of menopause, such as aches or hot flushes. Exercise is an excellent stress-reliever, and so a reduced ability to exercise will contribute to increased stress levels. 

Stress can contribute both directly and indirectly to weight gain

 

Key points:

  • Menopausal weight gain could be due to the ageing process itself as well as hormonal changes
  • Some potential causes of weight gain during menopause include hormonal changes, decreased physical activity, cravings, changes in body composition, sleep disturbances, and increased stress levels

 

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How to manage weight gain during menopause

During menopause, the body is going through massive changes, so it’s important to remember that weight isn’t the only predictor of health. 

Be kind to yourself and try to focus on working on the tips below with the intrinsic motivation of feeling better and managing other symptoms and weight will be secondary. 

If you’re finding that your symptoms are significantly impacting your quality of life, we’d strongly advise you to chat with your GP, as there are treatments available. 

Nutrition

It’s important to pay attention to our diet during menopause to ensure we feel our best and manage any potential weight gain. Try to eat three healthy and balanced meals each day and drink plenty of water. Our body can easily mistake thirst for hunger when we’re dehydrated.

There’s some evidence that suggests our resting metabolic rate (the number of calories our body uses per day when at complete rest) decreases by around 10 per cent post-menopause

The combination of a lower resting metabolic rate and hormonal changes increase the likelihood of weight gain in our midlife. These changes make overeating and weight gain more likely if we continue with the same diet and lifestyle as before. It may be necessary to adjust your diet or portion sizes, and increase your activity levels where possible as you enter this new stage of life. 

Evidence suggests that a lower-carbohydrate diet is the most effective and sustainable diet for weight loss. Following a lower-carb diet plan during menopause may help to manage potential weight gain. 

Lowering our carb intake can also help prevent insulin resistance, which women going through menopause are at higher risk of due to the redistribution of body fat. 

As insulin also promotes fat storage, reducing our carb intake might lessen this risk as insulin is released in response to glucose (sugar) found in carbs. 

With a lower-carb diet, we naturally increase our protein intake (e.g. chicken, tofu, or eggs) and healthy fats (e.g. salmon, avocado, or olive oil). These are digested more slowly than carbs, which can help us feel full and reduce cravings for unhealthy foods, which can be stronger during menopause. 

On top of the food we eat during menopause, certain supplements can promote health. Post-menopause, women are at higher risk of osteoporosis (weakening of the bones), which means that calcium requirements increase to prevent bone breakages. Foods high in calcium include milk, yoghurt, cheese, seeds, and sardines. Vitamin D increases calcium absorption, and since natural foods, apart from oily fish, contain little vitamin D, supplementation is recommended. Vitamin D can also promote a better quality of sleep. Keeping our bones strong and sleeping better both contribute to managing our weight. 

If you’re not eating many high-calcium foods, for example, if you follow a vegan diet, you may want to discuss the option of a combined calcium and vitamin D supplement with your GP. 

 

Key points:

  • During menopause, we should aim for three balanced meals per day, along with plenty of water
  • A lower-carb approach is effective for weight loss in the long term and can prevent insulin resistance, which women are at higher risk of post-menopause
  • Supplementing vitamin D and eating foods high in calcium is important during and after menopause

Exercise

Studies have suggested that post-menopausal women were, on average, less active and more likely to engage in low-intensity exercise than pre-menopausal women

However, exercise can help improve our mental and physical health, which is essential in managing our weight, particularly during menopause.

One 16-week study split post-menopausal, overweight women into three groups, A) control (no diet or exercise), B) diet, and C) diet plus exercise. Results demonstrated that the diet plus exercise group (C) lost significantly more subcutaneous fat (fat visible under the skin) than the diet alone group. The diet plus exercise group also lost more visceral fat (fat around the organs) than the diet alone group, but this difference wasn’t significant. 

Diet and exercise trial with postmenopausal women

There’s a progressive decline in muscle mass during and after menopause due to the natural ageing process and declining oestrogen levels. For this reason, high-intensity or strength training, in particular, can benefit women at this point in life. 

In general, high-intensity interval training (HIIT), or short bursts of vigorous exercise, is more effective for weight loss than extended periods of light or moderate activity. A small pilot study suggests the same is true for overweight post-menopausal women

Strength or resistance training is any higher intensity exercise that uses weight. This could be weight machines that you find in a gym or our own body weight (e.g. squats, lunges, or push-ups). This type of exercise helps us build and preserve muscle and maintain healthy bones, which is particularly important for post-menopausal women due to the higher risk of osteoporosis. 

More intense exercise doesn’t need to be done for long periods to be effective. Quicker sessions, known as ‘exercise snacking’, can still have a large impact. A good option if you’re short on time or new to this type of exercise is to fit smaller bursts of activity around your daily routine. For example, doing squats while you wait for the kettle to boil or push-ups while your food is heating in the microwave.

As well as weight loss, evidence suggests that strength training can positively impact fat distribution in our bodies by reducing abdominal fat in older adults, which is one of the effects of menopause. 

Lower-intensity aerobic exercise, such as walking or gentle yoga, might be less effective for weight loss but still provide fat-burning benefits and are hugely beneficial to our mental and emotional health. Menopause can impact many women’s psychological wellbeing, so you should also incorporate this sort of exercise into your routine. 

 

Key points:

  • High-intensity interval training or strength training are the best options for weight loss and reduced visceral fat
  • You can include short bursts of this type of exercise into your daily routine, e.g. squats while the kettle boils
  • Less intense exercise, like walking, hugely benefits our mental and emotional wellbeing

Sleep 

There are several different methods we can try to improve the quality of our sleep. For some evidence-based approaches, read our guide on how to sleep better.

On top of the general advice to improve our sleep, there are other reasons that women might struggle to sleep during menopause. Hot flushes and night sweats can be very uncomfortable and keep women awake at night. Try these techniques to relieve some discomfort:

  • Keep your bedroom cool and use a fan if necessary
  • Spray your face with cool water or use a cool gel pack (available at most pharmacies)
  • Wear loose, thin clothing to bed that can be easily removed if necessary
  • Avoid synthetic fabrics and opt for thin cotton nightwear or sheets
  • Sip cold or iced water 
  • Have a lukewarm shower or bath rather than a hot one

In addition, following the advice above around eating a balanced diet and exercising regularly will help to improve the quality of your sleep. 

Key points:

  • There are many evidence-based techniques we can try to improve the quality of our sleep
  • During the menopause, women might experience discomfort from hot flushes at night, so try to use specific strategies to manage these
  • Eating a balanced diet and exercising regularly will also help to improve sleep

Stress

Working on getting a restful night’s sleep and regular exercise of any type will help us manage our stress levels. On top of that, there are some specific techniques we can draw on:

Meditation or deep breathing

Brain scans taken on people during meditation have shown increased activity in regions of the brain directly correlated with decreased anxiety and depression. 

Try practising breathing or meditation every morning when you wake up. For some extra support, there are many apps, such as ‘Calm‘ and ‘Headspace‘, or for free alternatives, ‘Simple Habit‘ and ‘Smiling Mind

 

Journaling gratitudes

Reflecting on positive experiences can help us shift our attention away from negative emotions, such as stress, anxiety, or depression. It’s not necessarily about ignoring negative moods or experiences but rather about balancing these with positive ones when we’re struggling to cope. 

A gratitude journal can also be a powerful coping tool to look back over when negative thoughts or feelings take over. Try writing one to three points in a journal each day. They can be as simple as ‘I am grateful for…the sun shining through my window today.’ or ‘I am grateful for…a funny phone call I had with my family member.’

 

Progressive muscle relaxation (PMR)

Progressive muscle relaxation (PMR) is a relaxation technique that has been shown to reduce stress-related activity in the brain, similar to the effects seen with common anxiety medication.

Just before we sleep tends to be a good time to practise PMR, as it helps us drift off. Each night this week, put in some headphones and listen to the recording we’ve made here at Second Nature

It takes 6 minutes and guides us through the process of PMR, step by step. Consider how your mind and body are feeling once you’ve finished – if you’re still awake!

 

Joining a programme

If you’re feeling overwhelmed trying to achieve a healthy weight, consider joining a programme. Evidence suggests that communicating with a mentor is one of the most powerful tools to help us cope and change our behaviours. Plus, we mirror the behaviour of other people who we engage with

For those struggling to cope, joining a programme to gain that extra support can be extremely beneficial. 

Second Nature is a completely digital habit change programme that gives you daily, online support from a health coach and peer group. All of the health coaches are registered nutritionists or dietitians. The programme takes place entirely within the app, with no need for in-person meetups. This year, 2337 women between the ages of 45-60 have lost at least 1 stone since joining the programme. 

 

Key points:

  • Getting a restful nights sleep and regular exercise of any type will help us manage our stress levels
  • Meditation and deep breathing, journaling gratitudes, PMR, and joining a programme are techniques to help us cope with high stress levels

Hormone Replacement Therapy

Hormone replacement therapy (HRT) is one option for perimenopausal and menopausal women, helping to supplement and stabilise hormone level fluctuations. Benefits include reducing common symptoms of menopause such as night sweats and hot flushes, and lowering the risk of osteoporosis. 

Some studies have suggested that HRT may also increase insulin sensitivity and blood glucose control in menopausal women with type 2 diabetes. Other studies indicate that HRT may help to mitigate the weight gain and increased visceral fat associated with menopause. 

However, the evidence is still inconclusive, so further research is needed to understand what role HRT may play in insulin sensitivity and weight gain post-menopause, especially in non-diabetic women

Over the years a number of studies have also linked HRT to worrying conditions such as cancer and heart disease. As a result, some women and their doctors have been reluctant to use HRT.

More recent research shows that there are indeed some elevated risks. Possible risks include a higher risk of breast cancer if taken for more than five years and an increased risk of blood clots

The evidence suggests that HRT does not increase risk of heart disease, and may even help to prevent it’s development

For most women, it’s likely that the benefits will outweigh any risks. However, there are different types of HRT and it may not be a suitable option for everyone, so speak to your GP about the options available to you. 

 

Key points:

  • Hormone replacement therapy is one option for women experiencing symptoms of menopause
  • HRT may increase the risk of developing breast cancer or blood clots, but these risks are thought to be small with the benefits outweighing the risks

 

Take home message

  • Menopause is part of the natural ageing process for women, usually between the ages of 50-55
  • Some potential causes of weight gain during menopause include hormonal changes, decreased physical activity, cravings, changes in body composition, sleep disturbances, and increased stress levels
  • During menopause, we should aim for three balanced meals per day, along with plenty of water
  • A lower-carb approach is effective for weight loss in the long term and can prevent insulin resistance, which women are at higher risk of post-menopause
  • Supplementing vitamin D and ensuring a balanced diet might help with sleep disturbances
  • High-intensity interval training or strength training are the best options for weight loss and reduced visceral fat
  • Less intense exercise, like walking, hugely benefits our mental and emotional wellbeing
  • There are many evidence-based techniques we can try to improve the quality of our sleep
  • During the menopause, women might experience discomfort from hot flushes at night, so specific strategies can be used to manage these
  • Meditation and deep breathing, journaling gratitudes, PMR, and joining a programme are techniques to help us cope with high-stress levels.

 

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Write a response

Commenter
Pauline Holmes
24 September, 2021

Thank you so much for such an informative article.


Commenter
Anna
5 October, 2021

Hi Pauline,

So pleased you’ve enjoyed this guide 🙂

On the Second Nature programme, you’ll have access to communities where you can join the Menopause community to connect with more resources. If you’d like to learn more about our programme, you can take our health quiz here.


Commenter
Joy Windsor
3 August, 2020

There’s a lot here which is really helpful and I will look at incorporating some strength training into my day as well as cycling. How does HRT help or hinder weight loss?


Commenter
Fleur Forer
28 July, 2020

A fantastic article with so much helpful advise. Thank you so much ❤️


Commenter
Janet Archibald
27 July, 2020

Brilliant article, just what I needed.


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