*Content reviewed by HotPause Health Nutrition Expert & Registered Dietitian Val Schonberg, MS, RD

Weight Gain In Menopause

Oooooofffff. This topic. Let us start by saying: women should feel empowered and supported, no matter their body type, nor what their scale reflects. However, we also recognize that menopause can bring about changes and symptoms to your body that you might not necessarily love and moreover, might negatively impact your self-esteem and overall body image. Menopause nutrition expert and Registered Dietitian, Val Schonberg, dives right in to everything you need to know about midlife weight gain. As women age, maintaining their usual weight can become increasingly challenging. The onset of weight gain frequently begins during perimenopause and tends to persist until after a few years after the final menstrual period. Studies show women gain an average annual increase of approximately 1.5 pounds throughout their 50s. [1] Although averages are what are reported from studies like this, we are aware that each woman's experience of shifts in weight can vary greatly, so it is not uncommon for some women to gain more or less than this during the transition to menopause and beyond. This change can also be accompanied by accelerated gains in fat mass and simultaneous losses in lean mass. [2] Gaining weight during menopause is common. However, adopting a balanced diet and maintaining an active lifestyle can help mitigate this trend. And, perhaps more importantly, help with managing overall health concerns that arise during this stage of life.

Why Do You Gain Weight In Menopause?

Weight gain during menopause is influenced by a combination of hormonal changes, age-related factors, lifestyle, genetics, and specific conditions like muscle loss, insulin resistance, and sleep disturbances. Hormonal and Age-Related Changes: The hormonal upheaval during menopause increases the likelihood of abdominal weight gain. Yet, hormonal changes alone don't fully account for weight gain. A decrease in muscle mass can begin around age 40, leading to a slower metabolism and making it harder to maintain a person’s usual weight without adjusting diet or increasing physical activity. [3] Lifestyle and Genetic Factors: Sedentary behavior tends to increase with age, so being intentional with increasing physical activity or movement, in general, is important to help with overall health goals while helping to attenuate weight gain. Genetics also play a role; if close relatives carry extra weight around the abdomen, it's more likely you will too. Insulin Resistance: Insulin resistance becomes more common after age 45. If you develop insulin resistance, this can lead to fat accumulation around the midsection. This not only contributes to weight gain, but also increases the risk of metabolic syndrome, Type 2 Diabetes, cardiovascular issues, and sleep problems. Sleep Quality: Menopause symptoms like hot flashes, night sweats, and insomnia can disrupt sleep, with issues like sleep apnea becoming more common. In fact, studies have shown that postmenopausal women are 2.6–3.5 times more likely to develop obstructive sleep apnea (OSA) than premenopausal women. [5] Poor sleep can contribute to increased cravings or feeling out of control with food. Calorie restriction can also interfere with sleep, so it’s important to focus on an overall balanced diet to improve sleep and manage weight concerns. [6]

What Can You Do About Weight Gain In Menopause?

What if weight was not a “problem” to fix or worry about? Sounds like a crazy idea - right? We totally get it. The desire to prevent weight gain or lose weight in menopause is palpable and unbearable at times. However, the obsessive thinking about menopausal weight gain increases anxiety and stress at a time when life is stressful enough. We wish we had an easy solution to help you feel better. However, there are a few things you can do to stay healthy:

• Movement & Physical Activity: All types of activity are important for women as they go through the menopause transition and beyond. Aerobic exercise, like brisk walking, jogging, bicycling, and swimming, and weight-bearing exercise, like push ups, jumping jacks, pilates, and strength training are all important for decreasing muscle loss, strengthening bone, and improving overall function and quality of life as we age. These types of activities may help manage weight as we age.
  • Aim for at least 150-200 minutes of moderate aerobic activity weekly, with strength training sessions twice a week. Participating in enjoyable movement, including lifting weights if that is something you are able to do, can also be an ally in helping you embrace feeling stronger as you age and may be helpful in making peace in your relationship with your body.
• Self-Care and Enjoyable Activities: Incorporating activities you love, such as gardening or yoga, can provide both exercise and relaxation, potentially improving sleep and making regular exercise more achievable.
• Make Healthy Food Choices: Menopause is an opportunity for women to reevaluate their food and eating patterns and potentially make adjustments to improve overall diet quality. Including more foods like fruits, vegetables, whole grains, legumes, nuts, soy, fish, and dairy are important in everyday meals and snacks.
• Monitor Sugar and Alcohol Consumption: If you over consume foods and beverages with added sugars, it may be beneficial to decrease your intake of these. Similarly, it's important to reduce or limit alcohol intake to less than one serving per day (a serving is the equivalent of 6 oz wine, 12 oz beer, or 1 oz spirits).
• Seek Support: Engage with a supportive community of friends and family, or join a group committed to healthy living. Sharing recipe ideas, attending cooking classes, and collaborating on exercise goals can enhance motivation and consistency.
• Prioritize Your Sleep: We recognize this can be tough during menopause when you’re experiencing symptoms like night sweats and hot flashes. Do your best to practice sleep hygiene for overall improved health and wellbeing.
• Address body image concerns: There are many reasons that women may be concerned about weight changes during menopause. Body image and body dissatisfaction is an issue for most middle-aged women. In a large survey of over 1800 women, with an average age of 59, almost three-fourths of the women were trying to lose weight and 80% of them said that their weight or body shape strongly impacted their self-perception. [7] Body image is a complex issue that resides in the mind, and despite feeling better with weight loss, most often this is temporary.

Moving toward a more positive relationship with your body is about internal acceptance and focusing on respectfully caring for the mind and body, such as consistently nourishing the body, engaging in enjoyable activities, and working toward self-acceptance. By focusing on these strategies, navigating menopause-related weight concerns can become more aligned with values related to promoting health and longevity.