When you reach your forties and fifties you know who you are, mature, experienced, happy in your own skin but you still need to put the effort into staying healthy. Obesity and overweight is a serious concern for women over 40 because with excess weight gain there is a greater risk of chronic health conditions.
The North American menopause society states there is no scientific evidence that menopause or hormone therapy is responsible for midlife weight gain. According to the Swan study though, the average woman with gain 10kg during the menopause transition (perimenopause and menopause)
So menopause doesn't cause weight gain but women are gaining weight. So what's going on? In this article we'll look at the causes behind weight gain in women over 40 and how to lose weight and increase your health if you fall into the overweight category.
How common is weight gain during menopause?
According to the House of Commons research briefing, in 2021, 70% of people aged 45-74 were more likely to be overweight or obese than other age groups. In England, although men are more likely to have a body mass index measurement above normal than women there are still 58% of women who fall into the overweight or obese category.
Obese is when you have a body mass index of 30 or higher.
Why do women gain weight during menopause?
The North American Menopause Society states age and lifestyle ie diet and exercise levels are the main factors which contribute to weight gain during menopause as does the NHS. Hormonal fluctuations and hormonal changes cause common symptoms like hot flashes, mood swings, sleep disruption, anxiety and brain fog. These symptoms can disrupt a woman's life, changing her behaviour, personality and daily routines.
Women in the menopausal transition, struggling with symptoms can quickly fall into more sedentary behavior and a less healthy diet which puts them at an increased risk of gaining weight. Other factors contribute to this. Muscle mass, weight and fat distribution changes naturally as women age which can lead to menopausal weight gain.
When does menopause weight gain start?
After the age of 40, which includes perimenopausal, menopausal and postmenopausal women, women lose muscle mass at around 8% per decade. Muscle mass burns more energy than fat, helping us to lose weight when we are at rest. Less muscle means a higher body mass index, slower weight loss and more weight gain.
Fluctuating and falling hormone levels around menopause changes the way women store fat. Fat storage changes from the hips and thighs to around the midsection. Insulin resistance is also common - which makes body store, rather than burn calories.
Why you need to take menopause weight gain seriously
It goes without saying you're gorgeously unique whatever size you are, however there are some stark FAQ based on hard data you need to be aware of. Menopause and weight gain or living with obesity in menopause increases health risks of diabetes, heart and circulatory diseases which include heart attacks, strokes and even vascular dementia.
Coronary Heart Disease
Coronary heart disease, the main cause of heart attacks, kills more women as breast cancer in the UK every year. There are more than 800,000 women in the UK living with coronary heart disease and 50% of them have survived a heart attack.
Before menopause, oestrogen helps to protect the heart from cardiovascular disease by managing cholesterol levels and keeping the arteries free from fatty plaque which can block them. Having high blood pressure, high cholesterol, diabetes, weight gain and not doing enough exercise all increase your risk. The British Heart Foundation also lists menopause as a risk factor for CHD. Aerobic exercises help to keep the heart healthy.
Type 2 Diabetes
Diabetes is a condition where blood sugar levels are too high. Diabetes.org lists the menopause symptom of carrying more weight around the middle as contributing to the risk of diabetes.
Research has shown that this fat - visceral fat, sometimes referred to as ‘active fat’ can affect how hormones function. High amounts of visceral fat is connected to health issues such as type 2 diabetes.
During perimenopause some women can experience rapid changes in blood sugar and in menopause, as oestrogen levels fall, insulin resistance is common, which means there is more sugar in the blood because the body can't turn the sugar into energy and it stays in the bloodstream.
Metabolic syndrome is a medical term for diabetes, high blood pressure (hypertension) and obesity. This combination puts you at greater risk of getting coronary heart disease, a stroke and conditions that affect the blood vessels.
High stress levels can make you gain weight
Midlife for women can be quite stressful balancing careers, family and relationships. During menopause the adrenal glands act as the oestrogen Plan B - releasing small amounts. When stress levels are high, the adrenal glands release stress hormones adrenaline and cortisol - oestrogen production is put on the back burner.
When the adrenal glands stop producing oestrogen - the body increases belly fat to access oestogen via the fat cells. Weight loss is very hard when stress hormones are at play.
Why not sleeping can mean weight gain
Disrupted sleep is a very common menopausal symptom - around 50% of women experience it. Hot flushes, night sweats, anxiety and nocturia can all interrupt a good nights slumber. Sleep is crucial for overall health, helping the body and the brain to relax and recover.
Sleep plays a part in weight management by helping to control blood sugar. Hunger hormones can be affected by not enough sleep. Ghrelin is higher in sleep deprived individuals. An increase in appetite can lead to extra weight and more fat and make weight loss harder.
What's the best way to prevent menopause weight gain?
The best way to prevent menopause weight gain is to keep active, follow a healthy diet 80% of the time ( you're only human) and to understand the relationship between calories consumed and calories expended. The NHS recommended the calorie intake for a physically active woman in menopause is 1800 calories and she should be physically active every day.
What do we mean by physically active?
The minimum activity goal is to do at least do at least 150 minutes of moderate intensity physical activity a week or 75 minutes of vigorous intensity activity a week.
The recommendation also advises adults to reduce the time spent sitting or lying down and avoid long periods of not moving.
Does hormone therapy cause weight gain?
There is little evidence that menopause hormone therapy causes excess weight or belly fat. Most women in menopause will gain a little weight due to age and a change in body composition. This can be managed with diet and exercise.Hormone replacement therapy will help to manage symptoms which in turn will help keep you active, motivated and more energetic.
How do you know if you need to lose weight?
You'll have an idea you need to lose weight without using a tape measure or a BMI calculator. Clothes will become tighter, your fitness levels will start to suffer. But losing weight needs to start with a baseline and a healthy weight goal.
You can plan to lose weight by increasing activity and consuming fewer calories. NICE guidelines recommend using both waist measurement and BMI to maintain a healthy weight.
The recent NICE guidelines advise to keep central adiposity ( the body fat level around the middle) in a healthy range a persons waist measurement should be less than half their height. This has been introduced because it's an easier 'rule of thumb' for people.
Body mass index
Body mass index should also be used to measure body weight and height to work out if your weight it healthy. You can check your BMI here now.
3 weight loss tactics for losing menopause weight
Each woman's experience of menopause and why they gain weight can be different. Fluctuating hormones ( perimenopause) or steadily decreasing hormones ( menopause and post menopause) and the symptoms that creates can make weight loss challenging. The tricks you used when you were younger wont work anymore. You may have to experiment and change things up to reach a healthier weight.
Adopt a Mediterranean Diet
Rich in plant foods like wholegrains, fruit, vegetables, pulses and lentils, moderate in protein and low in processed foods. Plants are naturally lower in calories and high in fibre which can help you to stop overeating.
Try using meal replacement shakes
Meal replacement shakes from responsible manufacturers like Eve Biology are safe, cost effective, deliver quality nutrition and comply with applicable legislation. Meal replacement shakes have a proven track record of helping people lose excess weight and maintain weight loss long term.
Restrict your eating times - Intermittent Fasting ( IF)
IF refers to an eating plan which switches between abstaining from food and eating within a timed eating window eg the 16:8 means you fast for 16 hours per day and eat within an eight-hour window. People tend to eat less calories. The theory is that the body switches to burning its fat stores for energy when you haven't eaten for a while.
Minimize Weight Gain and Other Menopausal Symptoms
As well as adapting a healthy diet and regular daily exercise there are other lifestyle changes which can help to minimise weight gain and other menopausal symptoms.
Stop eating late - There is some evidence that eating late can increase appetite, decrease how fast your body uses energy when you’re awake and increase fat storage.
Get enough sleep - tiredness is linked to overeating and poor food choices. The last thing you need when you're a menopausal woman is caffeine. Caffeine can make symptoms like hot flashes and anxiety much worse.
Learn how to manage stress levels - as oestrogen levels drop your ability to keep cool and calm headed can be affected. That paired with balancing a career, a family and taking care of ageing parents is a perfect storm. Stress increases cortisol and cortisol can increase fat storage. Walking is a brilliant tactic for improving your mood, clearing the head and exercising the body.
The bottom line
The menopausal transition and symptoms can be challenging. Energy levels can fall and many women drop regular exercise and succumb to a more sedentary lifestyle. Watching your weight really isn't about vanity. Menopause weight gain can increase serious health risks like high blood pressure, diabetes and heart disease. Lifestyle changes which include a healthy diet, strength training and regular aerobic exercise can all help you reach a healthy weight and decrease your health risks