Weight Gain and Menopause: What’s Going on With My Body?

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Many changes occur as we enter the midlife years. One of the most distressing for many women is the tendency to gain weight.

My Habits Haven’t Changed, Yet the Weight is Creeping Up

It’s important to know that you are NOT alone! According to the Healthy Women Study, the average weight gain during the perimenopausal years was around five pounds. However, 20% of women during those years reported gaining 10 pounds or more! And on average, women tend to gain 1.5 pounds per year during their 50s and 60s. In the US, almost two-thirds of women 60 years and older are overweight.

So, why do the pounds pack on?

Top 4 Causes of Weight Gain During Menopause

1. Your Body Changes with Age: Data from the National Health and Nutrition Examination Survey (NHANES) found that 68.1% of women between the ages of 40 and 59 were classified as “overweight” or “affected by obesity.” As we age, we naturally start to:

  • Lose lean muscle mass
  • Increase fat storage
  • Decrease our resting metabolic rate (reducing the number of calories we burn at rest)
  • Reduce our physical activity, further decreasing lean muscle mass

If you don’t lower your calorie count with a slower metabolism, you are going to gain weight. Eating healthy foods, watching your sugar intake, and exercising are critical during your midlife to maintain a healthy weight.

2. Hormonal Changes: During the premenopausal years, estrogen encourages fat deposits to accumulate in our lower body, mainly the thighs, hips, and buttocks (as well as our breasts). In the postmenopausal years, when your ovaries stop producing estrogen, fat is stored all over the body, especially around your midsection.

Not only does the location of fat storage on your body change, but the location of fat storage within your body is different, too. Premenstrual estrogen encourages more subcutaneous fat accumulation, just below your skin. Postmenopausal low estrogen increases visceral fat—fat deposits located deeper around your organs. Visceral fat increases by 44% during menopause which can cause serious health consequences:

  • Hyperlipidemia
  • High blood pressure
  • Insulin insensitivity
  • Heart disease
  • Diabetes

If that isn’t enough, when we carry excess fat, testosterone is converted to estrogen in our fat tissue. But this fat-derived estrogen does not have the same health-protective benefits as premenopausal estrogen. Instead, it increases fat in our hips, bottom, and thighs! Ugh! 

3. Stress: Stress is rampant in our culture. It affects your entire body. Unfortunately, your resilience to tolerate stress reduces as you age and go through menopause. Stress can cause a spike in your cortisol level and continual high cortisol can cause abdominal weight gain among other negative health consequences.

4. Sleep Disturbances: In my practice, midlife is a very common time for women to report sleep disturbances. Not only does the drop in estrogen cause sleep-disrupting night sweats, lower estrogen and progesterone in general can negatively impact your quality of sleep. This is also a common time for mood swings, which can impact sleep. Mood changes and fatigue from lack of sleep can affect lifestyle habits and contribute to weight gain.

Obstructive sleep apnea also becomes more common as we age, particularly if you’re holding a little extra weight. Good sleep is critical, especially during this stage of your life. In a study of more than 68,000 women, those who slept 5 hours or less gained more weight than those who slept more than 7 hours a night.

I know this can be a very frustrating time, but fortunately, there are things you can do to help prevent weight gain during menopause.


Dr. Briana Sinatra

Meet Dr. Briana Sinatra

Dr. Briana Sinatra is a board-certified naturopathic doctor with a vibrant practice in the Pacific Northwest. There she focuses on women’s and family health, taking a holistic approach to healthcare by empowering women with the knowledge and tools they need to live their best life now and protect their future wellness by looking at how all the systems in the body work together and how diet, lifestyle, and environment all influence health.

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