Maybe in your 20s, you could have lived on pizza and donuts and still buttoned your jeans without a second thought. But these days, it can seem like you put on 5 pounds just by looking at a box of cookies.
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Whether you’re nearing menopause or long ago bid adieu to your menstrual cycle, you can blame hormones for a lot of changes — including those that lead to weight gain.
“Weight gain is common before menopause and can be even more challenging after menopause,” says women’s health specialist Lynn Pattimakiel, MD. “Every year we get older, our metabolism slows down. Then, around menopause, it’s common to see a significant drop in your metabolic rate, accompanied by weight gain.”
But your hormones don’t have to be in charge here, adds women’s health specialist Pelin Batur, MD. “Menopause can affect the hormones that regulate fat storage, among other things. It may take more effort to maintain your weight or return to a healthy weight for you, but it’s possible.”
Here, Dr. Pattimakiel and Dr. Batur, both certified menopause practitioners, share why menopause weight gain is so common and what you can do to manage your weight in a healthy way.
During perimenopause, your estrogen levels start to decline. That hormonal shift slows your metabolism. So, even if you eat the same (mostly) healthy diet you ate in your 30s, you’re still more likely to gain weight.
Let’s break that down a bit.
When you’ve gone 12 consecutive months without your menstrual cycle (period), you’ve hit menopause and enter a period of postmenopause. When you enter menopause will vary, but the average onset is age 51.
But the effects of menopause on your body — including mood swings, irregular periods, hot flashes and, yes, weight gain — can start years before. That’s called perimenopause. It’s also called the “menopause transition” stage, and it can last up to 10 years before you officially enter menopause.
Starting during your perimenopause years, a slower metabolism plus the loss of hormones are a double-whammy that can make it harder to maintain your weight.
“Menopause weight gain is a normal and expected result of the aging process,” Dr. Batur explains. “As we get older, our metabolism naturally slows down and we often lose muscle mass — all of which contributes to weight gain.”
Living with a chronic illness like diabetes can put you at higher risk for weight gain during menopause. The same goes for people with polycystic ovary syndrome or sleep apnea. And if you have health limitations that make exercise more difficult, that’s just one more obstacle to overcome.
What’s more is that other changes and symptoms of menopause can make weight gain more likely.
“Menopause symptoms can disturb your sleep, and sleep is essential to regulating our hormones, our mood and our physical health,” Dr. Batur adds.
Think about it: You’ve been up half the night tossing and turning, night-sweating and hot-flashing. You’re exhausted. Your stress hormones are raging. It only makes sense that it’s now that much harder to exercise and make healthy food choices.
It’s true that menopause weight tends to settle around your midsection.
But having excess weight in your midsection can put you at risk for serious health effects.
“Unfortunately, carrying excess weight in your belly increases the risk of heart-related problems,” Dr. Pattimakiel says. “So, it’s worth making some changes to keep your weight in the healthy zone as you get older.”
Some people choose hormone therapy for menopause symptoms, which helps treat moderate to severe hot flashes and night sweats, and which can improve sleep and overall quality of life. Women on hormone therapy tend to have a leaner body mass index, most likely due to improved energy, functioning and improvement of insulin resistance. But hormone therapy can come with other side effects, and it’s not the best choice for everyone.
Dr. Batur says that for most people, addressing menopause weight gain comes down to basics — a healthy diet and exercise.
“Being persistent is more important than working for quick results,” she continues. “With a slow, steady approach to diet and exercise, you can incorporate changes over the long haul as part of a healthier lifestyle.”
Eating a diet that’s healthy for you can help keep your weight in check. And some foods may help to lessen other symptoms of menopause, too.
Dr. Pattimakiel suggests cutting back on processed foods in favor of whole, natural foods and eating less added sugar (including sugar substitutes and artificial sweeteners). Build your meals around healthy calories, like lean proteins and veggies. And try to have your bigger meals earlier in the day, so you’ll have more time to burn calories before you hit the pillow.
“It can be harder to burn starchy carbs like bread, pasta and baked goods, so be mindful about cutting back or avoiding them,” she advises.
Beverages, too, are often a source of sneaky calories. To cut back, reach for sparkling water in place of wine or soda. Add a splash of milk to brewed coffee instead of ordering a latte.
One way to keep yourself accountable to a healthy diet is to keep a food journal. You may be eating a lot more calories than you realize. Keeping a record of everything you eat can help you to avoid mindless snacking and be more conscious of what you’re eating and when.
Managing your weight is a matter of balancing what you eat with plenty of physical activity. No matter your age, a healthy diet and exercise are the pillars of keeping your body healthy and your weight in a healthy range.
How much exercise you need depends on a lot of factors, like your weight loss goals and any health conditions you’re living with. A general rule of thumb is to aim for 150 minutes of exercise each week. And include a variety of different exercise methods to keep your full body moving and grooving.
Dr. Batur says to aim for a combination of exercises throughout the week, including:
If you’ve made healthy lifestyle changes and the scale isn’t budging, there may be other factors at play. Talking to a healthcare provider, like a doctor or registered dietitian, can help you identify any obstacles that are holding you back from maintaining a healthy weight. And find solutions that work for you.
“You can’t avoid your metabolism slowing down. But that’s rarely the only factor contributing to weight gain,” Dr. Pattimakiel states. “There may be other reasons for weight gain, such as thyroid problems, medication side effects or depression, so you’ll want to rule out other causes.”
Maybe recurring knee pain is interfering with your exercise plans. Or your busy caregiving schedule doesn’t leave much energy for planning and cooking healthy meals. By identifying the hurdles to a healthier lifestyle, you and your healthcare team can find ways to sidestep them.
“It’s easy for life to get in the way sometimes, so you have to figure out what works for you,” Dr. Pattimakiel encourages. “Weight gain after menopause can feel inevitable, but it doesn’t have to be.”