This is a question I get frequently, so let’s review data. A lot of the data comes from the SWAN study. The Study of Women’s health Across the Nation (SWAN) was an observational study of the menopausal transition. Let’s review the study of over 3k women aged 42-52 who were followed from 1996-2000.
Several sub analyses of the data from this study supported that age and lifestyle changes were the main contributors to weight gain (mean 2.1 kg) and increase in waist circumference (mean 2.2 cm). They found that with age, fat mass increases and lean mass decreases. But the actual weight gain was not related to the timing of the menopausal transition, rather it was related to increase in age and decrease in physical activity levels. One study demonstrated that an increase in physical activity could effectively prevent the weight and waist circumference gains.
We do however think that the menopausal transition changes body composition and fat distribution. Perimenopause has been found to be associated with increase fat around the abdomen and decrease in lean mass (a transition to an apple from a pear shape).
A more recent study by Greendale et al published in the Journal of Clinical Investigation Insight supports this. It was another analysis of the SWAN data. It concluded that the start of the menopausal transition was correlated with a significantly accelerated gain in fat mass and loss of lean mass compared to before and after the transition. However, there was no noticeable weight change at the start of the menopausal transition. The rate of increase of weight gain remained stable through the perimenopausal and menopausal time periods.
Can HRT help?
There is mixed data about whether HRT can prevent this increase in fat distribution around the waist or weight gain in menopause. However, we know from the data that HRT does not worsen weight gain. So basically, we can blame age for the weight gain and peri-menopause for where the weight is gained. If you don’t know, Hormone Replacement Therapy (HRT) treats symptoms of hormonal imbalances or deficiencies during menopause. HRT restores hormone levels by administering hormones like estrogen and progesterone, reducing symptoms like hot flashes, mood swings, and bone loss. You can tailor HRT to individual needs, and it comes in various forms, including pills, patches, and creams. Only use it under medical supervision due to potential risks and side effects.
What to do about weight gain in menopause
Managing weight gain in menopause involves a combination of healthy lifestyle habits.
- Focus on a balanced diet rich in whole foods like fruits, vegetables, lean proteins, and whole grains.
- Reduce processed foods and sugars.
- Reduce your alcohol intake.
- Aim for a mix of cardio, strength training, and flexibility exercises. Don’t underestimate the power of walking.
- Manage stress through mindfulness or yoga (stress can lead to weight gain!).
- Get good sleep (poor sleep can affect metabolism and hunger hormones).
Source: NAMS, SWAN data
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