Making Sense of Menopause Weight Gain

The topic of weight gain during menopause is a cause of concern for many and is often raised by patients in the doctor's office. However, it may come as a surprise to learn that the average increase is only 2–5 pounds during this life stage? While this might seem like a relatively small number, the impact of any weight gain can be substantial for some people. And it’s quite common — around 36% of females ages 40 to 65 say they’ve gained weight during the menopausal transition.* 

Your body may not look and feel the same as it did 25 years ago, but that’s okay. After all, you’ve lived a lot of life, and your body has done a lot for you. The changes you’re experiencing, and the weight shift you may be going through, are part of the overall menopause experience for many. So, now is a good time to understand why you may be gaining weight, accept that it’s happening, and learn what you can do to manage weight gain and feel your best.

What happens in the body that leads to weight gain during menopause?

Muscle mass wanes and metabolism slows down

Weight gain is a complex issue. Genetics, medical conditions, sleep, stress, mental health, and prescription medications are just a few factors that can impact how and when you gain weight. Hormones are one piece of a much larger puzzle.

As estrogen levels change and testosterone levels gradually go down, the number and size of muscle fibers in your body naturally decreases. This can cause you to lose muscle mass. Less muscle mass can lead to a slower metabolism. This means that your body burns fewer calories at rest, and the calories that aren’t burned get stored as fat. So, if you’re eating the same number of calories that you’ve always been eating, you may be more likely to gain weight.

Fat is redistributed around your belly

With menopause comes a change in where the fat on your body is located. Decreasing estrogen levels, along with the decline in muscle mass, forces visceral fat, or the fat that lives deep inside of the abdomen and surrounds the liver, kidneys, stomach, and intestines, to accumulate in the abdominal area, leading to the infamous "menopause belly”. Not only is this a cosmetic concern, but this visceral fat can increase the risk of cardiovascular disease and diabetes. Keep reading to learn more about this.

What other factors contribute to weight gain during menopause?

While diet does play a role, many other health choices can affect your weight during menopause.

Less physical activity

It may seem obvious, but research has, in fact, shown that the less active you are, the more likely you are to gain weight, especially as you age. Getting regular exercise can help you lose weight or keep it off. Moderate aerobic activity for at least 150 minutes each week and strength training for about 30 minutes twice a week are good goals to aim for. Talk to your healthcare provider before starting any new exercise routine.

Stress

Menopause can be a stressful time of life because of the physical symptoms, emotional changes, and additional everyday life stressors. For some people, increased stress levels can sometimes lead to emotional eating (often on things high in added sugar and simple carbohydrates). Our bodies metabolize those types of foods differently and because they aren't very nutrient-dense, we’re often still hungry and eat more. This vicious cycle can often result in weight gain.

Poor sleep

There’s a link between poor sleep and weight gain. When you don’t get a healthy amount of sleep, your body has trouble regulating the hormone leptin, whose role is to tell the body when you feel full. Instead, the body produces a hormone called gherlin, which increases appetite and causes food cravings. During menopause, metabolism slows down. This is because muscle mass decreases and fewer calories are burned. As a result, weight gain can occur.

In addition, research has shown that when your sleep schedule includes late bedtimes, you’re more likely to eat or snack later in the evening. Some studies suggest eating late at night may cause weight gain, but more research is needed to confirm this connection. There's evidence to suggest, however, that staying up later leads to a lack of physical activity.

Medications

Sometimes healthcare providers prescribe antidepressants to help manage both the emotional and physical symptoms of menopause. There’s some evidence that some antidepressants can cause unwanted weight gain. In addition, some beta-blockers used to treat high blood pressure and some prescription sleep medication may also cause weight gain. It's essential to discuss these concerns with your healthcare provider, who may be able to adjust your medication, as necessary or recommend alternatives.

What are some of the health risks of menopause weight gain?

While the number on the scale is a tangible measure of weight gain, it’s not the only concern when thinking about your overall health. Considering some of the health risks associated with menopause weight gain is an important step before taking action and working to manage your weight. If you have any concerns about your weight and the risks associated, make sure you talk about them with your healthcare provider.

Chronic disease

Excess weight during menopause can increase the risk of chronic diseases like heart disease, type 2 diabetes, and high blood pressure. Visceral fat is a significant risk factor for these conditions. This type of belly fat lives deep inside of the abdomen and surrounds the liver, kidneys, stomach, and intestines. It makes more of certain proteins that can inflame these organs, as well as your body’s tissues. It can also narrow your blood vessels, which can make you more susceptible to health concerns.

The Centers for Disease Control and Prevention (CDC) recommends one way of determining your risk of disease is to measure your waist circumference. To do so, place a tape measure just above your hip bone and wrap it around your body. Breath out, then check the measurement. A number higher than 35 inches for females and 40 inches for males may indicate a higher risk.

Emotional well-being

Weight gain can have a substantial impact on a woman's self-esteem and body image. It can make some people feel sad, depressed, and anxious. In addition, menopause can cause increased amount of stress in life. And food is sometimes used to manage these emotions, making it harder to focus on weight management and an overall healthy diet. It's important to address these emotional aspects of weight gain and seek support if needed.

What can I do to manage weight gain during menopause?

Managing menopause weight gain goes beyond simply focusing on the numbers on the scale. It involves adopting a holistic approach to overall health and well-being. Keep in mind that living a healthy lifestyle is a marathon, not a sprint. Some days will go better than others, and that’s okay. Start small, set goals, and get support from others if you need it.

• Maintain a balanced diet. As much as possible, focus on a meal plan that prioritizes fruits, vegetables, lean proteins, and whole grains. Try to include 25g of fiber each day. For some context, a ½ cup of cooked pinto beans has 7.7g of fiber and 1 cup of raspberries has 8g of fiber. Minimize processed foods and sugary drinks. Consider working with a registered dietitian to get personalized dietary and nutrition advice.
• Stay physically active. Remember that regular physical activity is essential for managing weight and staying healthy. Aim for at least 150 minutes of moderate aerobic exercise, 30 minutes of strength training at least 2 days each week, and flexibility exercises. Pro tip — find activities you enjoy so that you can make exercise a regular part of your routine.
• Manage stress. Practicing stress-reduction techniques such as meditation, deep breathing exercises, or yoga can help manage stress. Consider other activities that help you feel relaxed and keep those in mind if you need to find some peace.
• Prioritize sleep. Know the power of sleep. It’s hard but try your best to establish a consistent sleep schedule and create a comfortable sleep environment to improve your overall sleep quality. Talk to your healthcare provider if you need help getting a good night’s sleep.
• Embrace a positive body image. Most importantly, keep in mind that your weight is just a number on a scale. Remember that your worth isn't determined by your weight or appearance. It’s not the easiest thing to do, but one thing you can do to start to improve your body confidence is think about all that your body does for you daily. Doing so can start you on a path towards self-acceptance.
• Filter out negative media. Some social media can have a negative effect on how we view ourselves and our bodies. Be mindful of what social media you’re engaging with and pay attention to how it affects you. If you find yourself feeling down after scrolling, take a break.
• Connect with your support system. Surround yourself with supportive friends and family who appreciate you for who you are. Look to them for support when your menopause symptoms have you feeling down, and you need some encouragement.
• Talk to a healthcare provider. If you're struggling with weight gain during menopause, consider talking with a healthcare provider. They can work with you to better understand your situation and provide personalized advice.

Menopause weight gain is a common concern for many people going through menopause. Understanding why it’s happening, and more importantly, what you can do about it can help empower you to move through this life stage with self-love, grace, and good health.

*Data from Attitudes & Usage study conducted in August 2021 with 4,578 female participants ages 40-65. Funded by Kenvue.