Understanding Weight Gain During Menopause

Perimenopause and menopause bring a number of physical effects–some of which are widely known and others less part of the dialogue. Knowing more about the ‘why’ of the physical effects can help support a person if they begin to notice any changes. Any weight changes are important to talk about with a healthcare professional to advise on any treatments or mitigation strategies. Combined with the physical implications of weight management, there is also a need to make sure that a person’s mental health is also supported and an overall holistic and individualised approach to weight management.

The British Menopause Society reports that women gain about 1.5 kg a year in their 50s and the leading cause of this is menopause. The weight gained during menopause, particularly abdominal fat, is not just a cosmetic concern. It’s associated with increased risks of various health issues like; cardiovascular disease, type 2 diabetes, stroke and mental health conditions

Causes of Weight Fluctuation in Menopause

Hormones

Hormones play a key role in fat distribution around the body; a person’s sex at birth can indicate where fat is collected and stored. As a person in perimenopause or menopause will experience a decrease in oestrogen production which leads to a change in weight distribution. This means that while previously a person who saw weight gain in their hips and thighs, may now begin to see weight being stored around the abdomen. While there is a hormonal cause there are other factors that can lead to weight gain during perimenopause and menopause.

Sleep

There are other extenuating circumstances for weight gain and loss during menopause. Any lifestyle change can be stressful and combined with a lack of sleep, there is an increased risk of a sedentary lifestyle which also contributes to weight gain. Prioritising quality sleep by establishing a consistent bedtime routine and limiting screen time before bed can help regulate hormones and reduce stress-related weight gain. Additionally, seeking support from friends and loved ones is essential for comfort, motivation needed when making healthy sleep habits as part of a daily routine.

Microbiome

Another indicator of weight management that isn’t always obvious is a person’s microbiome. The microbiome is the entire sum of microbes, bacteria, fungi, and viruses that naturally live on our bodies and inside us. The North American Menopause Society reported that the decline in oestrogen production before and during menopause directly affects the microbiome. The microbiome, among many other things, can regulate the body’s metabolism meaning that a person may experience more weight gain than in other times of their life.

Weight Management Strategies

Medical

Everyone experiencing weight fluctuations at any point in their life should speak with a healthcare professional. There are medications that doctors can prescribe to help with weight management. These can include drugs that target weight management in general or specifically for people in menopause. GLP-1 drugs like Ozempic and Wegovy have shown promise in managing menopausal weight gain. In Ireland, these medications are currently mostly used to ease insulin resistance and potentially reduce the risk of type 2 diabetes and cardiovascular disease. However, they’re not suitable for everyone, and long-term use may be necessary to maintain benefits. Other treatments specifically for menopause are treatments such as hormone replacement therapy which has been shown to help reduce weight gain during menopause but this also depends on other indicators.

Lifestyle

Along with medical therapies, a person should consider other lifestyle factors that affect weight management. No two people are alike in their physical body and in their menopause journey and that means there is no single remedy. Alongside a well-balanced diet, physical activity, and a regular sleep routine, an emotional support system is also crucial. Family and friends can provide support and there are many menopause groups for people to share their experiences. Weight management can be very triggering for people at any time of life; with the addition of menopause symptoms this can be even more pronounced. Approaching these changes with the knowledge of why it’s happening, strategies to deal with them, medical and emotional support will provide a greater sense of empowerment for a healthy daily life.