Menopausal Weight Gain: It's Not All Bad!

One of the most common complaints I hear from menopausal clients is about weight gain. According to the British Menopause Society, this affects more than 50% of individuals, with an average weight gain of as much as 10kg by the time menopause is reached.

Weight gain can be concerning for several reasons: physical discomfort, altered body image and self-esteem, the need to buy new clothes, and an increased risk of diabetes and cardiovascular disease, to name just a few.

However, menopausal weight gain is a natural phenomenon and isn’t necessarily all bad. This article explains why and what can be done to prevent unhealthy weight gain during menopause.

Menopausal Weight Gain: Why It’s Not All Bad

There are several reasons why weight gain during the menopausal transition is not necessarily a bad thing.

Firstly, following menopause, our main source of oestrogen switches from oestradiol, which is made by the ovaries, to oestrone, which is made in adipose (fatty) tissue. Therefore, having a certain amount of body fat at this time ensures continued oestrogen production.

Although oestrone is not as biologically active as oestradiol, having higher levels of this hormone correlates to certain health benefits, including increased bone mineral density. This aligns with research suggesting that having a higher body weight post-menopause is associated with a decreased risk of osteoporosis.

Furthermore, having a lower body weight is often associated with malnutrition in elderly individuals and increases the risk of frailty. Meanwhile, older people classified as overweight tend to live longer than those who are underweight.

Of course, this is not to say that we should intentionally pile on the pounds, as being overweight comes with its own set of challenges and health risks. However, it does demonstrate that menopausal weight gain is a natural process and not necessarily always a harmful one.

What Causes Weight Gain During Menopause?

Whether we lose, gain, or maintain a constant body weight actually comes down to relatively simple mathematics.

If we consume the same amount of energy that we expend each day, we will maintain our current weight. If we consume less energy than we expend, we will lose weight, and if we consume more energy than we expend, we will gain weight.

Energy is measured in kilocalories (kcal) or kilojoules (KJ), and we use energy both when we perform physical activity and at rest.

The amount of energy we use at rest, to perform physiological functions like breathing and digestion, is known as our basal metabolic rate (BMR), and it makes up a large proportion of our energy expenditure each day.

BMR is affected by sex, age, body size, and body composition. Younger people with larger bodies and more muscle mass have higher BMRs, and older people with smaller bodies and less muscle mass have lower BMRs. Typically, men have higher BMRs than women, as they tend to be larger and have more muscle mass.

As we age and transition through menopause, we usually lose muscle mass, which in turn reduces our BMRs. Therefore, if we continue to consume the same amount of energy and do the same amount of exercise as before, we are likely to gain weight at this time.

Moreover, many of us become less active during the menopausal transition, whether it be due to physical symptoms or emotional stress. This means even lower energy expenditure and an even greater chance of weight gain.

The Importance of Protein

Another potential contributor to menopausal weight gain is insufficient protein intake. As we age, our protein stores begin to break down, and our ability to synthesise protein reduces. Therefore, we need to include more protein in our diets.

An increased need for dietary protein can increase our appetites, but failing to eat enough protein-rich foods can cause us to consume a surplus of energy from carbohydrates and fats.

It is estimated that, during the menopausal transition, around 20% of our total energy intake should come from protein. This can be achieved by making a small increase from the general recommendation of 1g per kilo of body weight per day to 1.2g per kilo per day. This equates to a person weighing 70kg (approximately 11 stone) eating 84g of protein per day.

By eating more protein, our appetite for carbohydrates and fats should naturally reduce. However, it is important to keep consuming these food groups as each has its own essential roles in maintaining health. Choosing complex carbohydrates, such as whole grains, sweet potatoes, and root vegetables, and healthy sources of fat like nuts, seeds, olive oil, and oily fish is key.

How to Stop Menopausal Weight Gain

As the above sections suggest, increasing protein consumption, while limiting energy intake, is fundamental to avoiding menopausal weight gain. However, it is essential not to sacrifice nutrition while doing this, so be sure to continue eating healthy carbs and fats as well as plenty of fruit and vegetables.

Some simple ways to cut calories while maintaining nutritional intake include reducing portion sizes, planning nourishing snacks rather than unconsciously grazing between meals, and limiting our intake of alcohol and refined sugars, which just provide “empty calories.”

Extreme diets are not recommended as they are often lacking in nutrition and unsustainable in the long run, meaning any weight lost will usually quickly be regained after stopping the diet. Making small, easy-to-manage changes is far more effective overall.

It is also crucial to engage in regular physical activity to increase energy expenditure. One of the best forms of exercise for burning calories is aerobic exercise.

Sometimes also known as “cardio,” this form of exercise increases heart rate and is one of the best forms of exercise for managing body weight. High-intensity interval training (HIIT) is considered one of the most effective types.

Strength and resistance training are also key, and the British Menopause Society describes them as “non-negotiable” for menopausal individuals wanting to lose weight.

Strength and resistance training build muscle, which helps counter weight gain by increasing BMR and, therefore, the amount of energy we use at rest. Strength training also helps us to stay mobile and independent post-menopause by reducing frailty and the risk of falls.

Just keep in mind that gaining muscle will not necessarily lead to weight loss (muscle is much denser than fat), so use body shape as an indicator that it’s helping rather than relying on the scales.

Menopausal Weight Gain: Chinese Medicine Perspective

From a Chinese medicine perspective, ageing is often associated with a reduction in yang qi and, consequently, a slowing of digestion and metabolism. We can counter this by engaging in regular, moderate activity, staying sexually active, and eating plenty of yang-nourishing foods.

We should also practise good eating habits, such as keeping regular mealtimes, eating slowly and mindfully, and not overeating or eating late at night. This helps to support the Stomach and Spleen in their functions of transforming food essences and promoting healthy digestion.

While we may not be able to avoid menopausal weight gain completely, and perhaps we shouldn’t, we can take steps to reduce its impact and maintain our health and wellbeing throughout the transition and beyond.

For more on how to manage menopause naturally, check out my Embracing Menopause online course.