Menopause

Menopause and weight gain: What you need to know

As we age, we may notice it's harder to maintain our weight or even experience unwanted weight gain, despite no major differences in our eating or lifestyle habits. For women, these changes tend to start during menopause (typically in your 40s or 50s). While menopause is a natural change that happens to all women, this increase in weight can be frustrating. The good news is, while you can’t avoid menopause, there are things you can do to mitigate the symptoms, including unwanted weight gain. We’ll explore when and why these changes happen, potential health risks, and ways you can take action to minimise weight gain and improve your metabolic health during this life stage. When does weight gain start during menopause?  While menopause is defined as the point in time 12 months after a women’s last period, (1) the hormonal changes and associated symptoms start to take place well before. Perimenopause, the transition stage when your ovaries gradually stop working before full-on menopause, typically starts with the onset of menstrual irregularities. Women typically reach perimenopause in their mid to late 40s, (2,3) and this is often when women start to notice weight changes. While these shifts do stabilise with time, perimenopause lasts on average about seven years, but can be up to 14 years for some women. (4) Why am I gaining weight during menopause?   While weight gain during this time is most often correlated with overall ageing versus menopause per se, one of the predominant features of the menopause transition is a change in overall body composition. A decrease in oestrogen often causes increased fat mass and redistribution of fat to the abdomen. (3) Additionally, changes to the gut microbiome and metabolism (especially glucose metabolism) and lifestyle factors such as exercising less, poor sleep quality, and social factors may also contribute to weight gain at this stage in life. (5) Research confirms that post-menopausal females consume more sugar, report poorer sleep overall, and tend to be more sedentary, all of which can be attributed to the decline in oestrogen and can play a significant role in weight gain during this time. (6) The hormonal shift and accompanying loss of lean mass and redistribution of fat to the abdomen can disrupt metabolism, further exacerbating the other causes of weight gain that are observed. More abdominal fat has been associated with increases in cholesterol and triglycerides as well as disruptions in carbohydrate metabolism, (6) meaning our body has a harder time maintaining steady glucose, especially when eating foods rich in carbohydrates. This is due to increased insulin resistance and hyperinsulinemia (higher-than-normal levels of insulin in the blood), which we will discuss in more detail below. Studies have also shown that contrary to common opinion, hormone replacement therapy (HRT) has not been shown to cause weight gain and in some women may help reduce the accumulation of abdominal fat that occurs when oestrogen starts to decline. (3) The use of HRT has been shown to mediate some of the side effects of lower oestrogen, including less visceral fat and reduced blood biomarkers such as fasting blood sugar, insulin, and inflammation. (6) Every woman is unique, and you should discuss the pros and cons of HRT with your doctor. Are there any health risks associated with weight gain during menopause?  Weight gain and changes to overall body composition can have a significant impact on metabolism. Disruptions in lipid and carbohydrate metabolism increase risk of cardiovascular disease and type 2 diabetes, most likely related to hyperinsulinemia, insulin resistance, and visceral obesity. (6) This means that the way our bodies process the food we eat changes, which can have an impact on our weight and body composition. Emerging research highlights the value of monitoring these risk factors throughout the menopause transition. CGM data has unveiled that post-menopausal females had significantly higher fasting blood glucose, hemoglobin A1c (HbA1c), and markers of inflammation as well as higher overall sugar intakes, and poorer sleep compared with pre-menopausal females. Also, post-meal spikes, glucose variability, and time in range were worse post-menopause vs pre-menopause. (6)    How can I minimise weight gain during menopause?  The good news is, while you may not be able to stop menopause from happening, there are many lifestyle interventions that you can utilise to minimise the weight gain during this phase of life, including: Nutrition Adjusting your nutrition can have a positive impact on overall weight and body composition. One of the most important things you can do heading into menopause is to prioritise protein, which is one of Lingo’s Fundamentals. Not only is it harder for our bodies to properly metabolise carbohydrates as we get older, but we also need more protein to stimulate muscle growth, (7) which is a key component of regulating the body composition changes that occur during menopause and maintaining healthy muscle as we age. Additionally, eating more protein can help to keep you full after meals. This means you’re less likely to crave carbs, sugar, and calorie-rich foods that make weight management harder. Aim for at least 1.5 g of protein per kilogram of ideal body weight. If your goal weight is 68 kg (about 150 lbs), that means at least 102 g of protein per day. Try to get at least 30 g per meal to maximise muscle maintenance and growth. Here’s what 30 g protein looks like: 113 g cooked chicken breast 3-egg omelet with a couple slices of Canadian bacon 270 g cottage cheese 160 g cooked firm tofu Another nutrition staple is to eat more non-starchy veggies, especially leafy greens. This is in line with another Lingo Fundamental: go with green. Research shows a more favourable microbiome profile may help reduce inflammation and visceral fat as well as fasting and postprandial glucose, which can also help mitigate weight gain and body composition changes during this time. (6) Incorporate a vegetable at every meal, whether it’s a salad, roasted veggies, mixed into a dish, or eaten raw. Including more plants in your diet overall is a great way to improve your microbiome. Fibre is also important. In addition to veggies, beans, legumes, and whole grains all contain healthy fibre. These fibre-rich options help blunt the rise in glucose from carbs and high fibre foods tend to be more filling for fewer calories. Choose these options over highly processed foods or simple carbohydrates like sugary treats and pretzels. Exercise While we all know that exercise can be a good strategy for weight management, strength training in particular during the menopause transition is extra beneficial. Not only does this type of exercise help maintain and build muscle (which is a key component to healthy ageing), but it also helps your body use the protein you eat more effectively. (8) Having more muscle also means you burn more calories at rest, making it easier to maintain your weight. Additionally, maintaining muscle during this period can help preserve your overall metabolic health by increasing insulin sensitivity, meaning you are better equipped to handle the changes to metabolism that occur. (10) Aim to strength train at least two days a week focusing on free weights, resistance bands, bodyweight exercises, or machines. Gradually increase the intensity or difficulty of each session, which will help you maintain the muscle you have as well as stimulate new muscle growth. Other lifestyle habits Focusing on quality sleep and reducing stress are great ways to support steady glucose, which has been shown to play a positive role in weight loss and weight maintenance. (9) Try to get 7-8 hours of sleep each night and find ways to reduce daily stress. Check out our tips for better sleep, and try stress-reducing exercises like deep breathing, yoga, taking a hot bath, journaling, or whatever you find to help calm your nervous system. It is recommended that lifestyle changes, such as physical activity and dietary adjustments be the first choice to combat any metabolic changes seen during menopause, including weight gain and body composition changes, (6) however some may benefit from pharmaceutical interventions as well such as HRT or weight loss-specific medications. It is important to discuss these options with your provider to find a combination of strategies that will work best for you. A final note from Lingo     Menopause can feel daunting, especially as you start to notice changes that feel out of your control. Knowing what is going on in your body, as well as taking proactive strategies to address these changes, is the first step. Using a continuous glucose monitor (CGM) like Lingo can give you insights into what is going on in your own metabolism and help you navigate these changes effectively. With Lingo’s real-time coaching, you can make the adjustments needed and address the metabolic changes that occur. Additionally, having a support system is key. While a seemingly universal phase of a women’s life, menopause is not talked about as openly as it should be. Finding others who are going through similar life changes can be a great way to gain support and accountability during this major life transition.