Menopausal Menace: Are Women Doomed To Gain Weight Once They Hit The 'Big Change'?

Hot flashes. Night sweats. Mood swings. Trouble sleeping. Many women experience the menopausal transition as a cruel and twisted end to their reproductive years, a kind of second puberty whose only benefit is an end to years and years of monthly periods. Though the perimenopause — the time leading up to the menopause — lasts on average seven years and may drag on for as many as 14, it does end. A new normal is waiting for you.

Does the menopause really make you gain weight?

Well, let's put it this way. Menopause is marked by both hormonal fluctuations (specifically a decline in estrogen) and, usually, older age. Combined, they mean that women gradually lose muscle mass while their bodies store fat more efficiently around this time. In addition, sleep disturbances — a recognized feature of perimenopause — are associated with increased appetite and therefore weight gain. Insulin resistance also becomes more prevalent after the menopause and this, too, can lead to extra pounds. 

The menopause may not be a direct cause of weight gain, but research has indeed suggested that many women naturally gain around an extra 500 grams a year after this time. Even if the numbers you see on the scale don't rise, your body-fat distribution changes, and you have a higher risk of so-called "central obesity" — fat that's disproportionately distributed around your abdomen. 

If you don't change your lifestyle, following the same eating and physical activity patterns you settled into before you hit the perimenopause, it is quite realistic to expect either steady weight gain or a change in the way fat is distributed around your body. That sucks, but it doesn't mean you are "doomed". Even if you do gain weight during and after the menopausal transition, you're not a powerless bystander, and you don't have to accept a higher weight as the new normal. 

What can women do to lose weight after the menopause?

I was underweight for much of my life — to the point that some folks in my social circle literally called me a "stick insect". I remember my mother in-law telling me that it wouldn't last in my (much) younger years, but for whatever reason, it did. I weighed 53 kilos (around 116 pounds) for years. When the menopause came around, I didn't notice any immediate changes. About 10 years after my last period, however, I weighed 67 kilos, or nearly 147 pounds. 

Though I never kept track of my calorie intake, I don't think I changed anything about my diet. I remained as physically active as ever. But the change was undeniable. I was now heavier and visibly fatter than ever before. Like so many others, I assumed that this was an inevitable part of aging and that the menopause was partly to blame. I just bought bigger and bigger clothes as my size shifted. 

That is, until a friend challenged me to join her on a restricted-calorie diet. We both signed up for calorie- and nutrition-tracking apps that counted our resting metabolic rates — the calories the body burns just by doing basic things like breathing and pumping blood around — along with the calories we got from food and got rid of by being physically active. 

If you want to join me on a quest to lose middle-age flab, here's what not to do:

• Don't simply decrease your portion sizes or skip meals, thinking that fewer meals or less food will automatically lead to weight loss. That nightly cheese binge I had going cost me a lot. I could have had a hell of a lot of celery for the same "price" as a small piece of cheddar. 
• Join a gym or commit to some other kind of workout, without changing anything about your eating habits, thinking it will make the numbers on the scale drop. Exercise is absolutely important for your cardiovascular and overall health, but research shows it isn't likely to make you lose more than a few kilos on its own. 
• Go on a "crash" or "fad" diet that has you eating something silly like only tomato soup or pumpkin seeds, or drop to a calorie intake that resembles that of someone with a serious eating disorder. Healthy and sustainable weight loss is gradual and responsible. 

Instead, try this:

• Calculate your body mass index. (Or let the internet do that for you.) If you are overweight, obese, or on the higher end of the healthy weight scale, set yourself up with a daily calorie deficit. A deficit of around 500 calories a day will lose you about half a kilo a week. An app will help you keep track easily.
• If you have a healthy BMI but a lot of fat around your abdomen, make an appointment with your family doctor to see if this is something you should do something about for medical reasons.
• Eat a healthy, balanced, and varied diet that includes all sorts of vegetables, fruits, grains, meats, fish, dairy, eggs, beans, and so on. Try to get the right amount of all the essential vitamins and minerals for optimal post-menopausal health. You can even have the odd junk food. Just add it to your total and don't go "over budget" in terms of calories.
• Exercise to keep healthy and to have fun. Keep track of the calories you burn this way, too.
• Weigh yourself every day for the best success rate. 

Being able to lose the weight I piled on over the years feels great, and I'm certainly thrilled to fit into those old jeans from 20 years ago again. More than that, though, I know that I am doing the best I can for my health — and that makes me even happier than the results I see on the scale and in the mirror. 

The menopause may bring us new challenges, but it definitely doesn't have to defeat us. It is, ultimately, an excellent time to reevaluate our lifestyle choices and make the kinds of changes that will keep us healthy for the rest of our lives.