The Midlife Midriff: Menopause, weight gain, and what you can do about it

Your legs probably don’t go as fast as they did when you were twelve, and neither does your metabolism. At the same time as you start to produce less estrogen and progesterone, your Basal Metabolic Rate (BMR) also slows down, triggering changes in weight and shape. This slowing down of metabolism is related more to the aging process than hormonal changes but, in general, slower metabolism means easier weight gain. Your winding down metabolism is a likely candidate for weight gain during the menopausal years.

What you can do: What you shouldn’t do is go on a diet. Dieting can actually make menopausal weight gain worse. Cutting out too many calories puts you into starvation mode which actually lowers your metabolism even more – not much help really! It also triggers sugar and fat cravings, which, if indulged, are a great way to add even more pounds. If you’re not getting enough calories you also risk bone and muscle depletion, which is a bad thing for anybody’s body, let alone one that is heading into an age where strong bones and muscles are even more vital for good health.

As your metabolism slows, however, you do need fewer calories. It is generally recommended that postmenopausal women consume around 1900 calories a day, compared to 2200 for younger women. That means a drop of between 200 and 400 calories a day. This is best achieved by decreasing portion sizes of meals while keeping a wide variety of foods in your diet to ensure adequate nutrition. Limit fatty foods and excessive alcohol and fill up on more wholegrains, legumes, fruits and vegetables.

You lose about half a pound of muscle every year after the age of 35. Because muscle is more metabolically active than fat, it requires eight times more calories to maintain, even at rest. Therefore, as you lose more muscle you burn fewer calories. If all other factors remain constant, it translates into about 4 lbs of muscle lost and 15 lbs of fat gained every decade! Might just be a factor in midlife midriff expansion, don’t you think?

What you can do: If you include some strength training in your exercise program, you can reduce muscle loss. Each extra pound of muscle may burn an extra 50 calories per day, so it's worth doing some muscle-building exercises. In general, eat less fatty foods and exercise regularly to minimize fat gain.

Although hormone changes may be a factor in menopausal weight gain, a study published in Postgraduate Medicine concludes that "the factor most consistently related to weight gain in this age-group is decreased physical activity." Whether women get too tired or stressed to exercise, whether they lose interest and motivation, or whether they feel "too old" for it, the fact remains that most women decrease their physical activity at a time when they should be doing the opposite.

What you can do: Keep exercising, or start if you haven’t already. It’s also a good time to review what you do for exercise; it might be time to make some changes. Talk to a health professional or fitness expert and work out a plan that best meets your needs. This is especially important if you haven’t exercised in a long time. Remember that aerobic exercise can help boost your metabolism and burn fat, while weight-bearing exercise such as walking, jogging and dancing will also strengthen your bones and counteract bone loss, which helps defeat osteoporosis. You may want to try including strength training to help increase muscle mass and raise your metabolism. Exercise will improve your overall body shape, as well as boost your body-confidence. Apart from a little weight, you have nothing to lose when it comes to exercising!

Some people find change more difficult than others, but regardless of how easy or hard you find it, the changes of menopause can trigger a lot of emotional turbulence. Some women in particular find the thought of aging extremely frightening, whether because of body image, health, fear of death, or any number of other reasons. These fears can accumulate and lead to depression. (And we haven’t even started to talk about hormonal changes and emotional health). Depression is a key factor in weight gain at any stage of life. People who are depressed, or even just feel out of sorts for an extended period of time, often find it harder to exercise regularly and easier to eat poorly. Weight gain is a natural consequence.

What you can do: If you know that your depression, or lack of motivation, is partly to do with your change in body shape and the feelings associated with getting older, try to get things in perspective. Assess whether you really are getting “fat” or are just not as thin as you were when you were sixteen. A forty-five year old is not supposed to look like sixteen year old; you don’t have pajama parties and pretend to be Britney Spears anymore, or giggle stupidly at MTV presenters, so don’t expect to look like someone who does. Our bodies are supposed to change, and we should ride with the change in the healthiest way we can. If you are exercising regularly and eating well, but you still gain a little weight, then don’t be hard on yourself; just accept that your body is changing.

Something else to consider is the changes your body went through when you hit puberty. That time of change required a few new wardrobe items didn’t it! Well, menopause is time for another change. Stop trying to fit into your twenty-year old jeans and tank tops, and treat yourself to some new wardrobe items that make your body look gorgeous.

And try this out for a healthy attitude: "I look forward to being older, when what you look like becomes less and less an issue and what you are is the point". – Susan Sarandon

Although it’s a commonly held belief that HRT will make you gain weight, many studies show that, for most women, the treatment has no effect on weight gain. Then again, some studies suggest it might. So what do you do!?

What you can do: If you are on an HRT treatment that you think might be causing you to gain weight, talk to your doctor about whether the type of hormone you are taking or the dose of your treatment can be adjusted. As always, a healthy diet and plenty of exercise is still your best therapy for countering weight gain.

Even if your body feels like it's spiraling out of your control, the one thing you do have command over is your attitude - so keep it healthy! In the (slightly amended) words of Abraham Lincoln: "A man (or a menopausal woman) is about as happy as he makes up his (her) mind to be."