Is Midlife Weight Gain in Women Due to Menopause or Aging?

Is Midlife Weight Gain in Women Due to Menopause or Aging?

In last week’s blog post we began discussing menopause and belly fat. We talked about the fact that belly fat was more than just a cosmetic issue; it is a health problem. We also discussed BMI and other issues about midlife weight gain. This post continues the conversation. Is midlife weight gain due to menopause or aging?


As I discuss in my best selling book, The Estrogen Fix, about hormone balance and menopause, it is true that the body’s metabolism slows down a little each decade. That does cause a weight gain of about 1 pound per year due to age. But is your jelly belly a function of weight or weight distribution? Is it just weight gain or has a huge rearrangement of your body’s fat seemed to implant a bull’s-eye on your belly? And what role do your hormones play?


The transition from your reproductive years to menopause, called perimenopause, begins when your periods become irregular and ends with your last period. Evidence is mounting that this transition is marked by “unfavorable changes in body composition, abdominal fat deposition and general health outcomes.”


Your ethnic group and level of activity should be considered when it comes to obesity and fat distribution. In a study of 16,000 women, telephone interviews were done with US Caucasian, African American, Hispanic, Chinese, and Japanese women. The study concluded that the mean weight of the entire group of women over the 3 years of the study did not differ as the women progressed from premenopause to postmenopause after adjusting for age and other variables. Interestingly, the mean weight of the Caucasian women was significantly greater than the weight of the Chinese women by 2.1 kilograms (about 5 pounds), and the study design led the researchers to determine this increased weight was not due to menopause.


In another study, researchers randomly assigned about 17,000 postmenopausal women who were not using hormone therapy to either a control group that ate whatever it wanted or a different group with a healthier diet that included among other things increased fruits, vegetables, and whole grains. After a year, women in the group who ate a healthy diet had fewer hot flashes and were three times as likely to have lost weight. You can’t control your heritage. You can, however, control what you eat. And what you eat does make a difference in your weight.


In our next post, we’re going to discuss what role hormones play in menopausal weight gain. In the meantime, you can see how much your weight gain and other menopause symptoms are affecting you by taking this short, free

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  • July 10, 2020

    Dear Dr. Mache,
    First, I want to thank you again for speaking with me on the phone two years ago. I was trying to decide whether or not to resume HRT. After our talk, I decided that going back on HRT was the right decision for me. I can give anecdotal evidence that severe menopausal symptoms – huge numbers of hot flashes and major sleep disruption – do lead to weight gain. I used estrogen patches and progesterone tablets for two years between 2012 and 2014. I lost 8 pounds without changing either my diet or exercise. The weight just fell off over the course of the first few months I was on HRT. I discontinued the meds when my insurance company refused to pay for them any longer. My rebound hot flashes were extreme. At the five year mark I was still not back to my baseline. I gained weight during the years of sleepless nights. I was finally able to get on a somewhat appropriate dose of HRT in May 2019. (My doctor made me try 3 different low dose birth control pills first. They did not do much to help with my symptoms and, in fact, actually led to one full blown period – the first time I had even so much as spotted in 11 years!) Again, I lost weight without making a single life style change. The weight just falls off when I start sleeping more normally. I still have hot flashes and am considering asking my doctor to up my dosage. But, I feel much better on hormones and wish that I had never discontinued them. My last period was in May 2008. In the 12 years since that time, the only times I have felt close to my “normal” self have been the 3 years when I have been using HRT. I am 65 years old – supposedly too old to be on hormones – but I can’t stand the idea of going back to my tired, sleepless, hot self! I greatly appreciate the work of doctors like you and Avrum Bluming. I pray that your work becomes much better known. Thanks so much!

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