“Aging and lifestyle seem to be the primary culprits behind weight gain in women around the time of menopause. Aging is associated with slowing of the metabolism”.¹

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Menopause or Not

Does menopause cause weight gain?

The good news or not is, menopause does not cause weight gain. On page one in Major Review Finds Menopause Does Not Cause Weight Gain, But Increases Belly Fat published for World Menopause Day in 2012, the International Menopause Society (IMS) explain:

“A comprehensive review by the International Menopause Society has found that going through the menopause does not cause a woman to gain weight. However, the hormonal changes at the menopause are associated with a change in the way that fat is distributed, leading to more belly (abdominal) fat”.²

On page four in Maintaining Health and Preventing Disease After the Menopause: Preventing Metabolic Effects Post Menopause published for World Menopause Day in 2014, the IMS also note:

“Although women frequently report weight gain at midlife, studies across different populations have consistently shown that weight gain is primarily influenced by age, not menopause”.³

Weight Gain

If menopause does not cause weight gain, what does?

In Changes in Weight and Fat Distribution: Age and Lifestyle Are the Main Culprits the North American Menopause Society (NAMS) explain:

In Health After Menopause: Weight Gain or Redistribution the (Australian) Jean Hailes for Women’s Health (JH) explain:

In Menopause FAQS: Your Health After Menopause – Q. I’m Finding It Harder To Lose Weight Now That I’m Older. Is Menopause To Blame? the NAMS elaborate on:

“A. Many women gain weight during the menopause transition, although neither menopause nor menopause treatments have been shown to be responsible. Midlife weight gain appears to be mostly related to aging and lifestyle, and although the cause is not menopause, menopause may be related to changes in body composition and where fat is stored, with a decrease in lean body mass. These changes may have detrimental metabolic consequences, so it’s important to avoid weight gain during and after the menopause years through diet and exercise, which minimizes fat gain and maintains muscle, thereby reducing body size”.⁶

Weight Redistribution

Can menopause cause wight redistribution?

The good news or not is, menopause can cause weight redistribution. The JH explain:

“Menopause doesn’t cause women to gain weight, but it can cause body fat to shift from the hips to the abdomen due to the decrease in oestrogen levels”.⁷

On page five in Prevention of Diseases After Menopause: Metabolic Effects, Obesity and Diabetes Mellitus – Obesity and Menopause the authors elaborate on:

“The abrupt decline in estrogen at menopause is characterized by increased abdominal subcutaneous and visceral fat without commensurate change in physical activity or total body weight. The result is a transition from a gynoid to an android pattern of fat distribution and an increase in total body fat. This menopause-associated change in body composition is seen across ethnicities and in non-obese as well as obese women”.⁸

In Menopause Management: Healthy Living – Healthy Weight the JH also note:

“As women age and move through menopause, the fat that used to sit around the hips moves up towards the waist area. Younger women tend to be shaped more like a pear, and older women like an apple. This shift in weight to the waist area increases the risk of cardiovascular disease, so it is important to try to minimise weight around the waist area”.⁹

In Changes In Weight and Fat Distribution: Does Menopause Affect Body Shape? the NAMS explain:

“Several studies have shown that perimenopause, independent of age, is associated with increased fat in the abdomen as well as decreased lean body mass. This suggests that menopause plays a role in many midlife women’s transition from a pear-shaped body (wide hips and thighs, with more weight below the waist) to an apple-shaped body (wide waist and belly, with more weight above the waist) (see figure). However, further study is needed on the exact role of menopause in body composition”.¹⁰

Chronic Disease

Is there an association between chronic disease and weight gain?

In Major Review Finds Menopause Does Not Cause Weight Gain, But Increases Body Fat the IMS explain:

“Being overweight or obese is a major worry for many women, and through midlife, women tend to gain on average around 0.5 kg per year (around 1lb per year). This can have significant consequences, as being overweight or obese is associated with a range of conditions including depression, hypertension, cardiovascular disease and diabetes”.¹¹

On page four in Maintaining Health and Preventing Disease After the Menopause: Preventing Metabolic Effects Post Menopause, the IMS also note:

“The accumulation of abdominal fat in postmenopausal women is a critical factor in the development of insulin resistance, which in turn is a major risk factor for progression to type 2 diabetes. Furthermore, abdominal weight gain after menopause is associated with the development of other age-related conditions in postmenopausal women, namely CVD, dementia and breast cancer”.¹²

The JH also note:

“Weight gain around the stomach is not healthy. It can increase blood pressure and blood fat, and can increase the risk of high blood pressure, diabetes, cardiovascular disease, dementia and some cancers. Maintaining a healthy weight and fitness at this time of life is very important to help reduce the risk of chronic disease”.¹³

According to the NAMS:

“Regardless of the different contributions of aging and menopause to weight gain and body composition, the fact is that most women in North America are overweight at midlife. Any excess weight raises the risk of many diseases, including cardiovascular disease (which is particularly linked with excess fat in the abdomen), type 2 diabetes, high blood pressure, osteoarthritis, and some types of cancer (including breast and colon). Beyond their clear effect on a woman’s overall health, these conditions tend to compromise her sexual function through reduced energy, reduced mobility, poor self-image, and other factors”.¹⁴

Metabolic Disease

Is there an association between metabolic disease and apple and pear shapes?

In Metabolic Syndrome: Symptoms & Causes – Overview – Apple and Pear Body Shapes the (United States) Mayo Clinic explain:

Body Mass Index

What can body mass index (BMI) be an indicator of?

In Body Mass Index (BMI) the (United States) Centers for Disease Control and Prevention explain:

“Body Mass Index (BMI) is a person’s weight in kilograms (or pounds) divided by the square of height in meters (or feet). A high BMI can indicate high body fatness. BMI screens for weight categories that may lead to health problems, but it does not diagnose the body fatness or health of an individual”.¹⁶

Weight Loss

What may result in preventing weight gain or weight loss?

In Preventing Weight Gain In Women At Midlife: Healthy Eating the JH elaborate on:

“Dr Davison encourages women to eat healthily and mindfully. Eating less food, but eating more often, can also help.

“Lowering portion sizes, eating small but frequent meals to maintain metabolic rate, lowering carbohydrate and caloric intake and reducing alcohol intake can all be effective for weight loss,” she says””.¹⁷

In How To Beat Weight Gain At Menopause the authors note:

Health Care Provider

What if I would like help with weight loss?

If you would like help with weight loss, it may be in your best interest to choose to talk to your health care provider about this.

In Weight Control the (United States) National Center for Complementary and Integrative Health (NCCIH) elaborate on:

“If you’re thinking about starting a new weight-loss program, talk with your health care provider, who can assess your weight and health risks, determine whether you need to lose weight, and provide information that will help you make informed decisions about an effective weight-loss program”.¹⁹

In Weight Control: Safety the  NCCIH also caution:

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Topic Last Updated: 06 July 2022 – Topic Last Reviewed: 06 July 2022