Menopause Weight Gain

Yes, weight gain is a common symptom of perimenopause and menopause, and Women’s Health Concern reports that over half of women are affected. The British Dietetic Association adds an important detail: much of the weight gained at this age comes from ageing, while the menopause itself mainly changes where fat is stored. Several things tend to arrive together:

• falling oestrogen, which makes the body more likely to store fat around the abdomen
• loss of muscle with age, which lowers the energy your body uses
• poor sleep, often made worse by night sweats
• moving a little less or eating a little more than before
• alcohol, which adds energy and makes snacking more likely
• low mood or aching joints, which make activity harder

What you eat and drink, and how much you move, still matter most, so the weight responds to the same changes it always has.

Weight settles on the stomach during the menopause because falling oestrogen makes the body more likely to store fat inside the abdomen. The NHS notes that menopause weight gain often sits around the stomach and upper body, and Women’s Health Concern explains that fat which used to spread more evenly is laid down as visceral fat around the organs.

That shift matters for health as well as shape, because fat around the waist raises cholesterol, blood pressure and the risk of diabetes. These are the signs worth tracking:

• weight gain around the stomach and upper body
• a waist that is more than half your height
• clothes that fit differently while your weight stays the same
• rising blood pressure
• rising cholesterol or blood sugar on a blood test

No exercise takes fat off the stomach alone. A menopause belly shrinks as overall body fat falls, and the visceral fat page explains how to measure it.

Weight gain often starts in perimenopause, the stage when periods become irregular before they stop altogether. The NHS says the menopause usually affects women between the ages of 45 and 55, though it can come earlier. Women’s Health Concern reports an average gain of around 1.5kg a year during perimenopause, and describes this stage as a perfect storm for weight gain, because hormonal, metabolic and lifestyle changes all have an effect at once.

Sleep problems, night sweats, low mood and aching joints make any routine harder to keep. If the gain is sudden, or comes with tiredness, feeling cold or constipation, ask for a thyroid test, because an underactive thyroid shares several symptoms with perimenopause.

There is no fixed end point, and how long it lasts varies from woman to woman. The NHS says menopause symptoms usually last 7 to 9 years, sometimes longer, and change during that time. Women’s Health Concern gives an average gain of around 1.5kg a year during perimenopause.

Some of the causes carry on after the menopause, so the weight does not simply lift when other symptoms ease. The British Dietetic Association notes that much of the weight gained at this age is due to ageing, and muscle keeps declining with age unless it is trained. That is why the same things move it at any stage: strength training, a steady energy deficit, good sleep and less alcohol.

Losing weight during the menopause works through a modest, steady energy deficit combined with strength training. Women’s Health Concern suggests eating 300 to 500 calories a day fewer than you use, found by trimming snacks, portions and alcohol, alongside a mix of aerobic and strength exercise.

• resistance training two or three times a week, which the British Dietetic Association recommends to keep muscle strong
• enough protein, which the BDA lists with calcium and vitamin D for keeping bones healthy
• more daily movement, such as raising your step count most days
• a tape measure alongside the scales, since your shape can change before your weight does

Women’s Health Concern advises against diets below 1,200 calories a day, long fasting periods and cutting out whole food groups at this stage. A medical weight loss programme builds the plan around your blood results.

During perimenopause the same plan applies, with extra attention on the symptoms that make it harder to follow. Women’s Health Concern notes that weight is easier to manage once other symptoms are under control, because insomnia, low mood and aching joints all get in the way.

• Keep to a regular sleep routine, and keep your bedroom cool if night sweats wake you.
• Keep alcohol within 14 units a week, since it carries almost as many calories as fat and makes snacking more likely.
• Plan meals and snacks for the day, so long gaps do not end in large portions.
• Notice eating that is driven by low mood or boredom, which cognitive behavioural therapy can help with.

If symptoms are hard to live with, raise them with your GP first, because getting them under control makes the weight plan easier to follow.

Menopause care itself sits with your GP or a menopause clinic, so contact your GP if you have symptoms of perimenopause or menopause and want to know your options. There is no routine test for either, and a GP usually diagnoses them from your age and symptoms. See your GP too if you have a fast or pounding heartbeat, if your periods have become heavier, or if you bleed at all after 12 months without a period. Weight gain with tiredness, feeling cold or constipation can point to an underactive thyroid, and weight gain with new thirst or passing more urine needs a blood sugar test. If eating or your weight is causing you distress, speak to your GP or contact Beat on 0808 801 0677.

A first assessment arranged by Medical Weight Loss London at UNTIL Soho measures your weight, waist and blood pressure, and arranges the blood tests that matter at this stage: HbA1c for blood sugar, a lipid profile, because cholesterol tends to rise during the menopause, and thyroid function, because thyroid problems and the menopause share many symptoms. Liver and kidney function and a full blood count complete the usual set. First assessments at London clinics cost about £150 to £310, with tests on top (what a programme costs).

Ask what to get checked and UNTIL Health Concierge arranges the appointment with a registered clinician. Decisions about menopause treatment stay with your GP or menopause clinic.