health ideas
Making Your Efforts Work During Menopause
By Robin K. Levinson | 2/17/2006


Do you know the truth about weight management during menopause, or have you been tricked by old wives tales?

Decide whether the five following statements are true or false, then click on them to see if you're right.

1. The loss of estrogen associated with menopause causes weight gain.

2. I can maintain my goal weight in mid-life by eating the same and exercising as much as I did in my 30s and 40s.

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3. After menopause, women are likely to gain more weight on their belly than on their hips and thighs.

4. Weight gain during menopause is a side effect of hormone replacement therapy (HRT).

5. No matter what I do, I am going to get fatter, and my belly is going to get bigger, as I get older.


1. The loss of estrogen associated with menopause causes weight gain. False. According to Pamela P. Boggs, education director for the North American Menopause Society, research has shown that estrogen loss is unrelated to weight gain. On the other hand, weight gain is a natural part of aging - the average weight gained during midlife is about 10 to 15 pounds. This may be due to the age-related slowing down of the metabolism as well as the decrease in physical activity that people tend to gravitate toward as they age.

In some cases, menopausal symptoms trigger certain behavioral changes that can contribute to weight gain, observes Paul Gluck, MD, an obstetrician/gynecologist who provides weight-loss services in his Miami medical practice. Say you're the type of person who turns to "comfort food" when you're feeling blue or stressed out. The dramatic mood swings that sometimes accompany menopause could trigger more frequent episodes of overeating, Gluck explains. Also, if hot flushes keep waking you up at night, you may be too fatigued during the day to exercise. So speak to your doctor to see if you can get these symptoms in check.

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2. I can maintain my goal weight in mid-life by eating the same and exercising as much as I did in my 30s and 40s. False. Gluck says that after your teens, your metabolism slows down by about 10 percent per decade. Loss of muscle tone is another natural part of aging; muscle burns more calories than fat. In order to maintain a healthy weight after menopause, you must step up your physical activity, especially weight-bearing exercise, to build muscle, Gluck says. Otherwise, you will probably gain extra weight.

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3. After menopause, women are likely to gain more weight on their belly than on their hips and thighs.True. During childbearing years, most women have a pear-shaped figure. After menopause, body fat tends to redistribute itself toward the midsection, giving the body more of an apple shape. Why this occurs is not entirely clear, but Margery L.S. Gass, MD, director of the Menopause and Osteoporosis Center at the University of Cincinnati, says loss of muscle tone in the abdominal region is a contributing factor.

"I have patients who swear they gained no weight, but now have an abdomen sticking out and never used to," says Gass. To firm up your middle, be sure your exercise regime includes cardio exercises - to get rid of fat - and a strength-training routine with a good abdominal workout.

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4. Weight gain during menopause is a side effect of hormone replacement therapy (HRT). False. HRT is associated with a slight slowing down of age-related weight gain. In 1997, the Journal of Clinical Endocrinology and Metabolism reported a study that followed large groups of women taking HRT or a placebo (dummy pill) for three years. The placebo group logged a much larger weight gain than the HRT group, which experienced a small weight gain.

HRT may influence insulin levels and therefore improve the body's fat-to-muscle ratio, notes Wulf Utian, MD, PhD, executive director of the North American Menopause Society. On the other hand, HRT should not be construed as a weight-loss pill. "If you take hormones and exercise more and maintain a healthy diet, then you'll have an easier time maintaining your weight or losing weight," says Gluck. "Im not saying, 'Keep doing everything you're doing, I'm going to give you these pills, and you'll lose 10 pounds.' It won't happen."

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5. No matter what I do, I am going to get fatter, and my belly is going to get bigger, as I get older. False. Gaining weight as you age does not have to be inevitable. Researchers at the Washington University School of Medicine have shown that women and men who maintain a high level of endurance exercise training with advancing age "appear to avoid many of the undesirable changes in body composition and fat distribution that typically occur with aging."