Here's why you're more likely to gain belly fat during menopause

Hormones have a major impact on women’s lives: Puberty in your teenage years is just the beginning—between monthly cycles and pregnancy, changes in hormones are pretty much part of daily life. And as you age, there will be a new layer of hormone fluctuations to experience during menopause.

Menopause is a point in time 12 months after a woman's last period, according to the NHS. Menopause can be accompanied by many symptoms, but a few well-known (and oft-dreaded) ones are hot flushes, night sweats, and 'menopause belly.'

The not-so-glamorous term may make you think of annoying weight gain that does not seem to go away no matter what you do (hello, weight-loss plateau) or constantly feeling and looking bloated. But what exactly is 'menopause belly' and why does it happen?

Meet the experts: Naomi Parrella, MD, is Chief of Lifestyle Medicine at Rush University in Chicago.

Catherine Hansen MD, MPH, is and OB-GYN and Head of Menopause at Pandia Health, a women-founded, women-led, doctor-led birth control delivery service.

Anel Pla is a certified personal trainer at Simplexity Fitness.

Here is everything you need to know about the major hormonal changes that occur during this stage of life, how they can potentially affect your midsection, and what you can do about them.

What causes menopause weight gain?

There are quite a few potential causes of 'menopause belly' and weight gain in general, says Naomi Parrella, MD, chief of lifestyle medicine at Rush University in Chicago.

First of all, hormones, and oestrogen specifically, influence where excess weight is stored. With a good amount of oestrogen flowing, excess fat is divided up between the breasts, butt, hips, and legs. However, after menopause, when there is a lack of oestrogen, that fat tends to get distributed around the waist.

People also tend to become less active as they age, says Dr. Parrella: 'In combination with the loss of the effects of female sex hormones, this leads to loss of lean mass (bone and muscle) which reduces daily energy needs.' In addition to slowing your metabolism, if you move less, you need less fuel, so it is easier to overeat relative to what you can burn.

On top of that, stress and other factors that come along with aging could lead to irregular eating (and craving foods that promote inflammation and weight gain vs health-promoting foods) and, potentially, metabolic dysfunction, says Dr. Parrella. In particular, alcohol intake often increases around midlife for women (and men) and that leads to abdominal weight gain.

Exacerbating any actual fat gain around the midsection is bloating, another common symptom of menopause. 'Many people experience food intolerances (which may be temporary) during this time,' notes Dr. Parrella.

While you probably won’t wake up one day suddenly gluten- or lactose-intolerant or sensitive, Dr. Parrella notes that there seem to be microbiome changes during this time of life that may affect the way we digest foods and our sensitivity to certain foods.

What are the risks of menopause belly?

To start, there are two types of abdominal fat: subcutaneous and visceral. The former is the kind you can feel and pinch that lies right under the skin. The latter is the more dangerous type that is associated with increased risks of cancers, heart disease, high blood pressure, diabetes, and more, explains Dr. Parrella. In fact, it’s an uptick in this visceral fat that’s responsible for the fact that women’s cardiovascular risks begin to match rates in men post-menopause, she adds.

So how do you know if you’re dealing with visceral or subcutaneous fat (or both)? A growing waistline (think: your pants feel tighter) or using a body fat composition scale or other tool will be your best guides since the weight on the scale isn’t necessarily an accurate reflection of what is happening metabolically. 'The loss of muscle (from being less active or not eating enough protein) may present as weight loss or no change in weight, but that is still not good,' shares Dr. Parrella.

'Waiting until the weight on the scale starts creeping up means waiting until the gain of fat mass is large enough that it exceeds how much muscle is lost,' she continues. 'This is why weight gain of fat mass is sometimes silent because people may be losing muscle and bone density.'

So, if you notice your waistline is increasing—with or without actual weight gain—talk to your doctor. They can also help rule out or address more serious problems (such as ovarian cancer or bowel pathology), Dr. Hansen says. Other symptoms to look out for are fatigue or pain that’s causing you to be less active, which could be a sign of insulin resistance.

'The earlier you intervene, the easier and faster it will be to get back on track to feeling great and doing what you can to prevent future health problems so you can live the life you want, freely,' notes Dr. Parrella.

When does menopause weight gain start—and how long does it last?

'This is a tough question because most people cannot say at what date they felt like their menopausal changes began,' explains Dr. Parella. 'Once the hormones start to fluctuate, the fat cells and weight gain can begin.' However, often, the menopausal transition begins in a woman's 40s, per Catherine Hansen MD, MPH, OB-GYN and Head of Menopause at Pandia Health, a women-founded, women-led, doctor-led birth control delivery service.
It usually lasts between ten and 14 years, she adds.

How to prevent and treat menopause belly

Prevention is key, as it is always harder to lose fat than to keep it off, says Dr. Hansen. 'Midlife is a wake-up call and all women in their 20s, 30s, 40s, and beyond could be thinking about their health in an all-inclusive way.'

Many of the best ways to prevent menopause belly are also solid ways to treat it. A few tactics:

1. Eat a balanced diet.

'Maintaining a healthy and balanced diet is key to support your body through this transition,' shares Anel Pla, a certified personal trainer at Simplexity Fitness. 'Focus on whole foods, including fruits, vegetables, high-quality lean proteins, whole grains, and healthy fats.' Also, be sure to limit alcohol, processed foods, and sugary snacks.' A good example of this would be the Mediterranean Diet.

2. Prioritise protein.

'While protein requirements do not necessarily increase, it is important for busy midlife women to pay attention to their diet and ensure adequate intake of healthy, lean proteins,' shares Dr. Hansen. 'Proteins are the building blocks of all cells and that includes bone, brain, endocrine system (hormones), heart muscle, skeletal muscle, and skin,' she says.

A good general recommendation is to aim for 1.2 to 1.5 grams of protein per kilogram of bodyweight per day.

3. Maintain muscle.

Sad but true: Women lose lean muscle mass over time starting in their 30s and a loss of muscle can lead to a lack of balance, stamina, and strength, says Dr. Hansen, as well as a reduced metabolism and increased risk of fracture due to bone loss.

logo, company name
logo, company name

Hearst Owned

To combat this, work in resistance training and high-impact exercise (with your doc’s approval!). 'It is the stress that is placed on the bones and muscles that leads to the development of increased bone mass and improved muscle strength,' says Dr. Hansen.

4. Keep up with cardio.

Cardio exercise also continues to be important for heart health in order to maintain blood pressure and lower cholesterol. 'Walking seems to work best for weight management (as well as bone and heart health) than heavy cardio exercise for midlife women,' says Dr. Hansen.

5. Consider hormone therapy.

Hormone therapy has been shown to reduce central fat, aka 'menopause belly.' How? It likely reduces inflammation and stabilises hormones that increase that belly fat, per Dr. Hansen. 'Hormones also stabilise mood that can, therefore, contribute to less cravings, emotional eating, and increased appetite,' she adds. If you are interested in seeing if hormone therapy is the right option for you, schedule an appointment with your doctor.

6. Reduce stress and get enough sleep.

Easier said than done, but cortisol, the stress hormone, sustains hormonally active fat accumulation, per Dr. Hansen, so reducing it is key. To do just that, get restorative sleep for seven to eight hours a night and create intentional stress management practices.

Dr. Hansen recommends a daily wellness practice that involves moving the body, feeding the mind something positive, and calming the soul (think: a walking meditation). 'Daily exercise may seem hard to fit in but it is essential because it is not only good for the body, but also for the mind and soul, which fuels overall wellness and productivity throughout the day.'

More health news...

You Might Also Like