Menopause! Weight Gain?

Menopause! Weight Gain?

A common concern with perimenopausal and postmenopausal women is weight gain. Weight gain during this time in life could lead to poor heart health and diabetes. Typically, there is 1.5 pounds per year during the fifth and sixth decades of life that is gained. This is shown to be independent of a woman’s initial body size before this weight gain.

It was previously believed that the increase in weight coincided with the onset of menopause most likely due to the drop in estrogen levels. Although declining estrogen levels has, in fact, has been shown to lead to an increase in total body fat, it also results in a decrease in lean body mass thus creating little to no net gain in total weight.

A more accurate theory on this midlife weight gain includes a combination of aging and lifestyle influences such as the following factors:

Aging results in a decline in lean body mass which lowers the resting metabolic rate.

Aging may lead to less physical activity, decreased lean body mass, and lowered resting metabolic rate; without compensatory reduction in caloric intake, weight gain is common.

Aging often results in sleep disturbances, which may lead to daytime fatigue and further decreases in physical activity.

The changes seen during peri- and postmenopausal years – including an increase in total body weight are warning signs of increased cardiovascular disease (CVD) risk.

CVD is the leading cause of death in women after menopause and that obese postmenopausal women have a higher overall mortality rate than their non-obese counterparts, it’s clear that supporting optimal body weight, composition and fat distribution is extremely important.

What can be done!

Leading a healthy lifestyle may not only help reduce the risk of CVD but also help reduce metabolic syndrome, type 2 diabetes (T2D), high cholesterol levels, and hypertension.

Weight reduction may also curb risk for obesity related diseases and conditions including breast and uterine cancers and vasomotor related symptoms.

Effective weight reduction programs are comprised of a multi-faceted approach supporting nutritional and eating changes, physical activity, and psychological considerations. It has been shown that utilizing a team-based approach with a wide variety of specialists such as medical practitioners, behavioral psychologists, dietitians, nutritionists, exercise specialists and lifestyle coaches also leads to improved outcomes.

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Nutrition: There have been many dietary protocols have been studied as supporting weight loss. However, the Mediterranean diet routinely stands out as helpful not only for weight loss but also in decreasing cardiovascular disease risk. Other dietary approaches have also been found to be helpful although it is suspected that the underlying component in all these other diets is the reduction in caloric intake and not necessarily the macro-nutrient composition.

Physical Activity: The American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society recommend 150 to 175 minutes of brisk walking or similar aerobic exercise per week for weight loss. It is recommended that this physical activity be coupled with caloric restriction to optimize weight loss outcomes.?Resistance exercise is endorsed as well as this form of training improves lean body mass leading to an increase in basal metabolic rate and energy expenditure while also decreasing abdominal fat accumulation.

Behavioral Support: Key to sustainable weight loss is support in identifying barriers, problem solving challenging situations or thought processes and creating a supportive social network.?Identification and treatment of mental and psychological health issues such as depression and anxiety are also crucial to successful and long-term weight loss management.

Why is this important?

Healthcare practitioners should routinely include screenings of peri- and postmenopausal women for obesity and obesity related health risks such as CVD

Women experiencing weight gain in peri- and post menopause should be educated on the increase in CVD risk associated with weight gain and central/visceral adiposity deposition

Lifestyle approaches are helpful in reducing weight gain in this population and should be implemented in primary care settings as a routine part of care

Kapoor E et al.?Weight gain in women at midlife: a concise review of the pathophysiology and strategies for management. Mayo Clin Proc. 2017:92(10):1552-1558.

Metagenics Institute

Suburban Wellness Group

Dan Cardellichio DC, MS

554 Bloomfield Ave.

Newark, NJ 07107

973-483-2277