Menopausal weight gain: everything you need to know, including how to avoid it

Ask many women one of their greatest concern around the menopause and they’ll bemoan the appearance of a persistent spare tyre. Appearing, apparently, from nowhere and there, it seems, for life. 

We’ve talked to the experts and got the low–down on the science behind why menopausal weight gain happens – and what you can do about it.

We’ve put together a no–nonsense, evidence–based action plan so you can plan your attack and take back control. Remember: to be a menopause ninja might take patience but it IS possible to kick spare tyres to the kerb. 

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The rules of weight management before menopause

According to the European Association for the Study of Obesity, before menopause arrives your ability to manage your weight is 80% genetic and 20% lifestyle choices.

If you’re genetically predisposed to gain weight and don’t make good diet and exercise choices you’re likely to be very heavy – while if you’ve got lucky ‘thin’ genes, eat well and take lots of exercise, you tend to be skinny.

Most of us fit somewhere in between the two throughout our adult life. That is, until menopause.

Everything changes – the knowledge

Dr Stephanie S Faubion from the North American Menopause Society explains. “Once oestrogen levels begin to fall during the perimenopause (the time before you have been one year without a period) genes play a less significant role.

Lower oestrogen causes your body to lay down fat around your trunk, and around your internal organs. This kind of fat is called visceral fat or ‘internal fat’. It is why menopausal weight gain tends to occur around the upper body.

Visceral fat is also partly to blame for the increased risk of heart disease, insulin resistance and some cancers that women face after menopause.

To add insult to injury, your body also recognises it’s ageing and as a result, you lose a small amount of muscle tissue. This slows your metabolism down making you less efficient at burning calories – a little like the fuel efficiency of your car declining over time.  

The combination of the lack of oestrogen and slowing of the metabolism means that most women can expect to gain about 1.5kg or about 3 ½ lbs a year once the perimenopause starts.

And that’s without eating more or being less active. On average women may gain around 4.5kg in total around the menopause – that’s enough to jump a dress size.

Remember you are turning back your body clock – this is a bit like stopping an ocean liner so you may have to go a couple of weeks before anything happens.

Be patient as your body regains the muscle it needs to get your metabolism going again. Make sure you take bust waist and hip measurements to see change – these will often drop before the scales show much weight loss.

Good news! You really can beat your biological clock

Before you leap into a one size fits all diet plan, or go rushing back to the slimming club where you lost your baby weight – stop!

Your body is not behaving the same way it was 10 or 20 years ago – you need a plan for your body today – a plan which accounts for the hormonal and metabolic changes your body is going through. 

Along with the eating plan you also need to do the right combination of physical activity and resistance exercise to rebuild the muscle that’s causing some of the problems in the first place. Hurling your self into every aerobics class you can is not going to help here. You need to be much more strategic.

Beating the menopause: diet basics

Lose 500 cals a day: You are going to need to eat and drink around 3,500 a week or 500 calories a day less than you currently consume to trigger your body to start burning the fat it’s stored.

Analyse what you eat right now: Decide where the savings can be made. Remember — whatever you do to lose this weight, you’ll need to keep it up for the foreseeable future.

Keep a food diary for at least three days: Ideally, including a weekend day – you can use an app like My Fitness Pal or Calorie Counter to count the calories for you.

Look for the big wins: Extra calories you have most days that you could easily do without – they soon add up.

Look for 3-4 changes which will give you a saving of 3,500 calories over a week, for example:

Reduce wine to 1 glass per night (1113 calories saved)

Cut out crisps at lunchtime (900 calories saved) 

Cut out mayonnaise (1230 calories saved)

Total calories saved 3,243

Don't set yourself up to fail: Your plan needs to be healthy, maintainable and suitable to take care of your bone health and heart health too. It’s no good just cutting 500 calories a day from a diet of pie and chips and it’s not the time for fad diets either.

The healthy eating basics need to cover:

5 fruit and veg day

2–3 servings of dairy food or calcium–enriched alternative

1–2 servings of fish each week – ideally one oily fish like salmon, trout or mackerel 

Plenty of whole grains and pulses

Not too much salt, sugar or saturated fat.

Exercise goals

OK – diet sorted? Now you need to think about activity and exercise.

The aim is to achieve 10,000 steps per day

This equates to around 8–9km or around 90 minutes brisk walking. Your starting point might be well below this figure, so set a realistic increase which you can build on over a few weeks.

The consistency and regularity of physical activity is the most effective way to increase muscle mass when combined with regular resistance exercise.

Regular resistance exercises

This is not about ‘pumping iron’ - it’s about gently challenging the major muscle groups to reach natural fatigue. 15 minutes a day, four to five days a week, ideal resistance exercise for building muscle mass:

Start with 10 repetitions of:

Squats 

Bicep curls

Box Press Ups

Abdominal curls

Once ten of each gets easier, slowly increase until you are doing 4 sets of ten of each resistance exercise – this will take around 15 minutes a day.

Menopausal weight gain: Q&A

What happens if I cut my calories back more than 500 calories a day?

If you take your calories down much lower than 500 calories less than you eat right now, you won’t be able to build the muscle you’re trying to replace. In fact, you might even lose more muscle as your body uses your existing muscle to fuel the exercise you’re doing.

What is I want to do a lot more aerobic exercise?

If you’ve already been doing a lot of aerobic exercise that’s OK – your body is used to it – but you do need to get the 10,000 steps a day sorted out so focus on that.

If you haven’t been doing a lot of aerobic exercise like running, spinning or Zumba – don’t go mad at this now – concentrate on getting your 10,000 steps done every day before you even think of anything more intensive.

Professor Ken Fox from Loughborough University says you’ll build more new muscle by being more active every day instead of going hell–for–leather 2–3 days a week.

Doesn't HRT cause weight gain?

A lot of women are convinced their HRT has caused their menopause weight gain, but according to the British Menopause Society and Women’s Health Concern, the evidence just isn’t there to support this theory.

One or two HRT preparations might lead a woman to retain a little fluid during the first few weeks but that settles quickly.  The reality is that the slight increase in oestrogen HRT supplies actually helps with weight loss, plus if your HRT relieves symptoms like fatigue, muscle and joint pain and hot flushes you are likely to feel much more motivated to eat well and get active. 

To give your menopause plan a fighting chance, you need to give it about 12 weeks. This should be enough time for your body to make the physiological adjustments it needs to get you back in the driving seat.

Most important of all, 12 weeks is a good amount of time for the changes you’ve made to become habits so you can put menopausal weight gain behind you for good.

Top notch bone health

Falling oestrogen levels mean your bones begin to turn over their strength and density more quickly. To slow the turnover down and take back control you need to:

Eat three servings of dairy food or calcium–enriched alternative each day

Take a 10µg vitamin D supplement daily – or try a complete bone health supplement like Osteocare if you think you might not manage to eat enough dairy food

Do some daily weight–bearing exercise

Keep ahead of heart health

Statins can help manage your cholesterol but if you want to try a food–first approach, a lot of people find combining The Portfolio of Cholesterol–Lowering Foods, recommended by Heart UK into their daily diet can have the same effect as taking a statin. 

Try this for 12 weeks and if your cholesterol levels don’t improve you may then need to consider a statin.