Weight Gain and Menopause: Are They Linked?

Dr. Frank Goicoechea

Weight gain is a common concern among menopausal women and those transitioning into menopause (perimenopause). In fact, the rate at which women gain weight and accumulate abdominal fat tissue increases more rapidly during midlife years. Dr. Frank Goicoechea, a Sharp Grossmont-affiliated OBGYN, answers a few questions to help clarify how weight gain in women is impacted by menopause.

Does menopause cause weight gain?
The relationship between weight gain and menopause has been somewhat unclear, but research findings demonstrate that the increase in weight among menopausal and premenopausal women is a function of age, and is not caused by hormonal changes related to menopause. However, there is evidence that menopause causes an increase in body mass index (BMI) and an accumulation of abdominal fat in women.

How is an increase in BMI and abdominal fat linked to menopause?
Hormonal changes experienced by perimenopausal and menopausal women contribute to a more rapid increase in fat mass and redistribution of abdominal fat. In addition, the degree to which women experience menopause symptoms correlates to the amount of weight gain. Obesity in perimenopausal women is associated with an increased likelihood to have more frequent hot flashes, night sweats and other related menopause symptoms.

Should women be concerned about increased fat around their midsection? How can women determine whether they are carrying excess fat around their waist?
Yes there is concern, as studies have linked increased abdominal fat to increased risk of heart disease and Type 2 diabetes. Abdominal fat can be measure several ways:

• BMI — BMI of 25 to 29.9 indicates being overweight; BMI of 30 or over indicates obesity. However, some researchers think BMI isn't always a valid indication of obesity, because it gives misleading results in people who are very muscular or very tall. Calculate your BMI using our online tool.
  
• Hip to waist ratio — Divide your waist measurement at its narrowest point by your hip measurement at its widest point. As a marker of a person's abdominal fat, this measure outperforms BMI. For women, the risk for heart disease and stroke begins to rise at a ratio of about 0.8.
  
• Waist circumference — Women with a BMI of 25 to 34.9 and waist circumference greater than 35 inches are considered high risk; however, a study found that in women, a large waist was correlated with diabetes risk — even when BMI was in the normal range of 18.5 to 24.9. Since abdominal fat can be a problem despite a normal BMI, health assessments should include both BMI and waist circumference. The relationship between waist circumference and health risk varies by ethnic group.

What can be done to reduce abdominal fat?
Keeping weight and body mass index at a healthy level is important in reducing risk of obesity and associated vascular and metabolic diseases. Women can incorporate the following techniques to reduce and manage weight.

• Alternative therapy — acupuncture, yoga and Chinese herbal medicine may also be beneficial to weight loss according to some research
  
• Eat less and exercise more — studies show that reduced food intake combined with increased physical activity offers more benefit together that diet or exercise alone
  
• Estrogen therapy — a number of studies demonstrate that estrogen-related therapies can help reduce the accumulation of abdominal fat in menopausal women
  
• Medications — certain anti-obesity drugs are designed to aid in weight loss by suppressing appetite, increasing feeling of fullness, increasing the body's metabolism and reducing the ability for the body to absorb specific food nutrients

What are some of the benefits associated with weight loss among menopausal women?
There are multiple benefits to weight loss for women during midlife, including improvements in menopausal symptoms among previously obese and overweight women. In addition, they experience improved psychological well being, health-related quality of life and self-esteem.

Talk to your doctor to learn more about how to manage weight during menopause. There are various options available to aid the weight-loss process and reach a healthy BMI. Combined with a healthy lifestyle, a successful weight management and weight maintenance program can be achieved.

Find a San Diego OBGYN
To find a Sharp-affiliated doctor, search for a San Diego OBGYN or call 1-800-82-SHARP (1-800-827-4277), Monday through Friday, 8 am to 6 pm.

For More Women's Health Information
To find general information about women's health, visit Women's Health in Adult Health or read the Women's Health News archive.