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Why do women gain more weight in their stomach during menopause?

Patricia Geraghty, NP
Women's Health

The decrease in estrogen that occurs with menopause has long been blamed for the weight gain many women experience. Recently this has been called into question. When women take estrogen for management of other menopause symptoms, very little if any weight loss is seen. Another hormone may be the culprit. Dr. Wendy Kohrt and her research team at the University of Colorado gave mice injections that blocked the hormone FSH. The mice lost weight and gained bone mass. While this is an exciting finding, the information is still a long way from application to women. In the meantime, we need to make changes in our food choices, stay active and get enough sleep.

Changes in hormone levels from menopause affect where women gain weight, usually in the stomach area as opposed to the hips or thighs. The hormonal changes affect only where you gain the weight, not why you gain extra weight. After menopause, weight gain is more likely a result of an inactive lifestyle and eating more calories than you burn. Genetics can also play a role in weight gain as we get older.

Strength training (weight lifting) will aid in managing your weight and help prevent bone loss that is associated with menopause. Adults who do not strength train lose between five to seven pounds of muscle every decade. Because muscle is a very active tissue, muscle loss is accompanied with a reduction in our metabolism. Research shows that you can add approximately 3 pounds of muscle in six to eight weeks by doing a strength training program 2-3 times a week at a moderate intensity.  When you add 3 pounds of muscle (this is the great part!), you can increase your metabolism approximately 5 percent. This means you can burn more calories even as you sleep.

Research also shows that the same training stimulus that increases muscle mass also helps prevent and possibly even increase bone density. This bone density loss is a concern for all adults, but especially for women during menopause and after.

Dr. Shelley C. Giebel, MD
OBGYN (Obstetrician & Gynecologist)

Each year over the age of 30 women lose lean body mass that help burn calories. Over the age of 30, women can lose up to 1/2 lbs of muscle mass every year. That's 25 calories less you must eat, or more you must exercise off every day. Just think, a 55 year old women could lose up to 12.5 lbs of lean body mass if she doesn't do some form of weight training. That's over 300 calories less she must eat to stay the same weight!

It really ads up every year.  Add to this, even more lean body mass loss by sitting watching tv or working on the computer. No wonder obesity is such a problem. The key is to build up lean body mass by strength training and do cardiovascular exercise. It's worth your effort.

On average, women put on 1.5 to 4 pounds per year after age 50. A few extra pounds in a year don’t seem like a lot, but if you gain five pounds a year starting when you are 45, by age 55 you are looking at 50 extra pounds! However, it isn’t the lack of estrogen that puts on the pounds, but midlife changes in metabolism and lifestyle. Women who continue to menstruate until they are in their late fifties also start to gain weight even though their ovaries have not shut down. Estrogen does affect the distribution of weight, so you can blame menopause if you suddenly have a muffin top even if you haven’t gained a pound!

Dr. Wendy Warner, MD
OBGYN (Obstetrician & Gynecologist)

Obstetrician/gynecologist and functional medicine expert Dr. Wendy Warner explains how the hormonal changes of menopause affect weight gain. Watch Dr. Warner's video for tips and information on women's health.

Boston Women's Health Book Collective
Administration Specialist

There is a tendency to gain weight, particularly around the waist, in the years surrounding menopause are associated with weight gain. However, much research indicates that this gain is associated with aging rather than with menopause. Although many of us find our appetite has increased, the weight gain may occur even if we are eating the same way we always did. Although menopause is not, strictly speaking, the cause of this gain, it is true that estrogen has a role in body fat distribution. Women of childbearing age tend to store fat in the hips and thighs, while postmenopausal women store fat around the abdomen, more as men do.

Weight gain is probably related to changes in metabolism that occur with age. Our body's metabolism slows, and we tend to lose muscles and replace them with fat. Muscles burn more calories than fat, so we need fewer calories than before. We also tend to be less active as we grow older. On average, women gain about a pound a year during the perimenopausal and postmenopausal years.

Our Bodies, Ourselves: Menopause

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Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

After menopause, women produce 50 percent less androgens, which are testosterone-like hormones (in addition to influencing sex drive) promote lean muscle production, and lean muscle mass increases metabolism, decreased ovarian and adrenal production can contribute to a woman's loss of muscle mass and to weight gain—especially the stomach pooch.

Progesterone deficiency is another reason that women gain weight after menopause. Progesterone increases basal body temperature, which burns calories. No ovulation means no progesterone, which means no increased temperature, and that ultimately means you burn fewer calories. Those extra calories can add up to several pounds a year.

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Manuel Villacorta
Nutrition & Dietetics Specialist

I can't tell you how many women come in and tell me how healthfully they're eating, how active they are, how well they're doing in general, and yet they gain a pound a year during peri- and actual menopause, which often adds up to ten to fifteen pounds in the midsection. There are a few reasons this happens. On average, women tend to become less active during this time. Metabolism and muscle mass decrease, and hormones change. Of course, your body's hormones have a direct impact on your appetite, metabolism, and fat storage, so weight gain during this time is more likely caused by hormones rather than overeating. In your younger years, you may have gained in the hips and buttocks, but now you'll notice you gain in your waist, which has to do with low estrogen.

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Natasha Turner, ND
Alternative & Complementary Medicine Specialist

For most women, shifts in weight begin before menopause (perimenopause) when an average woman gains approximately one pound a year leading up to menopause. Many women believe that the changing levels of estrogen are the main cause of weight gain, but other factors are also at play, including: reduced physical activity, excess caloric intake or improper combinations of protein, carbs and fats, a decrease in lean muscle mass, and a genetic predisposition to gain weight around your stomach.

In addition to dietary changes, which may include sticking to a low glycemic diet with enough healthy proteins and essential fats, try the following suggestions:

  • Have your thyroid gland tested. If you are menopausal, problems of the thyroid gland can occur, especially if you are taking HRT. You should have TSH, Free T3, Free T4 and thyroid antibodies. Your TSH should ideally be less than 2.
  • Have your fasting blood sugar and fasting insulin levels tested. If you have high insulin levels on fasting tests you will tend to gain weight around the abdomen and have difficulty losing weight in general.
  • Monitor your stress levels. Elevated cortisol levels cause an inhibition of thyroid gland function leading to accelerated aging, water retention and increased abdominal fat.
  • Make sure your estrogen and progesterone levels are healthy. Ask your health practitioner about bioidentical hormones.
  • Watch your sleep habits. Sleep in complete darkness and get to bed before 11 PM for optimal release of hormones that affect body composition. If you are sleep-deprived, it may cause weight gain and a tendency to overeat.

Women tend to gain weight in the belly area after menopause because loss of estrogen leads to redistribution of body fat, especially around the waist. Weight gain after menopause is common and is widely linked to both normal aging and ovarian aging. Estrogen is produced by the ovaries and after menopause, estrogen secretion decreases and eventually stops (as a result of ovarian follicular depletion).

Donna Hill Howes, RN
Family Practitioner

Hormonal changes during menopause don't cause weight gain. But, with these changes, women tend to gain more weight around their middle. This type of weight gain increases the risk of many illnesses, including heart disease and stroke. Lifestyle and genetic issues can also be a factor with how and where you gain weight as you get older. You can't change your genetics, but you can change your lifestyle for improved health.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.