Menopause and weight gain

How to manage weight gain during menopause

During menopause, the body is going through massive changes, so it’s important to remember that weight isn’t the only predictor of health. 

Be kind to yourself and try to focus on working on the tips below with the intrinsic motivation of feeling better and managing other symptoms and weight will be secondary. 

If you’re finding that your symptoms are significantly impacting your quality of life, we’d strongly advise you to chat with your GP, as there are treatments available. 

Nutrition

It’s important to pay attention to our diet during menopause to ensure we feel our best and manage any potential weight gain. Try to eat three healthy and balanced meals each day and drink plenty of water. Our body can easily mistake thirst for hunger when we’re dehydrated.

There’s some evidence that suggests our resting metabolic rate (the number of calories our body uses per day when at complete rest) decreases by around 10 per cent post-menopause. 

The combination of a lower resting metabolic rate and hormonal changes increase the likelihood of weight gain in our midlife. These changes make overeating and weight gain more likely if we continue with the same diet and lifestyle as before. It may be necessary to adjust your diet or portion sizes, and increase your activity levels where possible as you enter this new stage of life. 

Evidence suggests that a lower-carbohydrate diet is the most effective and sustainable diet for weight loss. Following a lower-carb diet plan during menopause may help to manage potential weight gain. 

Lowering our carb intake can also help prevent insulin resistance, which women going through menopause are at higher risk of due to the redistribution of body fat. 

As insulin also promotes fat storage, reducing our carb intake might lessen this risk as insulin is released in response to glucose (sugar) found in carbs. 

With a lower-carb diet, we naturally increase our protein intake (e.g. chicken, tofu, or eggs) and healthy fats (e.g. salmon, avocado, or olive oil). These are digested more slowly than carbs, which can help us feel full and reduce cravings for unhealthy foods, which can be stronger during menopause. 

On top of the food we eat during menopause, certain supplements can promote health. Post-menopause, women are at higher risk of osteoporosis (weakening of the bones), which means that calcium requirements increase to prevent bone breakages. Foods high in calcium include milk, yoghurt, cheese, seeds, and sardines. Vitamin D increases calcium absorption, and since natural foods, apart from oily fish, contain little vitamin D, supplementation is recommended. Vitamin D can also promote a better quality of sleep. Keeping our bones strong and sleeping better both contribute to managing our weight. 

If you’re not eating many high-calcium foods, for example, if you follow a vegan diet, you may want to discuss the option of a combined calcium and vitamin D supplement with your GP. 

 

Key points:

• During menopause, we should aim for three balanced meals per day, along with plenty of water
• A lower-carb approach is effective for weight loss in the long term and can prevent insulin resistance, which women are at higher risk of post-menopause
• Supplementing vitamin D and eating foods high in calcium is important during and after menopause

Exercise

Studies have suggested that post-menopausal women were, on average, less active and more likely to engage in low-intensity exercise than pre-menopausal women. 

However, exercise can help improve our mental and physical health, which is essential in managing our weight, particularly during menopause.

One 16-week study split post-menopausal, overweight women into three groups, A) control (no diet or exercise), B) diet, and C) diet plus exercise. Results demonstrated that the diet plus exercise group (C) lost significantly more subcutaneous fat (fat visible under the skin) than the diet alone group. The diet plus exercise group also lost more visceral fat (fat around the organs) than the diet alone group, but this difference wasn’t significant. 

There’s a progressive decline in muscle mass during and after menopause due to the natural ageing process and declining oestrogen levels. For this reason, high-intensity or strength training, in particular, can benefit women at this point in life. 

In general, high-intensity interval training (HIIT), or short bursts of vigorous exercise, is more effective for weight loss than extended periods of light or moderate activity. A small pilot study suggests the same is true for overweight post-menopausal women. 

Strength or resistance training is any higher intensity exercise that uses weight. This could be weight machines that you find in a gym or our own body weight (e.g. squats, lunges, or push-ups). This type of exercise helps us build and preserve muscle and maintain healthy bones, which is particularly important for post-menopausal women due to the higher risk of osteoporosis. 

More intense exercise doesn’t need to be done for long periods to be effective. Quicker sessions, known as ‘exercise snacking’, can still have a large impact. A good option if you’re short on time or new to this type of exercise is to fit smaller bursts of activity around your daily routine. For example, doing squats while you wait for the kettle to boil or push-ups while your food is heating in the microwave.

As well as weight loss, evidence suggests that strength training can positively impact fat distribution in our bodies by reducing abdominal fat in older adults, which is one of the effects of menopause. 

Lower-intensity aerobic exercise, such as walking or gentle yoga, might be less effective for weight loss but still provide fat-burning benefits and are hugely beneficial to our mental and emotional health. Menopause can impact many women’s psychological wellbeing, so you should also incorporate this sort of exercise into your routine. 

 

Key points:

• High-intensity interval training or strength training are the best options for weight loss and reduced visceral fat
• You can include short bursts of this type of exercise into your daily routine, e.g. squats while the kettle boils
• Less intense exercise, like walking, hugely benefits our mental and emotional wellbeing

Sleep 

There are several different methods we can try to improve the quality of our sleep. For some evidence-based approaches, read our guide on how to sleep better.

On top of the general advice to improve our sleep, there are other reasons that women might struggle to sleep during menopause. Hot flushes and night sweats can be very uncomfortable and keep women awake at night. Try these techniques to relieve some discomfort:

• Keep your bedroom cool and use a fan if necessary
• Spray your face with cool water or use a cool gel pack (available at most pharmacies)
• Wear loose, thin clothing to bed that can be easily removed if necessary
• Avoid synthetic fabrics and opt for thin cotton nightwear or sheets
• Sip cold or iced water 
• Have a lukewarm shower or bath rather than a hot one

In addition, following the advice above around eating a balanced diet and exercising regularly will help to improve the quality of your sleep. 

Key points:

• There are many evidence-based techniques we can try to improve the quality of our sleep
• During the menopause, women might experience discomfort from hot flushes at night, so try to use specific strategies to manage these
• Eating a balanced diet and exercising regularly will also help to improve sleep

Stress

Working on getting a restful night’s sleep and regular exercise of any type will help us manage our stress levels. On top of that, there are some specific techniques we can draw on:

Meditation or deep breathing

Brain scans taken on people during meditation have shown increased activity in regions of the brain directly correlated with decreased anxiety and depression. 

Try practising breathing or meditation every morning when you wake up. For some extra support, there are many apps, such as ‘Calm‘ and ‘Headspace‘, or for free alternatives, ‘Simple Habit‘ and ‘Smiling Mind‘. 

 

Journaling gratitudes

Reflecting on positive experiences can help us shift our attention away from negative emotions, such as stress, anxiety, or depression. It’s not necessarily about ignoring negative moods or experiences but rather about balancing these with positive ones when we’re struggling to cope. 

A gratitude journal can also be a powerful coping tool to look back over when negative thoughts or feelings take over. Try writing one to three points in a journal each day. They can be as simple as ‘I am grateful for…the sun shining through my window today.’ or ‘I am grateful for…a funny phone call I had with my family member.’

 

Progressive muscle relaxation (PMR)

Progressive muscle relaxation (PMR) is a relaxation technique that has been shown to reduce stress-related activity in the brain, similar to the effects seen with common anxiety medication.

Just before we sleep tends to be a good time to practise PMR, as it helps us drift off. Each night this week, put in some headphones and listen to the recording we’ve made here at Second Nature. 

It takes 6 minutes and guides us through the process of PMR, step by step. Consider how your mind and body are feeling once you’ve finished – if you’re still awake!

 

Joining a programme

If you’re feeling overwhelmed trying to achieve a healthy weight, consider joining a programme. Evidence suggests that communicating with a mentor is one of the most powerful tools to help us cope and change our behaviours. Plus, we mirror the behaviour of other people who we engage with. 

For those struggling to cope, joining a programme to gain that extra support can be extremely beneficial. 

Second Nature is a completely digital habit change programme that gives you daily, online support from a health coach and peer group. All of the health coaches are registered nutritionists or dietitians. The programme takes place entirely within the app, with no need for in-person meetups. This year, 2337 women between the ages of 45-60 have lost at least 1 stone since joining the programme. 

 

Key points:

• Getting a restful nights sleep and regular exercise of any type will help us manage our stress levels
• Meditation and deep breathing, journaling gratitudes, PMR, and joining a programme are techniques to help us cope with high stress levels

Hormone Replacement Therapy

Hormone replacement therapy (HRT) is one option for perimenopausal and menopausal women, helping to supplement and stabilise hormone level fluctuations. Benefits include reducing common symptoms of menopause such as night sweats and hot flushes, and lowering the risk of osteoporosis. 

Some studies have suggested that HRT may also increase insulin sensitivity and blood glucose control in menopausal women with type 2 diabetes. Other studies indicate that HRT may help to mitigate the weight gain and increased visceral fat associated with menopause. 

However, the evidence is still inconclusive, so further research is needed to understand what role HRT may play in insulin sensitivity and weight gain post-menopause, especially in non-diabetic women. 

Over the years a number of studies have also linked HRT to worrying conditions such as cancer and heart disease. As a result, some women and their doctors have been reluctant to use HRT.

More recent research shows that there are indeed some elevated risks. Possible risks include a higher risk of breast cancer if taken for more than five years and an increased risk of blood clots. 

The evidence suggests that HRT does not increase risk of heart disease, and may even help to prevent it’s development. 

For most women, it’s likely that the benefits will outweigh any risks. However, there are different types of HRT and it may not be a suitable option for everyone, so speak to your GP about the options available to you. 

 

Key points:

• Hormone replacement therapy is one option for women experiencing symptoms of menopause
• HRT may increase the risk of developing breast cancer or blood clots, but these risks are thought to be small with the benefits outweighing the risks