Menopause is a common time for weight gain – Studies have shown that the average weight gain is 2.1 kg ± 5.1 1.  And it is frustrating because many women have either struggled their whole life to control weight or what was actually working is no longer working anymore.

Common frustrations are: “Why is my body changing?” “Where is this belly fat coming from?” “Why don’t my clothes fit anymore?” Some women may be experiencing physical symptoms such as hot flushes, night sweats, feeling lethargic or emotional. In addition, there are likely some personal changes happening as well with kids moving out of home (or perhaps you’re wishing they would!), work challenges and ageing parents. And all of these things can make it hard to control weight at this time of Change.

woman checking belly

So what is happening with biology at the time of menopause?

There are 4 main changes that happen arond the time of menopause that affect weight.

  1. An increase in hunger 2 which lasts about one year
  2. Slowing of metabolism and movement 3 which is more persistent
  3. A decrease in muscle mass 4 – called Sarcopenia – this is a normal part of the ageing process but can contribute to the slowing of metabolism. It can be prevented with resistance exercises.
  4. More belly fat – with a drop in estrogen levels around menopause, the brain tries to stimulate the ovaries through prodction of FSH (Follicle stimulating hormone) and this increases central adiposity (fat around the centre).

Why is my body fighting against me?

With all of these changes it can feel a little bit like your body is fighting against you, but the good news is, it is possible to still maintain a healthy weight or even lose weight around the time of menopause! A study by Simkin-Silverman studied the impact of a lifestyle program (which consisted of a reduced calorie diet of 1300 kcal/day and 1000-1500 kcal/week of exercise) on stopping the weight gain around menopause.  The results showed that 55% of participants in the lifestyle program group were at or below their baseline weight compared to only 26% in the control group. This tells us that it is possible to prevent menopausal weight gain with some lifestyle change.

However, for women who have already been struggling with overweight or obesity prior to menopause, lifestyle change alone, may not be enough. What then?

women happy drinking

But wait there is hope!

We know that in addition to the hormonal changes of menopause, the biggest driver of your weight is appetite hormones. These are the same hormones that help you to survive in times of famine (“What famine?”, I hear you say. Yes your body is trying to help you be a storage machine).  In addition to diet and exercise, weight loss medications can play an important role in preventing the menopausal weight gain – they can help to overcome the hunger hormones that drive up weight and can help to reset your metabolism in order to achieve your ideal body weight. Studies show that some weight loss medications can help patients to achieve almost 10% of their body weight 6.

weight loss chart

How can we help?

At Alevia Medical Weight Loss our bariatric doctors understand the hormonal changes and the biology of what is happening at menopause. We can show you the ideal dietary plan to control weight, as well as medications that overcome the hunger hormones that change at this time in your life.  Menopause does not have to equal weight gain – it is possible to look good and feel good so that you can enjoy life to the fullest.

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  1. Guthrie JR, Dennerstein L, Dudley EC. Weight gain and the menopause: A 5-year prospective study. Climacteric 1999;2:205–11.
  2. Ainslie DA, Morris MJ, Wittert G, Turnbull H, Proietto J, Thorburn AW. Estrogen deficiency causes central leptin insensitivity and increased hypothalamic neuropeptide Y. Int J Obes Relat Metab Disord 2001;25(11):1680–88.Lovejoy JC, Champagne CM, de Jonge L, Xie H, Smith SR. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes (Lond) 2008;32(6):949–58.
  3. Messier V, Rabasa-Lhoret R, Barbat-Artigas S, Elisha B, Karelis AD, Aubertin-Leheudre M. Menopause and sarcopenia: A potential role for sex hormones. Maturitas. 2011 Apr;68(4):331-6.
  4. Simkin-Silverman LR, Wing RR, Boraz MA, Kuller LH. Lifestyle intervention can prevent weight gain during menopause: Results from a 5-year randomized clinical trial. Ann Behav Med 2003;26(3):212–20.
  5. Rubino D, Abrahamsson N, Davies M, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. 2021;325(14):1414–1425.
  6. Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, Lau DC, le Roux CW, Violante Ortiz R, Jensen CB, Wilding JP; SCALE Obesity and Prediabetes NN8022-1839 Study Group. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med. 2015 Jul 2;373(1):11-22. doi: 10.1056/NEJMoa1411892. PMID: 26132939.

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