Diet, Exercise & Lifestyle: Weight gain
Dr.Jane Johnston MBChB, MRCGP
Every year over the age of 40 years - our Basal Metabolic Rate (BMR - the rate at which we burn off calories) slows down. Sadly this means that if we continue to follow our current eating and exercise pattern we will gain a pound a year! How depressing! We need to reduce our intake or increase our exercise to stay the same.
Why do women gain weight at the menopause?
This process, during the menopause, becomes even harder because our bodies want to store the fat for later - a bit like "puppy fat" stored at puberty.
We develop "insulin resistance" making our bodies store, rather than burn, calories.
What changes is how you handle food due to the increased "insulin resistance".
For example , if you eat 1000 calories before the Menopause you will burn 700 of them and maybe store 300. After the Menopause you will store 700 and burn only 300!
HRT can only partly help reverse this process.
NB - Watch out for an underactive thyroid especially if there is a family history.
The only things that can effectively increase your metabolism are activity and exercise.
Therefore, calculate (honestly) what percentage of your day is spent being active (actually on the move) and how much of it sitting, driving and sleeping. Compare that to when you were 40 years old and 30 and 20...! Watch a small child - they are constantly on the go and usually their mothers are too.
When women gain weight after the Menopause the distribution of where it settles alters. An extra pound before the pre-menopause will settle evenly over hips, bottom, thighs and arms. After the menopause it ALL goes round the middle! Hence the term "middle age spread" or " midriff". A fairly modest weight gain can thus result in a change of dress size.
Womens muscle mass declines at the Menopause and this causes a drop in the Basal Metabolic Rate. Muscle is efficient at burning calories - that's why it's worth doing resistance work. An increase of 2kg of muscle results in a 10% increase in Basal Metabolic Rate. Developing strong and toned muscles will make the clothes fit better and help you keep the excess pounds off.
Does HRT cause weight gain?
Women often complain that HRT causes them to gain weight. Some women resist taking HRT for fear of weight gain but there is no scientific evidence that HRT causes weight gain. HRT should help you sleep better and therefore feel better, giving you more energy so that you are able to tackle excess pounds by exercising. You are less likely to "comfort eat" if you feel good. However, a very small group of women may develop fluid retention with HRT (up to 10lbs in a month) but much more often it is mild and will settle in 4 to 6 weeks.
Choose the Menopause as a time of life to try and bring out the best in yourself. Take more exercise and eat a healthier diet, this will have the added benefit of helping you cope better with menopausal symptoms.
Dr. Jane Johnston