Menopause is defined as an absence of menses for 1 year. The timeframe of this can range from 40s to 60s, but the average age is around 51. While thought to just be related only to reproductive health, menopause comes with many of its own physical changes. These changes can occur as early as 10 years before, and this transition period is known as “perimenopause”.

Perimenopause can come with a whole range of its own symptoms. I talk more about this here.

One of the symptoms many people report during this time is weight gain; a slowing down of their metabolism. On average, women gain 1 pound per year in this time. However, there is quite a variability in this number. 20% of women report gaining 10 pounds or more during this period.

What is causing weight gain in menopause?

It’s complicated. Unfortunately, there’s not one single answer, but rather a compilation of things. 

Here are a few considerations the research suggests.

Age-related changes

Our metabolism slows down as we get older. We see a reduction in our lean muscle mass (responsible for supporting our metabolism) and an age-related increase in body fat. Our protein demand increases as we get older and if this isn’t supported, it can directly impact our caloric intake and how well our metabolism is supported. Simply put, if you’re not getting enough protein, you’re not supporting your muscle mass and this is not going to help your metabolism. However, strategy around this is key.

Things that you were doing and working when you were in your 20’s and 30’s (such as the type or amount of exercise, the dietary habits) may not be effective anymore. The North American Menopause Society says it’s like “running to stay in place”.

Environmental changes

Your lifestyle in your 50s is often quite different from earlier days. Common things people will report are more sedentary jobs, and household and social priorities may shift where it becomes more difficult to prioritize your health goals.

For example, chasing around younger children can often increase your total steps in the day, unplanned. But as your kids get older, you loose that non-intentional exercise.

Hormonal changes

Contrary to what many believe, estrogen does not cause weight gain. Research suggests the loss of estrogen which occurs during menopause, can lead to a reduction in your resting energy expenditure. This means, that at rest, you burn fewer calories compared to your pre-menopause self. The result? You need more exercise than before to maintain your old metabolism weight.

In those who added back estrogen (through hormone therapy), we see an increase in the resting energy expenditure.

Hormone changes in menopause can also cause symptoms that make it difficult to lose weight, specifically, behavioural changes.

How can I support menopausal weight gain?

As we discussed, there are age, environmental, and hormonal changes that makes maintaining weight challenging. To take that one step forward and have the goal of weight loss, strategies that worked previously, likely need to be adjusted. The other symptoms that come during this life period for aomen - like mood swings, poor sleep etc., can make the execution of a new strategy more difficult. 

For example, if we need to work on protein and blood sugar balance through some tailored dietary approach, but you consistently also have poor sleep, research shows that this can directly impact your caloric intake the next day. This is working against the progress you’re trying to make. 

Thus a holistic approach, a plan that takes into account the menopause symptoms, hormonal changes and other factors is key to building a successful strategy.

Additionally, your plan will also shift and evolve as your clinical picture shifts and evolves. Finding consistency in your plan so it feels sustainable is key.

Key steps to building a successful plan:

1. Assessment

While there is commonality in perimenoapusal and menopausal symptoms, every person is unique. Every person has a different family history that needs to be taken into account. Every’s situation is different, as is their health. Understanding what specificially you need to focus on is key, so we’re not wasting our time on other things.

For example, maybe youre diet is great and you’re furelling well for your body, but your stress, sleep and blood sugar balance is preveting progress. We need to assess for these factors and build a plan that makes sense for you.

2. Holistic strategy:

A plan that takes into account not just what you’re eating and how you’re exercising but looks at your day-to-day environment, along with internal metabolic hormone health. Your hormones influence how you’re feeling and how well other factors in your plan are going to work.

3. Regular follow-up and plan adjustments 

As your health and body evolve, so will your plan. This is key to preventing yoyo-type changes to your metabolism. Regular check-ins also encourage accountability and allow you and me to evaluate what’s working for you and what’s not. It’s also a great opportunity to share where you need extra support and what resources I can provide to help you jump over those obstacles. This is so key to success, and we have research to support this. Those with regular check-ins achieved significantly greater weight loss than who were self directed. (Williams, 2019).

The take-home:

Perimenopause and menopause body transitions are common and not your fault. These changes may not warrant any intervention. However, if you’re noticing symptoms or changes that do not make you feel your best, or your strongest or you have a family history and risk factors you’re concerned about or want to prevent - there are absolutely options for you and worth discussing.

If you’re looking for a holistic, individualized plan - book a discovery call to learn more.

In Health, 

Dr. Ashley Damm, BSc. ND

Naturopathic Doctor - Vancouver, BC

Women's Health & Fertility

1. References:
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3. Weidlinger S, Winterberger K, Pape J, Weidlinger M, Janka H, von Wolff M, Stute P. Impact of estrogens on resting energy expenditure: A systematic review. Obes Rev. 2023 Oct;24(10):e13605. doi: 10.1111/obr.13605. Epub 2023 Aug 6. PMID: 37544655.
4. Simpson SJ, Raubenheimer D, Black KI, Conigrave AD. Weight gain during the menopause transition: Evidence for a mechanism dependent on protein leverage. BJOG. 2023 Jan;130(1):4-10. doi: 10.1111/1471-0528.17290. Epub 2022 Sep 25. PMID: 36073244.
5. Chopra S, Ranjan P, Malhotra A, Verma A, Kumari A, Sharma KA, Sarkar S, Vikram NK. Perceived risk factors for weight gain, barriers, and facilitators related to weight loss experienced by perimenopausal women: focus group discussion and thematic analysis. Menopause. 2022 Feb 1;29(2):219-224. doi: 10.1097/GME.0000000000001909. PMID: 35084375.
6. Williams LT, Collins CE, Morgan PJ, Hollis JL. Maintaining the Outcomes of a Successful Weight Gain Prevention Intervention in Mid-Age Women: Two Year Results from the 40-Something Randomized Control Trial. Nutrients. 2019 May 17;11(5):1100. doi: 10.3390/nu11051100. PMID: 31108930; PMCID: PMC6567062.