You’re not imagining it. Once women hit menopause, it really is harder to lose weight and keep it off.
“In menopause, the ovaries produce less estrogen,” explains gynecologist Laila Shehadeh, D.O., a gynecologist with Henry Ford Macomb Hospitals. “Animal studies show estrogen helps control body weight. With a lack of estrogen, we tend to eat more and be less physically active, and that lowers your metabolic rate.”
While there may be other factors behind your weight gain such as lifestyle changes due to changing work responsibilities or family commitments, research shows that a decreased level of estrogen does change your body composition and fat distribution.
Simply put …
With less estrogen, your body burns fewer calories—even if your diet stays the same. Those extra calories have a tendency to wind up as deposits of fat in your belly. The fat deposits in your belly can set the stage for a number of serious health issues.
“We really have a problem with obesity in America in general,” Dr. Shehadeh notes. “The average age of menopause for women in the United States is 51, so that’s a given. Thirty percent of women from age 50 to 62 are obese — not just overweight, but actually obese. Things become crucial as we cross that line — obesity can make women vulnerable to heart disease, diabetes, including insulin resistance, stroke and even cancer. Uterine and breast cancer have also both been linked to weight gain.”
The insidious link between fat cells and cancer in women
After menopause, a woman’s primary source for estrogen becomes her body fat.
“Fat cells convert into weak estrogen, and in women, that weak estrogen targets breast cancer and uterine tissue,” explains Dr. Shehadeh. “If a woman is obese, the estrogen constantly stimulates cells in the breast and uterus, continually building up the tissue there. That multiple proliferation of the lining becomes cancer.”
The trouble with belly fat
While excess weight is never a good thing, belly fat can be particularly problematic. Belly fat is one herald of metabolic syndrome — a cluster of serious health problems that also include increased blood pressure, high blood sugar and abnormal cholesterol levels, all of which increase the risk of heart disease, stroke and diabetes.
Excess fat can also worsen menopausal symptoms, making hot flashes, night sweats, insomnia, headaches, mood swings and forgetfulness more severe.
The solution is simple
It’s that same simple advice we’ve all heard before but it becomes more important as we age and small changes can really add up to make a difference.
“Eat less, work out more,” advises Dr. Shehadeh. “The change doesn’t have to be dramatic. For my patients who exercise two to three days a week, I tell them to add five or 10 minutes to the workout, or increase it to five days a week,” Dr. Shehadeh says. “High-impact cardio (running, jumping rope or jumping jacks) is what helps you burn fat.”
Dr. Shehadeh notes there are added benefits of increasing your exercise, beyond just weight loss.
“You create endorphins, and that helps you get rid of the anxiety and depression that can happen in menopause. Also, with high-impact cardio exercise, that movement and that pounding of your feet helps you create good bones. You’re lowering your risk of osteoporosis, heart disease and heart attack. We all have decreases in our hormones, and with that our muscle mass will decrease, but remember, you’re not fighting a losing battle. You just have to work harder.”
For patients that don’t exercise regularly, start slow.
“I would never tell somebody to suddenly start working out five days a week, but you do have to start,” Dr. Shehadeh urges. “Take baby steps. And always talk with your doctor about beginning an exercise program.”
“Diet is also very important,” adds Dr. Shehadeh. “You want to eat plenty of fruits and vegetables, and fewer fats.”
Visit your gynecologist
A visit to the gynecologist is about more than just a pap smear, Dr. Shehadeh emphasizes. You may need a pap smear to screen for cancer every three years, but that doesn’t mean we don’t want see you every year to do a breast exam, make sure your bone density is up to date, discuss cancer risks and talk about menopause. There’s a lot to discuss — should you be taking calcium or vitamin D3? How is your vaginal health, bladder health, general health?
“Just the weight gain alone can make women in menopause feel depressed, and it helps to have a physician tell you that you fall into the norm. That’s all you need to hear sometimes. A validation of your concerns can be enough to get us motivated to go out there and keep trying.”