What is Menopause?

Menopause is a natural biological process that marks the end of a woman’s reproductive years. Typically occurring between the ages of 45 and 55, it is diagnosed after 12 consecutive months without a menstrual period. Men experience a similar phase called andropause, characterized by a gradual decline in testosterone levels, usually occurring between 40 and 60 years of age. However, unlike menopause, andropause does not lead to the complete cessation of reproductive ability.

Over 43% of menopausal women have obesity. Research shows avoiding a body mass index (BMI) above 25 kg/m2 can prevent many of the chronic illnesses now characterized by developed countries.

---

---

Menopausal Weight Gain

On average, women gain approximately 1.5 pounds per year during the menopausal transition, whereas men gain approximately 0.5 to 1 pound annually during andropause.

---

---

Hormonal Changes: These gains are partly due to hormonal changes. The estrogen decreases in women can contribute to increased fat mass and decreased lean body mass. In men, decreased testosterone levels can result in increased fat mass, particularly around the abdomen.

Metabolic Rate: Both genders experience a decline in basal metabolic rate (BMR) as they age, making it easier to gain weight even with unchanged dietary composition and caloric intake.

Exercise and Diet: Reduced physical activity is common among aging adults. Coupled with dietary changes, such as increased consumption of high-calorie and low-nutrient foods, menopausal weight gain can be intensified.

Psychosocial Factors: Stress, depression, and anxiety can also be associated with the menopausal transition and lead to emotional eating and overeating, derailing efforts toward maintaining a healthy lifestyle.

Prevention and Treatment

Nutrition: A diverse intake, consistent with the now commonly referenced Mediterranean diet, including fruits, vegetables, whole grains, lean proteins, and plant and marine sources of dietary fat and protein can be most effective in controlling weight and improving overall health in menopausal women. Registered dietitians can be indispensable to those wishing to prevent and/or reverse menopausal weight gain through diet and lifestyle changes.

Physical Activity: Regular physical activity, including both aerobic exercises and resistance training, also helps. At least 150 minutes of moderate-intensity aerobic activity per week with resistance, muscle-strengthening activities two or more days can boost metabolic rate, increase muscle mass, and reduce fat mass.

Behavioral Interventions: Cognitive-behavioral therapy (CBT) and other behavioral interventions can be effective in addressing emotional eating and promoting healthier lifestyle choices. Many registered dietitians regularly incorporate CBT into their practice. Mindfulness-based stress reduction (MBSR) has also shown promise in reducing stress and improving eating behaviors.

Medical Treatments: Hormone replacement therapy (HRT) may help manage menopausal symptoms and aid in preventing weight gain by maintaining hormonal balance. However, HRT should be considered on an individual basis due to potential risks and side effects. For men, testosterone replacement therapy (TRT) might be considered to counteract andropause symptoms, including weight gain, though it must be approached cautiously and under strict medical supervision.

Conclusion

Weight gain during menopause and andropause is influenced by a combination of hormonal changes, reduced metabolic rate, lifestyle changes, and psychosocial factors. Addressing these issues through balanced nutrition, regular physical activity, and appropriate medical and behavioral interventions can help. Individualized treatment plans with medical providers, including registered dietitians, can prove vital for preventing and/or reversing menopausal weight gain and improve overall health.

Patrick Traynor, PHD, MPH, RD, CPT has an insurance based registered dietitian practice with MNT Scientific, LLC. He has offices in South Lake Tahoe, CA, Sacramento, CA, and Minden, NV and also works via telemedicine. Inquiries can be directed to Dr. Traynor at (530)429-7363 or info@MNTScientific.com.