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Weight Gain in Middle-aged Women: Avoidable or Inevitable?

by Dr. Jayashree Gopinath on October 15, 2022 at 10:49 PM
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Highlights:

Weight gain is a common complaint of women in their midlife, with more than two-thirds of midlife US women being over the ideal weight threshold. Aging-related metabolic changes promote weight gain in both sexes, but women face additional challenges because of menopause.


A presentation at The North American Menopause Society (NAMS) Annual Meeting in Atlanta, October 12-15, discussed the effect of age and menopause and strategies for managing weight.

Why Some Women Gain Weight Around Menopause?

It is a simple fact of life-the human body's metabolic rate drops with age because of a loss of muscle mass and reduced activity in the brown adipose tissue. Sleep disturbances and mood disorders, possibly related to the menopause transition, can additionally interfere with the adoption of healthy lifestyles, further promoting weight gain (1).

‘The loss of muscle mass and reduced activity during midlife can change body composition by depositing more fat to the lower body in women.’

The loss of ovarian hormones after menopause leads to altered body composition, with a reduction in lean body mass and an increase in visceral fat mass. In addition, menopause-related alterations in the gut microbiome can promote midlife weight gain.

All this added weight can worsen hot flashes while increasing a woman's risk of cardiometabolic conditions such as type 2 diabetes, hypertension, dyslipidemia, and coronary artery disease. Obesity also increases the risk of cancer in women, including breast and endometrial cancer.

Despite the rise in fad diets and over-the-counter supplements claiming to burn fat, the most important intervention for weight loss and maintenance remains calorie restriction.

How middle-aged women can fight back weight gain?

Although physical activity is less effective than dietary interventions for weight loss initially, it plays a crucial role in weight maintenance after the initial diet-induced weight loss and has multiple other health benefits.

Medications for weight loss are available, but there are concerns relating to costs, interaction with other medications, adverse events, and possible long-term toxicity.

Bariatric surgery may be a highly effective option in extreme cases, but ultimately, sustained behavior modification is necessary to maintain results over the long term.

Although hormone therapy should not be used for weight management in midlife women, when used for the management of bothersome menopause symptoms, it can improve body composition by redistributing the visceral fat to the lower body fat depots.

In the absence of active efforts at healthier eating and regular physical activity, weight gain is an inevitable occurrence in midlife women. Women must enter menopause with this knowledge and the familiarity with practical tips to prevent and manage weight gain (2).

Without a doubt, women face an uphill battle against weight gain as they age and transition through menopause, but that does not mean there aren't ways to help them combat the issue.

This presentation promises to provide some valuable insights that healthcare professionals can leverage when providing weight management advice to their menopausal patients.

References:
  1. Weight Gain in Women at Midlife: A Concise Review of the Pathophysiology and Strategies for Management - (https:www.mayoclinicproceedings.org/article/S0025-6196(17)30602-X/fulltext)
  2. Weight Management Module for Perimenopausal Women: A Practical Guide for Gynecologists - (https:www.ncbi.nlm.nih.gov/pmc/articles/PMC6947726/)


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