Women at midlife can suddenly find themselves dealing with stubborn weight gain, especially around your tummy. Like other symptoms at menopause, from hot flashes to mood swings, weight gain that’s harder to manage can be blamed on shifting hormones.
For example, decreasing estrogen levels worsen your body’s insulin sensitivity. This drives blood sugar up, triggering your cells to store fat.
“Estrogen is also linked to a lower metabolism, shifting fat distribution and increased visceral fat – which is fat around your vital organs, many of which are in the abdomen,” said Dawn Flickema, MD, an Avera physician who specializes in integrative and functional medicine.
“Increases in the stress hormone cortisol go hand in hand with less estrogen, which also can affect metabolism, insulin sensitivity and increased visceral fat,” added Morgan Willard, Avera registered dietitian.
Diet Plays the Leading Role in a Healthy Weight During Menopause
While healthy weight management involves a bigger picture, diet plays the leading role.
If you’ve always counted calories to control weight gain, that strategy may not work for you anymore at menopause.
“During menopause we shift the focus from eating less to instead eating in a way that promotes improved metabolism,” Willard said.
Protein: Protein is essential in preserving muscle mass and keeping your metabolism active.
“A lot of women are not meeting their increased protein needs at menopause, and that results in metabolic changes that cause unintended or unwanted weight gain,” Willard said. “So you want to look for those healthy protein options – and include protein at every meal.” Healthy proteins include lean meats, dairy products, beans and legumes, tofu, nuts and seeds.
It starts with breakfast. Most Americans opt for a sweet breakfast: donuts, pancakes, waffles or toast and jelly. Instead, look to a high-protein breakfast like eggs, milk and lean meat.
Fiber: Fiber enhances gut health and cardiovascular health and helps regulate blood sugar. Choose whole grains above highly refined flours and sugar, including white bread, white rice and pasta.
Fat: Is fat a “no-no” for the menopause diet? Not if it’s a healthy fat. “Healthy fats actually boost your energy levels, help promote healthy cholesterol levels, improve your nutrient absorption and help you feel full so you eat less,” Willard said.
Trade trans fats such as shortening and margarine for healthier versions like olive oil, coconut oil and butter in moderation.
Alcohol: Make sure your alcohol intake is within healthy limits – one drink a day or less for women or two drinks a day or less for men. In fact, less is recommended because menopausal changes can affect how alcohol affects you. “Calories from alcohol add up,” Flickema said. “And drinking before bedtime is not a good strategy for better sleep – it actually interrupts your natural sleep rhythms.” Even if you drink moderately, consider cutting back for improved overall health.
Weight loss drugs may benefit some people alongside lifestyle changes, especially those who have struggled with weight since childhood, Flickema added.
Read more: Menopause and Your Diet
Watch Your Eating Patterns
“We strive to get people away from constant eating throughout the day, which seems to be a habit for a lot of people,” Flickema said. “Instead, strive for three healthy meals a day and maybe one snack if you need it – but most people don’t.”
Try to get a 12-hour overnight fast each day, for example, eat nothing between 7 p.m. and 7 a.m. “That helps with insulin sensitivity and your metabolic health overall,” Flickema said. “Tightening up the eating window will help overcome snacking, too.”
While some people find success with intermittent fasting, the ultimate goal is to make changes that are sustainable for a long-term healthy lifestyle.
Exercise for Better Balance
“If I could bottle up all the benefits of exercise, it would be something I would prescribe for anyone,” Flickema said. Benefits include balancing hormones, improving mood, strengthening cardiovascular health and managing stress, to name a few.
Both cardio exercise and strength or resistance training are important. Cardio exercise gets the heart pumping, and can be as simple as walking, biking or swimming.
About 30 minutes of cardio exercise five days a week is recommended. You can split that up into 10-minute walks. Some exercise is better than none.
Strength training can include specific exercises that work a given muscle group, lifting weights, carrying weights or wearing a weighted vest while walking or jogging.
“Improving your muscle mass will improve your strength and metabolism. Strength training also helps counteract bone loss,” Willard said.
Don’t Overlook Stress
Good stress management involves the whole picture of what’s going on with your life, Flickema said. “What stress management tools do you have, like mindfulness or meditation practices? Do you have a good tribe around you?”
Find coping skills for stress in the moment, whether that’s deep breathing or getting outside for a quick walk, Willard said. “Sometimes it’s working to minimize the things that are draining your cup and concentrating on activities that can fill your cup.”
See your primary care physician or OB/GYN specialist to start a conversation about treatment for perimenopause and menopause symptoms.
Keep Reading
This is one in a series about women’s health before and after menopause. Watch for a new feature each month on topics including hormone therapy, sexual effects, mood, sleep, bone loss and more.
