It’s a common complaint: “Once I reached 50 the weight just seemed harder to shift.” Each year
we receive dozens of letters from readers about midlife weight gain. We’ve picked the most frequently asked questions and separate fact from fiction.
 I’m 50, and I’ve started putting weight on around my midriff, but nowhere else. Could this be due to menopause?
 Yes and no. Many women gain an average of 10 pounds during the menopause transition, but there’s little scientific evidence to link the weight gain to either menopause or hormone therapy.
Instead, research suggests weight gain is largely a result of lifestyle and aging factors. As you get older, reduced activity levels play an important part. Lack of sleep, which, in turn, can make you less active during the day, may contribute. In the Nurses’ Health Study, researchers found that women who slept for five hours or less gained 2.5 pounds more than those who slept for seven hours a night.
There is some suggestion, however, that menopausal changes to body composition or fat distribution could be part of the picture. Research shows that menopause is associated with increased fat around the abdominal region.
It’s important to control weight gain in this area because not only does it make it harder to zip your pants, an increase in central abdominal body fat increases your risk for type 2 diabetes, high cholesterol, hypertension and heart disease.Since I started using estrogen therapy I seem to be putting on a lot of extra weight. Could it be due to the hormones?No, don’t blame your hormone therapy for those 10 pounds you’ve packed on since perimenopause. Despite previous beliefs that hormone therapy led to weight gain, well-designed clinical trials show that isn’t so, says JoAnn Pinkerton, MD, director of The Women’s Place Midlife Health Center at the University of Virginia in Charlottesville
and Professor of Gynecology.
In the Postmenopausal Estrogen/Progestin Intervention (PEPI) trial, a three-year study of 875 women aged 45 to 64, researchers found no differences in weight change between women using any of four types of hormone therapy and women taking a placebo.
This doesn’t mean you should look to hormone therapy as a means of weight loss or maintenance. Most health experts, including The North American Menopause Society, recommend using hormone therapy only to help with specific menopause-related symptoms, such as hot flashes and vaginal dryness, and for preventing menopause-related diseases such as osteoporosis.I’m determined to lose the weight I’ve recently gained.
Are there any diets specifically tailored to menopausal women?There are no tricks or magic when it comes to losing weight. So forget low-carb, low-fat, low-sugar, body-type, French eating or any of the other dozens of diets out there that promise to let you eat whatever you want, watch TV all day and still lose weight.
When it comes to maintaining a healthy weight, only one thing matters: You must balance the calories coming in with the calories going out. And unfortunately, the drop in estrogen and the eventual slowing of your metabolism means you will have to work harder.
It is a simple math problem. The number of calories you burn a day—called your basal resting metabolic rate—drops steadily with each passing decade. “So a 5-foot-8-inch woman who needed 1,411 calories a day at age 35 will only need 1,313 at age 55,” says Ivy Alexander, PhD, a woman’s health expert at Yale University School of Nursing. That means, if you don’t adjust the amount of food you eat to match this decrease in your metabolism—or balance it with increased energy expenditure—the weight will slowly but surely pile on. It also means that maintaining weight through the menopausal years is an accomplishment!
Or another way to look at it—if you eat an extra Lifesaver® a day, which is
15 calories, you will gain 2 pounds a year. And 2 pounds a year for 10 years is 20 pounds!
I’m concerned my weight could increase my susceptibility to illness in the future. How can I get back to my premenopausal size?By doing simple exercises and eating a healthy diet you should be able to watch the scales drop. But it’s a good idea to get some support to help you through the process. In the Women’s Healthy Lifestyle Project, a clinical trial of 535 healthy perimenopausal women, participants were assigned to lose 10 to 15 pounds. The first group received a structured lifestyle intervention program, consisting of a low-fat, 1,300-calorie per day diet and a physical activity program of two to three miles of brisk walking most days. The second group was told to lose weight on their own. Researchers found that women in the intervention group remained at their baseline weight, or lost weight, whereas women left on their own gained, on average, 5 pounds.
So the message from the study is clear: Some structure is helpful and sometimes necessary. “If women are committed to changing their diet and exercise patterns in ways that work for them, then they are much more likely to be successful over the long-term,” says Pinkerton.
To begin with, try and ease yourself into a healthy diet. Then combine this with a healthy dose of exercise every day, and you should start to see the weight gain slow down or stop
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