Medical Files

Menopausal weight gain

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Last week we talked about menopausal blues and other symptoms which the fluctuation of the female hormones can cause. Rosenda Yang from Marikina City inquired about another problem that women usually have to contend with after menopause. This is the weight gain, especially the few extra pounds a woman may gain around the belly. Nine out of 10 women tend to gain weight as they near menopause and several years after the menstruation stops.

One should not feel guilty about it and start blaming oneself for any increase in weight. Even if one eats the same amount of food, the slowing down of the body’s metabolism will tend to gradually increase one’s weight and change the shape of one’s body from a pear-shaped to an apple-shaped form. This is because the increase in weight concentrates on the abdomen and not on the hips, thigh and buttocks.

Generally this increase in weight is gradual such that one may hardly notice it until she sees pictures of herself several years before and after menopause. For those experiencing early menopause due to the surgical removal of the ovaries, the increase in weight may be relatively faster and sometimes extreme.

With the reduced estrogen levels, more fat cells and less muscles tend to form in the body. The decrease in progesterone causes water or fluid retention and a bloated sensation.

Although the increase in weight is mainly due to the hormonal changes occurring during menopause, other factors such as lifestyle and genetic may be contributory too. If one’s mother has or had a big belly after menopause, chances are one would likely have a similar problem.

Psychological factors may also come into play as stress triggers may be present during this period like children leaving the house (or coming back in some instances), marital problems or separation with the spouse and other life changes requiring adjustments which one may not be able to cope with. Some tend to be careless with their diet and become sedentary in the presence of these postmenopausal stressors.

Preventive measures and other pointers that menopausal women could adhere to include the following:

•Maintain or even increase one’s physical activity as one nears menopause and for the rest of one’s life. Aerobic exercises increase one’s metabolism and help burn the extra fats. Weight-bearing and strength-training exercises including light weights can increase muscle mass and also minimize the risk of developing osteoporosis.

The aerobic exercises may involve moderate activity, like brisk walking for at least 150 minutes a week, or vigorous activity, such as jogging for at least 75 minutes a week. On top of this, strength-training exercises are ideally done at least twice a week. For those who are overweight, they may need to exercise more.

•One should be careful not to lose too much weight because very thin menopausal women are more prone to  severe osteoporosis than normal-weight or slightly overweight women.

•An important precaution one should take before enrolling in any exercise or weight-reduction program is to get a clearance from one’s family physician. Many menopausal women may already have undetected cardiovascular diseases and should be properly evaluated so they could be advised as to the level of activity they can safely tolerate.

•Eating a balanced diet—underscoring the word “balanced”—can’t be overemphasized. I don’t recommend “fad” diets which advise one to focus only on certain nutrients (such as proteins) and completely eliminating other calorie sources such as carbohydrates and fats. Our body needs some amount of these nutrients too.

“Crash” diets can also be disastrous. Very-low-calorie or “starvation” diets may cause one’s metabolism to slow down further and promote subsequent weight gain. It’s important that one follows a diet regimen she is comfortable with, and which she is confident she could sustain on the long term. Otherwise, one is likely to have a “seesaw” or rebound increase in weight which could sometimes be  worse than one’s baseline weight.

• Avoid refined sugars and have generous servings of fruits, vegetables, high-fiber cereals, nuts and legumes. Even for those with uric acid problems, nuts and legumes can still offer more benefits than the minimal potential risk of increasing their  blood uric acid levels.

• Since one tends to retain water after menopause, she should cut down on her salt intake and be cautious of hidden sources of salt such as canned products, condiments, biscuits and other snack products. One should also limit her intake of caffeine and alcohol. Smoking should be completely avoided.

•  Those who put on excessive weight during menopause might have concomitant medical abnormalities that need to be diagnosed and treated. They might have diabetes, cholesterol or thyroid problems. It’s always good advice to be checked by one’s physician if her weight gain is out of control. When one gets excessive fat stored around the abdomen—called visceral obesity—the risk of cardiovascular complications such as heart attack and stroke is significantly increased due to some deleterious hormones secreted by the fat cells in the abdomen.

A woman nearing menopause should learn to accept the tendency to gain weight as something that naturally happens at this stage of her life. A positive mindset about it can help in one’s adjustment process. Some experts even say that this is a compensatory mechanism as the little extra weight can help alleviate other symptoms associated with menopause, such as the anxiety and hot flashes.

Rather than losing sleep that some clothes don’t fit anymore, menopausal women should look at this stage with positive expectations, and focus on what they can do to remain healthy, active and free of any major illness.

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