Weight Gain in Menopausal Women

Las Vegas—With life expectancy in the United States on the rise, the number of years women are living postmenopause is increasing. Menopausal and postmenopausal women struggle with weight management, as 65% of women 40 to 59 years of age and 73.8% of women ≥60 years of age are considered obese.

Jeffrey P. Levine, MD, MPH, professor, director, women’s health programs, department of family medicine and community health, Rutgers-Robert Wood Johnson Medical School, led a workshop at the CRS meeting that focused on the weight gain menopausal women experience and measures to impede it.

Weight gain increases menopausal symptoms, and obesity is an independent risk factor for more severe menopausal symptoms. Obesity is associated with many medical conditions in women, including breast cancer, coronary heart disease (CHD), dementia, and stroke.  

A study showed that in overweight and obese women, a reduction in weight, body mass index, and abdominal circumference is positively correlated with a decrease in vasomotor symptoms [Arch Intern Med. 2010;170(13):1161-1167]. The researchers found that weight loss in postmenopausal women due to diet modification and exercise had a positive effect on insulin resistance, which may decrease cardiovascular risk.  

It is suggested that menopausal women engage in 60 minutes of moderate to intense physical activity each day to maintain an average weight, in addition to a diet that prevents against protein loss, while keeping calories from fat under 30% of their total caloric intake.

Another option for weight management in menopausal women is pharmacotherapy. Menopausal hormone therapy exhibited a decrease in central adiposity in most randomized, controlled trials and is considered the most effective treatment for vasomotor symptoms associated with menopause at any age [Climacteric. 2013;16(2):203-204]. In addition, a standard dose of estrogen could decrease CHD and all-cause mortality in women >60 years of age within 10 years of menopause onset. Estrogen plus progestogen therapy has shown similar results in terms of reduced all-cause mortality in this population, but no significant increase or decrease in CHD was found.

The Women’s Health Initiative executed a study that showed that estrogen–progestin therapy significantly assisted in maintaining lean body mass and inhibited a shift toward android fat distribution and improved sensitivity to insulin and may decrease the incidence of type 2 diabetes [Diabetologia. 2006;49(3):459-468].—Melissa D. Cooper