It’s one of the more frustrating changes that occur after menopause, the “pooch” that starts to show up around the middle. So common is this change in body composition, that some people refer to it as the “menopot.” In fact, much of the fat gain that women experience after menopause goes directly to the tummy and manifests as an increase in waist size and belly fat. Unlike loose, white fat that you can pinch between your fingers, the fat that predominates after menopause lies deep within the pelvic cavity and builds up around organs such as the liver.
More disturbing is the fact that the type of fat that you store around the middle is the most harmful from a health standpoint. We refer to this type of fat as visceral fat and it’s linked with a higher risk of chronic health problems, including type 2 diabetes, cardiovascular disease, and some forms of cancer. What makes deep, tummy fat so harmful? Research shows visceral fat cells produce inflammatory chemicals that are linked with insulin resistance. So, belly fat is more than a cosmetic problem. But what causes these unwelcome changes that so many women must deal with?
Blame It on Your Hormones
When you’re still having regular menstrual periods, your ovaries produce two sex hormones, estrogen, and progesterone. As menopause approaches, the production of both declines. The drop in estrogen is a stimulus for the accumulation of deep belly fat since women who take hormone replacement therapy, including estrogen replacement alone, develop less belly fat on average than women who don’t. Plus, research shows that women who stop taking hormone replacement therapy tend to gain belly fat. So, one solution would be to take hormone replacement therapy after menopause but that comes with risks that some women don’t want to take.
Another factor that drives the increase in visceral fat is a bump up in cortisol. Beginning with the menopausal transition, what we call pre-menopause, the adrenal glands start pumping out more cortisol. One of the drawbacks of increased cortisol production is this stress hormone shifts fat storage toward the waistline and belly. It also increases bone loss and disrupts normal immune function. Therefore, the increase in tummy fat you see during pre-menopause and early menopause is partly due to a rise in cortisol.
Another way a menopause-related drop in estrogen contributes to belly fat is it slows resting metabolic rate. Studies show when the ovaries stop producing estrogen, resting metabolic rate slows. Therefore, you don’t burn as many calories at rest. The decline in metabolic rate is around 50 calories per day. That isn’t a dramatic drop, but if you don’t compensate by eating less or exercising more, it can lead to a significant amount of weight gain over time.
Plus, insulin sensitivity declines after menopause and is partially fueled by the drop in estrogen and rise in cortisol. It’s not unusual to see an increase in blood glucose after menopause, especially in people who gain weight. Fortunately, exercise, both aerobic and resistance training, helps reduce the decline in insulin sensitivity that leads to blood sugar control. Still, it’s a good time to give up sugar and reduce the number of refined carbohydrates in your diet.
Lifestyle Factors that Contribute to a Gain in Belly Fat after Menopause
What else can explain the increase in body fat that takes place after menopause? It’s not just hormonal changes. How about lack of exercise? Women who have a tough menopause with hot flashes and fatigue may not feel motivated to exercise. Not staying physically active is a double whammy if you’re trying to avoid menopause-related weight gain. Your resting metabolism is already slowing as estrogen levels fall. In fact, exercise becomes even more important after menopause! Some studies even show exercise helps with hot flashes and other menopausal symptoms. Some women also experience mood changes, including depression, and exercise is a lifestyle habit that helps fight depression.
How about sleep? We know that at least 7 hours of sleep per night is important for weight and appetite control. Even one night of too little sleep increases levels of the appetite hormone ghrelin and boosts cravings for sugary and fatty foods. Plus, chronically not sleeping enough places stress on the body and increases cortisol, another contributor to belly fat. According to the National Sleep Foundation, more than 60% of women have problems sleeping during and after menopause. Some have problems falling asleep while others experience fragmented sleep with frequent nighttime awakenings. Studies clearly show a link between lack of sleep and weight gain. So, it’s important to work on sleep hygiene during menopause to avoid weight gain and an increase in belly fat.
Stress, too, causes a rise in cortisol, a hormone that’s not waistline friendly. The stress of going through menopause combined with lack of sleep further fuels the rise in cortisol. That’s why it’s important to make time for rest and relaxation during mid-life as well. Keep doing high-intensity exercise, but add stretching and yoga to your routine for balance.
The Bottom Line
Yes, there are physiological things going on during pre-menopause and menopause that make it easier to store fat around the tummy, but lifestyle is a factor too. Fortunately, you have control over the lifestyle you lead. Make sure you’re managing stress, sleeping enough, avoiding refined carbs and sugar, and staying physically active. You need strength training and, preferably, some high-intensity exercise as well. Lifestyle really can help you avoid the visceral fat and the health problems that go along with it.
References:
· J Appl Physiol (1985). 2015 Nov 1; 119(9): 975–981.
· Menopause. 2006 Mar-Apr;13(2):212-21.
· The Journal of Clinical Endocrinology & Metabolism, Volume 102, Issue 12, 1 December 2017, Pages 4457–4466, https://doi.org/10.1210/jc.2017-00825.
· Obstet Gynecol Clin North Am. 2011 Sep; 38(3): 537–566.doi: 10.1016/j.ogc.2011.05.008.
· Harvard Health Publishing. “Exercise is an all-natural treatment to fight depression”
· J Sleep Res. 2008 Sep;17(3):331-4. doi: 10.1111/j.1365-2869.2008.00662.x. Epub 2008 Jun 28.
· National Sleep Foundation. “Menopause and Sleep”
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Dear Cathy: Thank-you so much for this post and an earlier one on BMI values. I’m 65 and lately I have been feeling like I have this ball of ab fat that wasn’t there before. Recently, I put on a pair of shorts that I bought last year and I couldn’t button the waist or zip them up. When I bought them, I was three pounds heavier than I was last year. I know that I have lost muscle because my medical doctors are all concerned with my BMI, so for the last 5 years I have been dieting-and not doing much weight lifting- to get my BMI to a number that they want it to be. I was subscribing to the idea that weights would make me heavier and just doing cardio would get me results. I see that what I have been doing is not the best thing, and I wanted to share the experience so that others don’t do what I have been doing. I’m back to lifting heavier weights as well as doing cardio and also watching my diet.