Est-il inévitable de prendre du poids pendant la ménopause ?

Is it inevitable to gain weight during menopause?

The vast majority of my patients gain a little (or a lot) of weight during menopause. I often hear that it's much harder to lose excess weight after age 50. But what does the science really say?

Hormones, what difference does that make?

Menopause is characterized by a decrease in estrogen and progestin levels, which can lead to a redistribution of body fat, often toward the abdomen. This hormonal shift can make it seem as if menopause is directly responsible for weight gain. There is also a decrease in testosterone, which leads to a gradual decrease in muscle mass.

The real culprit: our bodies burn fewer calories

Interestingly, recent studies indicate that weight gain during menopause is more related to a reduction in daily caloric expenditure and lifestyle changes. This decrease in caloric expenditure begins well before menopause and slowly increases over the years. As we age, muscle mass naturally decreases, which reduces basal metabolic rate and therefore resting energy expenditure. This decrease in muscle mass is a key factor in slowing down metabolism. I have even found that it is the same in women who are post-menopausal or not: the older we get, the fewer calories our bodies burn at rest.

And since we are also more sedentary, we should clearly eat less each year if we want to keep the same weight.

And if we do more sport, does it work?

If reducing our caloric expenditure is the main reason for weight gain during menopause, you might think that maintaining a regular level of physical activity would solve the problem. It's true that resistance exercises, in particular, can help maintain muscle mass and increase caloric expenditure (brisk walking, cycling, hiking, dancing, etc.).

But sport only represents a few hours in a week. However, the rhythm of our days also has a significant impact on our caloric expenditure. When I was 30-35 years old, like many of my patients, I had young children, I ran all day, I carried the children, the suitcases, the schoolbags all day. I did the shopping for big meals, with people around the table, every day, I was constantly in a frantic pace. Over the years, the children become more independent, they end up leaving the house, we only do shopping for two, or for ourselves alone, we run less after the clock, we no longer carry so many heavy loads. Without realizing it, we greatly reduce our physical efforts in a normal day. This is the beginning of a sedentary lifestyle.

And if we are also lucky enough to be able to treat ourselves to a restaurant, a glass of wine, etc. more often, we significantly increase our calorie intake, also without realizing it.

The quality of your diet also has effects

It plays a vital role in weight management. It is recommended to focus on nutrient-dense, low-calorie foods and avoid processed foods high in sugars and saturated fats. Protein consumption helps preserve your muscle mass and increase satiety.

Surprising but true: the more you sleep, the less you eat!

Sleep is often overlooked, but it plays a crucial role in weight management. Insufficient sleep can disrupt hunger hormones, increasing appetite and weight gain. Make sure you get 7-9 hours of sleep each night to support metabolism and overall health.

Fun fact:

A 20-year-old woman burns on average 126 Kcal more per day, at rest, than a 50-year-old woman. Probably mainly because her muscle mass is more developed.

According to the WHO, the ideal to stay healthy is to practice 150 minutes per week of physical activity: 2-3 hours of cardio exercises per week and 2 times 30 minutes of weight training. In order to fight against muscle atrophy, for men and women. 75% of Swiss people say they apply this advice.

Waist circumference is the most important indicator for predicting metabolic risks. In women, the increased risk starts at 80 cm and becomes significant beyond 88 cm. In other words, women who accumulate fat on the buttocks or thighs have less risk for their health than those who accumulate at the waist. The same goes for men, by the way. It's very unfair because we can't choose, obviously...

Do you know the male version of menopause?

Men also experience hormonal changes with age, often called andropause, which can lead to similar or worse weight gain. As in women, reduced testosterone can contribute to decreased muscle mass and increased body fat.

In summary, here are my tips to remember:
  • Increase physical activity: Incorporate at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity per week.
  • Stay energetic and dynamic throughout the day: Park a few hundred meters away, walk briskly, take the stairs instead of the elevator, clean to music, play with the grandchildren, act like young people with a young mind!
  • Eat a healthy diet: Our bodies are no longer 20 years old and no longer manage imbalances as well. Eat a varied diet, rich in protein, fiber and healthy fats, limit processed products and drink plenty of water.

Conclusion

Weight gain during menopause is not inevitable. It is mainly the result of changes in metabolism and lifestyle. By eating a balanced diet, staying active and looking after your mental wellbeing, you can effectively manage your weight during this time. Menopause can be an opportunity to redefine your health and wellness routine, allowing you to live this stage of life with confidence and vitality.

Dr Patricia Delarive

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