Midlife Weight Gain: Is It Menopause or Lifestyle?

Karen Turner calls it "The Big Fat M." Menopause has affected her moods, her body temperature and her weight.

Especially her weight.

"It has been like heck to get it off," she says of her "belly weight."

"There's that middle section that just nothing helps, unless you go and suck it out and cheat and have the money to do it," says Turner, 48.

Turner's lament is common among women in their 40s and 50s whose weight seems to continually creep upward, even if they aren't eating or exercising differently.

But two local physicians say they aren't convinced that women's hormones are entirely to blame.

"This is a controversial subject," says family practice physician Alyson Thal. "Women will blame anything besides what they need to blame."

"I'm not a big believer in hormonal weight gain," agrees Rebecca Shoden, a obstetrician and gynecologist. "I think some things can encourage weight gain more than others."

So, what's happening here? Women aren't just imagining that their waistbands are tightening, but they may be pointing fingers at the wrong culprits, Thal and Shoden say.

Is it the Pill?
Women who still take birth control pills sometimes blame those for weight gain. But back in the 1970s, birth control pills were stronger than they are now, and there was no net change in women's weight, Shoden says.

And in 2006, a review found no truth to the widespread belief that birth control pills cause weight gain. Researchers found that women did tend to gain weight over time but they couldn't find evidence that the pills caused that gain.

Still, some birth control pills may increase a woman's appetite, Shoden says. Some newer birth control pills on the market, such as Yaz, are designed not to increase women's appetites or water retention.

Whether they're on the pill or not, most menstruating women will have a few days of feeling heavier each month.

"Every woman will feel like she's gained three or four pounds of water weight late in her cycle, right before her period," Shoden explains.

As women enter perimenopause, their brains become less sensitive to estrogen, which -- along with hot flashes, fatigue, depression and changing libido -- can trigger hunger, experts say.

Women on hormone replacement therapy often blame the medications for their weight gain as well.

"Some of my patients swear that they gain weight when they go on estrogen," Shoden says. "And when they go off, they lose 10 pounds, which is water weight because they drop it so fast."

But researchers have found that women who take hormone replacement therapy don't gain weight as a result. In fact, women in studies who took placebos tended to gain more weight.

Slowing Down
Experts say midlife weight gain appears to be mostly related to aging and lifestyle, but menopause may play a part. For one thing, after midlife, women need fewer calories because they expend less energy.

"I think our metabolic rate slows down," Shoden says.

Thal says she believes that hormones play some part in weight gain, but the question is, how much? "I think it's a partial truth, but it's not the whole story. Hormones may have some impact on weight, but it's a couple of pounds, it's not 20 or 30 or 40 pounds," she says.

People need to understand what healthy aging is, Thal adds. "Our hormones are going away because our ovaries are aging. A hundred years ago, we died when our ovaries died. We're in our second childhood now, and that's posing some interesting questions for doctors."

None of this means women are without options, she adds. "If I have a woman who's gaining weight on a birth control pill, I'll switch her to another one or switch her to the patch. I'll do my part, but then I'll ask, 'What are you doing?' There is no magic bullet."

Thal suggests women in midlife take a close look at their lifestyle and emotional health. Women often maintain unrealistic expectations of what they should look or feel like as they age. "We're programmed to be Barbie dolls, but we don't stay active enough," she says.

Thal says she challenges women to ask themselves these questions: Are you happy with your work? Are you watching your salt intake? Why are you eating what you're eating? What are you doing in your life regarding your weight? Many women are "bored, hate their spouses, and they eat their stress away," she contends. "We girls are programmed to swallow our anger."

Like Thal, Shoden says midlife weight gain is probably more of "an age and activity and stress phenomenon."

"I think you do have to work harder," Shoden says. "If you're taking in the same number of calories and doing the same amount of exercise, it's not going to work. It's not fair, but that's the way it is."

One simple but important change women can make, Shoden says, is to make sure they get enough sleep. It's easy for menopausal women to feel like they're losing their memories and control over their moods, and all of that is exacerbated by fatigue. "I think if you sleep better, you have more energy. You can just feel normal," she says. "You can get back to feeling like your brain works normally."

What works is different for every woman.

Turner has lost about 20 pounds in the past year and a half, much of it from giving up meat and increasing her intake of vegetables. "I haven't had a hamburger since January, and I'm noticing the difference in the belt," she says.

When she tired of going to Curves and doing the same exercise routines, Turner bought a stationary bike. "I've tried everything else, so now I'm fixing myself, because I'm feeling better, and I have a lot of energy."

(c) 2008 Albuquerque Journal. Provided by ProQuest LLC. All rights Reserved.