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women gain weight in midlife. raging hormones.

 

The reasons behind why women have a harder time shedding pounds during midlife.

"I've gained more than 10 pounds in the past three or four years. It's so frustrating!" "I don't eat any more than I used to. I avoid fats and junk food, and I take your exercise class twice a week. It used to be that when I needed to lose a few pounds, I could be really careful for a few weeks and take it right off. Now, forget it! Lots of my friends are having the same experience, especially those going through 'the change.' Is it hormones that are causing this weight gain, or is this just my body getting older?"

 

Is it hormones?

Menopause is the permanent cessation of the monthly menstrual cycle, typically occurring between the ages of 45 and 55 (52 is the average age for North American women). Since women don't know they have reached menopause until they have had no periods for a year, more useful terms for this life stage are "midlife" or "the climacteric." Both refer to a woman's midlife years, from 40 to 60, during which many hormonal changes occur. The climacteric begins with the late premenopausal period when a woman's ovaries gradually become less responsive to the hormones that cause them to produce the monthly rise of estrogen and progesterone. This usually occurs somewhere between the ages of 40 and 50. The next phase of the climacteric is the perimenopausal period, which includes the years immediately before and after menopause. The climacteric concludes with the early postmenopausal period, during which conditions related to changes in hormonal levels continue to occur.

A wide range of physical and psychological symptoms occur during the midlife years. Only two symptoms, hot flashes and vaginal dryness, have been shown to be exclusively related to hormonal changes.3 According to researchers, other symptoms, including mood changes, depression and weight gain, may be related to hormonal changes or may be caused by other factors. For example, night sweats (which occur when hot flashes occur during the night) may cause fatigue, depression, and muscular aches and pains because of sleep disturbances. Fatigue may lead to overeating and a fear that exercise will increase feelings of tiredness. Overeating and less exercise, of course, set the stage for weight gain.

Though many midlife women report weight gain, studies show that average body weight in North America increases steadily, beginning in the 30s, for both men and women. This increase generally continues into the 60s. Weight gains are typically about 1 pound per year, with some people gaining much less and others much more. Some researchers have suggested that, since weight gains occur in both men and women, it is not menopause so much as aging and lifestyle that are responsible for the weight gains that midlife men and women complain about.

Table of contents.
Weight gain and hormones.
Weight gain and aging.
The answer to mid-life weight gain.

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Keep in mind that people vary considerably in their weight histories. Many people do experience more rapid weight gain at certain times. Some women do experience significant weight gain during the menopausal years, so telling them about average national weight gains is irrelevant to their personal experiences!

Does hormone replacement therapy help? Studies of weight change in women receiving or not receiving hormone replacement therapy (HRT) are relatively inconclusive. So far, results suggest that HRT probably doesn't cause weight gain, but probably doesn't do much to prevent it either. A woman may have many good reasons to decide to try HRT (or to not try HRT), but weight control does not appear to be an important consideration, at least given what is currently known.

So what do you say when your client asks, "Is it hormones?" You can safely say, "Maybe."

Is it aging?

Some researchers suggest that loss of muscle mass is the real culprit responsible for midlife weight gain, since a decline in muscle mass leads to a slow but steady decrease in metabolic rate.2 Muscle mass begins to decrease in early midlife and continues into old age.

But is it aging? Many interesting studies suggest that a great deal of the age-related decrease in muscle mass may really be caused by inadequate physical activity. Physical activity, especially strength training, can increase muscle mass and help to preserve metabolic rate. One study found little difference in muscle mass or metabolic rate between young and old athletes in their group of 18- to 69-year-old women.2 Another study that followed women in their 40s for three years found that those who were least active gained the most weight.1 Such studies suggest that regular physical activity may help to prevent much of the midlife weight gain that is traditionally accepted as an inevitable part of the aging process.

It is important to note that it is easier for athletes to stay slim than for overweight clients to lose weight, so we must be careful not to promise our midlife clients pie in the sky with their exercise programs! The degree to which obesity can be reversed by lifestyle changes appears to be rather small for the vast majority of overweight people. Prevention works better than treatment for midlife weight gain.

And, having acknowledged these promising studies, also note that 60-year-old bodies are not the same as 20-year-old bodies; age does cause some decline in strength and muscle mass. So what do you say when your client asks, "Is it aging?" Once again, you can answer with a definitive, "Maybe."

What's the answer to midlife weight gain?

Whether midlife weight gain results from hormonal changes, aging or lifestyle, the answer is that old familiar refrain: exercise regularly and eat a healthful diet. Physical activity is the cornerstone of any weight-control program since it increases, or at least preserves, muscle mass, expends energy, enhances self-esteem, and hopefully is fun and reduces stress. Physical activity also addresses many of the health concerns that begin to become more of a reality in midlife: artery disease, diabetes, hypertension, osteoporosis and depression, for example.

Ironically, attempts to lose weight by severe caloric restriction, a weight-loss strategy popular among North Americans, may actually contribute to midlife weight gain. Such diets can further depress a declining metabolic rate, leading to frustration, continuing decline in muscle mass and more weight gain. While a well-balanced, nutritious diet helps combat midlife weight gain, very-low-calorie diets do not appear to be helpful.

Midlife clients may have to examine and readjust their expectations regarding achievable body composition and weight goals. In fact, they may want to get rid of goals entirely and focus instead on a healthful lifestyle that includes plenty of physical activity and a healthful diet.



REFERENCES

1. Owens, J.F., K.A. Matthews, R.R. Wing, et al. Can physical activity mitigate the effects of aging in middle-aged women? Circulation, 85 (4): 1265-1270, 1992.

2. Ryan, A.S., R.E. Pratley, D. Elahi, et al. Resistive training increases fat-free mass and maintains RMR despite weight loss in postmenopausal women. Journal of Applied Physiology, 79 (3): 818-823, 1995.

3. Shangold, M.M., with C. Sherman. Exercise and menopause: A time for positive changes. The Physician and Sports-medicine, 26 (12): 45-50, Dec 1998.


Barbara A. Brehm, Ed.D., is professor of exercise and sport studies at Smith College, Northampton, Mass.

 

 

 

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