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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.
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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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