Ask the doctor: “My wife says she can’t lose weight because she’s over 45 and going through menopause. Is that true?’

Question: How true is it that you can’t lose weight after 45?

Your wife keeps moaning about how she works out and eats right and she can’t lose weight because she’s going through menopause. Is that the case?

I’m not worried at all if she loses weight or not as I think she’s perfect just the way she is. I’d just like an expert opinion on whether or not it’s true that women’s weight loss is influenced by menopause/perimenopause.

Reply: I don’t think there is any evidence that weight loss is negatively affected by menopause. I believe that intentional, controlled, and well-planned weight loss (for the right reasons) is possible at any age. Weight gain and increased central fat distribution (the donut that lines the abdomen and flanks) is common in women in the early postmenopausal years.

The increase in fat mass with preferential accumulation of visceral fat (fat that surrounds internal organs such as the liver and intestines) is thought to be due to a reduction in energy expenditure (levels of physical activity) that occurs with age and the post-condition of menopause.

Total body weight on the scale may not change, but body composition, particularly fat distribution, and lean muscle mass will decrease unless you regularly strength train and eat a balanced diet.

A good way to gauge if you have too much visceral fat is to get a tape measure and measure your waist, aiming for a circle around the level of your belly button (measure your donut). Over 80cm for a female and over 94cm for a male is considered tall and steps should be taken to reduce this.

Simply put, weight gain occurs when energy intake exceeds energy expenditure, and what you eat and your level of physical activity affect that balance.

According to a report by the Surgeon General on Physical Activity, the percentage of adults who engage in physical activity steadily decreases with age, and decreased energy expenditure in both adults and children is indicative of weight gain.

If the basic requirements for a healthy, balanced diet and a minimum level of exercise are not met for days, weeks, months and years, this leads to an increased BMI. Scientists have proven that our metabolism doesn’t slow down until we’re around 60 years old. More likely, as we age, we become more sedentary and tend to eat more of the wrong foods.

For example, who would choose 250g of high protein, low sugar and 0% fat skyr yoghurt with fresh berries over a medium chocolate muffin or scone with butter and jam? The latter two options average over 400kcal, almost a quarter of your recommended daily intake, and are mostly carbohydrates, sugar and too high in saturated fat.

Weight gain can be listed as one of many possible symptoms of menopause, and indeed the increased levels of follicle stimulating hormone (FSH) that occur with menopause may be implicated in this weight gain independent of the natural decline in estrogen.

Interestingly, a meta-analysis of 28 randomized trials involving over 28,000 participants found that use of HRT (either estrogen alone or a combination of estrogen and progesterone) was not associated with a change in body weight.

I am fully in favor of a healthy diet and lifestyle, but not to the extent that she becomes dissatisfied with life and her own distinctly beautiful body.

dr Jennifer Grant is a GP at Beacon HealthCheck. Ask the doctor: “My wife says she can’t lose weight because she’s over 45 and going through menopause. Is that true?’

Fry Electronics Team

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