General Medical

Menopause Does Not Make You Fat: Dr. Pat’s Notebook

Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

I can’t tell you how many women come to me with the belief that menopause has caused their weight gain, and there’s nothing they can do about it.


Some claim hormone therapy made them fat. Others are certain that the loss of estrogen caused their weight gain. One thing’s for sure, they say: Something is making us fat, and it is worsening with age.

Is menopause to blame?

Mid-life weight gain can partly be explained by an alteration in fat cell biology that seems to promote fat deposition in the abdominal area. But other triggers are your food and alcohol consumption. And here, you are still in control.

There are five major causes for weight gain during menopause:

  1. Being overweight to start. Often, women enter menopause already 20 pounds overweight. It is harder to slim down after a steady weight gain accumulated over decades.
  2. A sedentary lifestyle. With less activity, you burn fewer calories. Regular exercise increases body mass and raises the metabolism rate.
  3. Unmanaged stress. In stressful times, the levels of cortisol — a hormone produced in the adrenal glands — rise, which increases appetite and triggers fat accumulation in the abdomen.
  4. Sleep deprivation. We don’t sleep the recommended eight hours a night, which in turn alters our metabolism. It causes a decrease in leptin levels in the blood (the hormone that signals the brain that you are not hungry) and an increase in ghrelin levels (this hormone stimulates hunger).
  5. Alcohol consumption. Alcohol increases appetite and is converted to sugar. It burdens the mid-life pancreas and causes a two-hour insulin spike. Sugar in alcohol is deposited as—you guessed it—belly fat.

If you want to break this cycle, work on reaching your ideal weight and commit to a few (perhaps long-overdue) behavior modifications:

  • Buy a scale and use it. The number on that scale is not an emotional event but the result of your food choices and calorie expenditures.
  • Shed the magical thinking about food. Yes, you do gain weight by eating while standing, while eating off someone else’s plate, and certainly when you eat whatever you want washed down with a Diet Coke. “Fat free and sugar free” still means calories.
  • Fight situations that trigger impulsive eating. Let family members and the food pushers in your life know how they can help you achieve your goals.
  • Eat responsibly and exercise. Stop the excuses. Chose a reasonable diet that works for you, and an exercise routine you can stick to.
  • Preparation is essential. Make sure that the foods you need for your weight-loss plan are ready and waiting in your kitchen. Take meals to work that fit into your new eating plan.
  • Stay  in charge of what you eat even while you travel. Ask the hotel concierge to empty the mini-bar of alcohol and junk food and stock it with healthy foods.
  • Arrive at cocktail parties late. Don’t consume alcohol, and eat at home before you go. Imagine how many people have put their unwashed hands on those canapés. That should be a real appetite suppressant.
  • Mindfulness is essential to any weight loss process. Think before you make food choices.

Menopause is your time for reinvention! This is the rest of your life; now make it the best of your life.

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  • Corinne Ferrer March 16, 2018 at 11:40 pm