Understanding healthy aging.

If you were to ask most women when they’d be most likely to gain weight in their lives, they’d probably pinpoint two life-changing events—pregnancy and menopause. While weight gain during pregnancy is expected and necessary, the same doesn’t hold true for menopause. Yes, the body undergoes changes that may make weight maintenance a bit of a challenge, but weight gain during the change of life isn’t inevitable.

As menopause approaches, hormone levels begin to fluctuate and women notice changes in the body. Hair may be come thinner, the skin may feel dry or dull, and many women experience hot flashes. But it’s the threat of weight gain and changes in body shape that many women have difficulty adjusting to.

Menopause and Estrogen

Estrogen is a hormone that promotes fatty deposits in the lower body. Stockpiling calories in the hips and thighs ensures enough energy will be available to support pregnancy and breastfeeding. As menopause approaches, though, these lower body fat deposits are no longer needed, since the reproductive years are waning. But in an attempt to maintain hormonal balance, the body tries to hang on to whatever fat it can, since body fat produces estrogen and releases it into the bloodstream.

Weight gain during menopause becomes noticeable in the midsection. Women find that their youthful “pear” shapes are starting to look more like “apples.” One menopausal patient of mine had a unique way of adjusting to her changing shape. As she lost the fat her hips and behind (and got rounder in front) she found that her pants fit better when she wore them backwards.

But a thicker waistline isn’t simply a cosmetic problem. The body fat that accumulates around the middle isn’t just the stuff you can pinch on the surface. Fat can also accumulate below the surface, surrounding internal organs and dumping hormones and other compounds into the system. This can raise blood pressure, wreak havoc with cholesterol levels, and interfere with the body’s ability to process carbohydrates. All of these factors can raise the risk of some of the most common chronic diseases associated with obesity, such as heart disease and diabetes.

Mid-Life Weight Gain, Diet and Fitness

The good news is that just because a woman is going through menopause, weight gain doesn’t have to follow. The same strategies for achieving and maintaining a healthy body weight still apply. Nutrient-dense, low calorie foods—plenty of fruits, vegetables, lean proteins and nonfat dairy products—provide what the body needs. Fruits and vegetables supply fiber and phytonutrients, protein helps keep hunger at bay, and calcium-rich dairy products support bone health at a time when declining estrogen levels can lead to accelerated bone loss.

Exercise is important, too, and one of the best things women can do is strength training. Not only does lifting weights help to keep bones healthy, it also builds lean body mass, which in turn increases the body’s daily calorie burn. And regular exercise can also help women feel healthy and strong while they are adjusting to all the changes their bodies are going through. I like to tell my patients to think of those hot flashes as “power surges”—and to use that energy to “muscle their way” through menopause.