Menopause and Belly Fat – Everything You Need to Know

One unwanted gift that ageing awards most of the women in midlife is belly fat. Besides the total weight gain, fat accumulation around the waist is another annoying problem that many women face around their middle age. The most disturbing and threatening fact is that this fat accumulation is not limited to the subcutaneous (under the skin) layer of the abdomen. It also accumulates intra-abdominally and surrounds the internal organs in the form of visceral fat. Hence the major concern of abdominal fat deposition during and after menopause is cosmetically an increase in the waist line and medically an increased risk of developing cardiovascular problems and type II diabetes. 1

Various studies on menopause and belly fat

It is a well established fact that the lean body mass constituted by muscles decreases with age and the fat mass increases with age. This change in the relative composition of the total body mass occurs with ageing in both men and women. What is more bothering is the undesirable pattern of fat distribution in women when they reach middle age.

A research 2 done in 2009 showed that the muscle mass, fat mass, total body weight and total cholesterol level of women observed in the study did not change with menopause but the total abdominal fat content increased. This shows that the increasing belly fat is not determined by how much weight you put on after menopause.

Unfortunately, the task of cutting down this extra pad of fat has not been so easy even for women who managed to maintain a good BMI in their pre-menopausal phase. The difference in the pattern of adipose tissue (fat) accumulation in pre-menopausal and post-menopausal women has been proved by studies. 3

What are the causes of belly fat during menopause?

It has been a myth that when women reach menopause they put on weight and the extra layer of padding around the waist that appears around menopause has been believed to be associated with weight gain. But the actual cause of belly fat appears to be something that is out of the hands of women who approach menopause. The lowering estrogen level is supposed to have an influence on this selective fat distribution in the body of middle aged women.

Another study proposes a genetic connection to this central fat accumulation. Researchers studied the genetic influence on central fat deposition on a large sample of postmenopausal twin population and found that specific genes that are different from those responsible for total fat distribution are responsible for fat deposition in the midsection of women. 4

How is estrogen related to belly fat?

Studies 5 say that the increase in total body weight after menopause is due to many non-hormonal factors but the central fat distribution is found to be due to hormonal changes – the post-menopausal estrogen drop redistributes the already stored fat from thighs, hips and buttocks to the abdomen (belly) thus increasing the waist circumference. But this central fat distribution can also be hidden. It may accumulate inside the abdomen, surrounding the internal organs and sparing your subcutaneous adipose tissue layer.

The possible explanation that researchers give for this ‘estrogen and abdominal fat’ association is that the hormone estrogen reduces the activity of an enzyme called lipoprotein lipase present in adipose tissue. This enzyme is responsible for the hydrolysis of fat (triglycerides) and their uptake by cells. 6 A change is adipose tissue metabolism plays a key role in the menopause-related abdominal fat accumulation. 7

The low level of estrogen and the consequent decrease in lipoprotein lipase activity in women who attain menopause in early life explain, why such women develop belly fat at an early age even if their total body weight does not increase.

Can you get belly fat after surgical menopause?

While natural menopause would give the necessary time to consider what to do about the growing weight and belly, a surgical menopause brings about the changes very soon. Be it natural or surgical, menopause-related belly fat is not going to abandon you unless you take necessary steps to maintain your weight and waistline. Nevertheless, the efforts from your part to cut down the extra fat also help to keep yourself healthy and prevent serious health issues like heart diseases, diabetes and colorectal cancer.

Ways to control belly fat during menopause

Women have long realized that it is not going to be easy to fight this stubborn fat that they gain during and after menopause. Relying on surgical methods like liposuction for cutting down belly fat merely for the reason that they provide quick relief is not advisable because they do not warrant a long term effect. Besides, they carry their own adverse effects.

What studies say about liposuction for menopausal belly fat?

Research does not prove any better effect of liposuction than that of diet and exercise when looking to cut down belly fat. 8 Fat is found to be redistributed especially in the abdomen after 1 year of undergoing liposuction. 9 Of course, it should be considered as the last resort when nothing else works. Obviously, a good exercise and diet control can do much more than liposuction when the effect is expected for a long term.

Best exercise to cut down menopause-related belly fat

Exercises in the form of aerobics, jogging, swimming and bicycling are highly fruitful when it comes to burning extra calories. It is necessary that you burn at least 400 calories a day to handle this problem. Vigorous exercise is necessary because the help that estrogen provided in increasing fat metabolism is no longer available after menopause. Resistance exercises help in burning more calories and increasing metabolism.These muscle-building exercises considerably help in improving your lean body mass and reducing your belly fat.

Diet that helps to reduce belly fat

Anything that reduces your rate of metabolism should be avoided and any nutrient that hastens metabolism should be added to your diet. Calcium revs up metabolism and it is also a very important mineral for women in middle age as it is necessary for bone health. An increased fruit- and vegetable-diet with low fat and calories would generally help in reducing fat accumulation. However, remember that fat should not be completely eliminated from the diet. Concentrate on consuming good fat that you can acquire from olive oil and other vegetable oils. Avoid trans-fat and saturated fat. Avoid junk foods completely.

As there is a slower rate of metabolism in middle age, small frequent meals would greatly help in preventing accumulation of fat. The food that is consumed does not turn into energy as quickly as it used to be before and you need to adjust your meal portions accordingly to get along with your slow metabolic rate.

More tips to control belly fat

Stress relief with yoga and meditation helps in reducing the cortisol level that aids calorie storage and fat deposition in the belly region.

Adequate sleep for at least 8 hours a day is essential for all the above mentioned lifestyle changes. Incomplete or insufficient sleep results in increased ghrelin (hunger hormone) levels that would provoke you to consume more food. A good sleep would also give you a fresh start for the next day’s workout.

Treatment options for menopause belly fat

Natural treatment

Some of the natural remedies that are advised for other menopausal symptoms have a positive effect in cutting down belly fat also.

Soy supplements are found to have a beneficial effect in reducing subcutaneous as well as total abdominal fat. 10

The probiotic Lactobacillus gasseri is found to have anti-obesity effects that lowers abdominal fat deposition and total body weight. 11

Pharmaceutical grade medications

Researchers 12 reported in their study that post-menopausal estrogen and progesterone hormone therapy had a beneficial effect on abdominal fat and this effect also reduced the risk of developing cardiovascular diseases in women even if there was no significant change in their serum lipids and lipoproteins.

However transdermal hormone replacement therapeutics have been shown to decrease abdominal fat accumulation but no significant effect on waist circumference have been accounted. 13

Diet replacement of dehydroepiandrosterone (DHEA) is found to have a positive effect in decreasing subcutaneous as well as visceral fat. DHEA, being a precursor for testosterone and estrogen would explain the reason for this effect. This daily dietary supplement is also found to have a beneficial effect in increasing insulin sensitivity and preventing the risk of metabolic syndrome with increasing age. 14 DHEA supplement creams have been proposed for reducing belly fat, but a possible long term effect is not warranted.

Belly fat in menopausal and post-menopausal women is of course a great challenge to face. The key to success in overcoming this problem lies in strict adherence to the lifestyle changes. However, for those who feel impossible to fight this stubborn fat, pharmaceutical and surgical remedies are available. After all, every woman is different and the treatment options differ according to the other symptoms and needs also. But it is always good to start with a healthy diet modification combined with exercise if you look to cut down this extra fat by natural means and for the long term.

Notes:

  1. Toth MJ, Tchernof A, Sites CK, Poehlman ET. Menopause-Related Changes in Body Fat Distribution. Annals of the New York Academy of Sciences. 2000 Jan 25; 904: 502-6. http://onlinelibrary.wiley.com/doi/10.1111/j.1749-6632.2000.tb06506.x/abstract;jsessionid=218584B25DA8A98D5963620E78759998.f02t03?deniedAccessCustomisedMessage=&userIsAuthenticated=false
  2. Franklin RM, Ploutz-Snyder L, Kanaley JA. Longitudinal changes in abdominal fat distribution with menopause. 2009 Mar; 58(3): 311-5. http://www.sciencedirect.com/science/article/pii/S0026049508003892
  3. Toth MJ, Tchernof A, Sites CK, Poehlman ET. Menopause-Related Changes in Body Fat Distribution. Annals of the New York Academy of Sciences. 2000 Jan 25; 904: 502-6. http://onlinelibrary.wiley.com/doi/10.1111/j.1749-6632.2000.tb06506.x/abstract;jsessionid=218584B25DA8A98D5963620E78759998.f02t03?deniedAccessCustomisedMessage=&userIsAuthenticated=false
  4. Samaras K, Spector TD, Nguyen TV, Baan K, Campbell LV, Kelly PJ. Independent Genetic Factors Determine the Amount and Distribution of Fat in Women after the Menopause. JCEM. 1997 Mar 1; 82(3): 781-5. Available from: http://www.twinsuk.ac.uk/wp-content/uploads/2012/03/Samaras.-JCEM.pdf
  5. Davis SR, Castelo-Branco C, Chedraui P, Lumsden MA, Nappi RE, Shah D, Villaseca P. Understanding weight gain at menopause. Climacteric. 2012 Oct; 15(5): 419-29. Available from: http://informahealthcare.com/doi/abs/10.3109/13697137.2012.707385
  6. Price TM, O’Brien SN, Welter BH, George R, Anandjiwala J, Kilgore M. Estttrogen regulation of adipose tissue lipoprotein lipase – Posssible mechanism of body fat distribution. American J Obstet Gynecol. 1998 Jan; 178(1): 101-7. Available from: http://www.ajog.org/article/S0002-9378(98)70634-9/abstract
  7. Tchernof A, Poehlman ET, Despres JP. Body fat distribution, the menopause transition and hormone replacement therapy. Diabetes and Metabolism. 2000; 26(1):12. Available from: http://www.em-consulte.com/article/79856
  8. Klein S, Fontana L, Young L, Coggan AR, Patterson BW, Mohammed S. Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. The New England Journal of Medicine. 2004 Jun 17; 350: 2549-57. Available from: http://www.nejm.org/doi/full/10.1056/NEJMoa033179
  9. Hernandez TL, Kittelson JM, Law CK et al. Fat redistribution following suction Lipectomy: Defence of body fat and patterns of restoration. Obesity. 2011Jul; 19(7): 1388-95. Available from: http://onlinelibrary.wiley.com/doi/10.1038/oby.2011.64/full
  10. Christie DR, Grant J, Darnell BE, Chapman VR, Gastaldelli A, Sites CK. Metabolic effects of soy supplementation in postmenopausal white and African American women: a randomized, placebo-controlled ttrial. Am J Obstet Gynecol. 2010 Aug; 203(2): 153e1-153e9. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206645/.
  11. Kadooka Y, Sato M, Imaizumi K et al. Regulation of abdominal adiposity by probiotics (Lactobacillus gasseri SBT2055) in adults with obese tendencies in a randomized controlled trial. European Journal of Clin Nutr. 2010; 64: 636-43. Available from: http://www.nature.com/ejcn/journal/v64/n6/abs/ejcn201019a.html
  12. Haarbo J, Marslew U, Gotfredsen A, Christiansen C. Postmenopausal hormone replacement therapy prevents central distribution of body fat after menopause. Metabolism. 1991 Dec; 40(12); 1323-6. http://www.sciencedirect.com/science/article/pii/002604959190037W
  13. Lobo RA. Metabolic syndrome after menopause and the role of hormones. Maturitas. 2008 May; 60(1): 10-18. Available from: http://www.maturitas.org/article/S0378-5122(08)00039-X/abstract
  14. Dennis T, Villareal, Holloszy JO. Effect of DHEA on Abdominal Fat and Insulin Action in Elderly Women and Men: A Randomised Controlled Trial. JAMA. 2004; 292(18): 2243-8. Available from: http://jama.jamanetwork.com/article.aspx?articleid=199765

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