Body Composition Changes During the Menopause Transition

One of the most common and frustrating symptoms reported during menopause is the shift in body composition, especially weight gain around the abdomen. Many women notice this change even if their diet and physical activity levels remain consistent. This added weight typically appears around the abdomen or trunk area, leading to an increase in what’s called visceral fat.

Visceral fat is important to understand because it poses unique health risks. Unlike subcutaneous fat, which is stored just beneath the skin and less metabolically active, visceral fat accumulates around internal organs and actively secretes hormones and inflammatory molecules. This makes it a contributor to metabolic dysfunction and inflammation, both of which can impact overall health. In fact, visceral fat has been directly linked to a higher risk of developing coronary artery calcifications, or plaque buildup in the arteries, which can ultimately lead to cardiovascular disease.

Menopause and Visceral Fat

Why does menopause cause this change? Before menopause, when estrogen levels are higher, women are more likely to store excess fat in subcutaneous tissue, particularly around the hips and thighs. Subcutaneous fat, unlike visceral fat, is not metabolically active, meaning it doesn’t produce the inflammatory hormones that contribute to health risks. As estrogen declines during menopause, the body’s fat storage preferences shift from subcutaneous to visceral fat. This shift increases the risk of cardiovascular disease and other metabolic disorders, including insulin resistance and type 2 diabetes. If you’ve noticed an increase in abdominal fat despite maintaining your usual diet and exercise routine, a reduction in circulating estrogen may be the underlying cause.

Understanding why these changes occur is often empowering. But just as important as the why is knowing how to manage these changes to support overall health and longevity. The first step is addressing nutrition, one of the primary factors that can influence inflammation levels in the body. Since visceral fat is inflammatory, following an anti-inflammatory diet can be incredibly helpful in reducing systemic inflammation. In Dr. Mary Claire Haver’s book, The Galveston Diet, she discusses the advantages of an anti-inflammatory diet specifically for women navigating menopause. This diet emphasizes nutrient-dense foods, rich in antioxidants and low in processed ingredients, which can help reduce visceral fat and support metabolism during menopause. For more about this approach, check out The Galveston Diet. If you would like one-on-one support for implementing lifestyle changes, we have health coaches and a registered dietitian that can help support you on your journey to wellness. You can find more information about each of these services at upliftforher.com.

Top 5 priorities for nutrition during the menopause transition include: 

1. Nutrients 
2. Fiber 
3. Antioxidants 
4. Decrease Inflammatory Foods 
5. Adequate Proteins and Fats 

The Role of Physical Activity

Another critical component in managing body composition changes during menopause is regular physical activity, particularly resistance training. Resistance training helps maintain and build muscle mass, which naturally declines with age in a process called sarcopenia. Sarcopenia often begins as early as age 30 and continues to progress, accelerating with hormonal changes in menopause. This loss of muscle mass can lead to a decrease in basal metabolic rate, meaning the body burns fewer calories at rest. Muscle loss can also create room for visceral fat accumulation, which further impacts metabolic health.

Some women may wonder why muscle loss doesn’t necessarily show on the scale. Unfortunately, when we lose muscle, the body often replaces it with visceral fat, meaning that while the number on the scale might not change, body composition shifts unfavorably. This is why body composition assessments, which are available at many gyms and fitness centers, can be more helpful than a standard scale for monitoring changes in muscle-to-fat ratios. To build and maintain muscle mass, it’s essential to engage in regular resistance training and consume adequate protein. For more ideas on staying active during the menopause transition, check out our blog post on Exercise & Menopause.

Hormone Replacement Therapy (HRT) and Body Composition

For some women, hormone replacement therapy (HRT) may also be a helpful tool for managing abdominal weight gain. The 2022 North American Menopause Society Consensus Statement highlights that HRT can help reduce the accumulation of abdominal fat associated with menopause. HRT is often prescribed to address other symptoms of menopause, such as hot flashes, brain fog, and joint pain, but it can also positively impact body composition and metabolic health.

Not all women experience severe menopause symptoms, but HRT can be beneficial beyond symptom relief. It’s FDA-approved for the prevention of osteoporosis (bone loss) and has been shown to reduce cardiovascular risk and decrease the likelihood of developing new-onset type 2 diabetes. If you’re interested in learning more about HRT and whether it’s right for you, see our guide, Navigating Hormone Replacement Therapy: A Quick Guide.

Seeking Support for Body Composition Changes

If you’re noticing changes in your body composition during menopause and are concerned about maintaining your health, we’re here to help. Our team can assist you in finding composition assessment tools, provide guidance on lifestyle changes and information on HRT options for appropriate candidates. To explore your options, schedule a free discovery call or book a Perimenopause/Menopause Consultation through our website.

Body composition changes are a common, and often frustrating, part of the menopause transition. However, understanding the shifts behind these changes and adopting a proactive approach to nutrition, exercise, and potentially HRT can support a healthy, balanced body composition during this phase of life.

Sources:

https://www.sciencedirect.com/science/article/pii/S000291492400153X?via%3Dihub

https://menopause.org/wp-content/uploads/professional/nams-2022-hormone-therapy-position-statement.pdf