Many women in menopause find that the same diet and exercise they previously followed to lose weight no longer works. Some women describe a “plateau” no matter what diet, fasting plan, or intense exercise program is added. Some even experience weight gain, especially around the belly, despite these efforts. This can be a frustrating and vicious cycle of over-restriction, over-exercising, and can ultimately create physical and mental stress.

Menopause is defined as 12 months without a menstrual period. This is marked by one specific day. The life stage that comes after this date is considered post-menopause. Many women will experience cycle changes and symptoms for several years leading up to the actual date of menopause. Read more about navigating the common symptoms of perimenopause in my previous blog. The average age of menopause in the United States is 51 years old, though the age range varies across the 40s and 50s and is unique for each woman. By the time menopause occurs, the ovaries produce very few sex hormones like estrogen and progesterone. Smaller amounts of estrogen and progesterone are still produced and released by the adrenal glands.

There are physiological explanations for this weight gain and weight loss resistance post-menopause. One factor is the decrease in sex hormones as well as decline in lean body mass (muscle) which decreases resting metabolism (the number of calories burned at rest). Your body may be operating under different conditions BUT there are nutrition and lifestyle approaches to address this:

• Shift your focus from weight loss to muscle gain: The health and wellness community has shifted attention to muscle health, protein requirements, and optimizing body composition versus simply losing weight. You have likely heard that muscle weighs more than fat, so why do we still worry so much about the number on the scale? Body composition analysis tools like InBody and DEXA scans can help us determine how much of our body weight is muscle versus fat. This data can help you track your progress over time with the general goal of increasing lean body mass and decreasing body fat percentage (for women, the ideal range is 18-28% body fat).
• Weight training: If you are new to weight training, consider working with a trainer and/or group fitness class to learn how to safely move, minimize injury and build muscle. Incorporating rest days is also very important to prevent injury so that your muscle gains can help you in your daily life (think about the functionality of muscle, not just the aesthetics). Ideally work up to 3-4 sessions of weight training per week which can include body weight exercises, resistance bands, and/or weights.
• Protein requirements for building muscle: A general rule of thumb for finding your protein goal for building muscle is to use your ideal or goal body weight in pounds multiplied by 0.7 – 0.8 grams. For example, if your ideal body weight is 130lbs, multiply that by 0.7 – 0.8 grams to get 91-104 grams of protein per day. Some individuals may go as high as 1 gram per pound with regular and consistent weight training. If your estimated protein goal is much higher than you usually eat, work up slowly and spread your protein intake throughout the day. On days when you are exercising, have a protein-containing meal within 60 minutes of completing your session.
• Dietary patterns to consider: One option for losing body fat is a low carbohydrate or modified ketogenic diet. Ketogenic diets generally represent higher fat and low carbohydrate intake with the goal of changing the way the body burns food for energy. In ketosis, the body uses ketones produced from fats versus using sugar as the primary fuel source. One keto approach for post-menopausal women is Dr. Anna Cabeca’s Keto Green diet ®. This diet emphasizes non-starchy green vegetables to support gut health, detoxification, and energy. Keep in mind that ketogenic diets are meant to be short-term and there are many ways to structure “keto cycling” which includes periods of higher carbohydrate intake. Regardless of diet, a short-term calorie deficit WITH adequate protein can be beneficial for fat loss. Although calories in and calories out do matter for weight loss, it should not be the only focus. The quality of foods included in your diet are just as important as quantity. Work with a nutritionist to find a tailored approach that works with your lifestyle, health concerns, and food preferences.
• Don’t underestimate the role of stress: Surprise, surprise – managing stress is important for managing your weight, too. Unfortunately, many of us live in a state of “fight or flight” where every email notification sets off a physical stress response where hormones like cortisol are released. In states of high stress, the body will prioritize survival and NOT weight loss or muscle gain. Weight loss is best achieved under perceived safety (lower stress). It is important to find the consistent stress management practices that work for you. This can include practices like HeartMath or less structured practices like going for quick walks throughout your day, listening to calming music, or journaling before bed.  Also consider physical stressors including frequently skipping meals and exercising too often or too hard without rest. Earlier in your life these strategies may have temporarily helped you to lose weight (this probably included some muscle). However, there are diminishing returns to these practices related to your physical stress response. Consider eating breakfast and dinner earlier. In more recent years the craze around intermittent fasting has caused many people to push breakfast back to “brunch” or skip the meal all together. Many people will benefit from a breakfast containing at least 30 grams of protein earlier in the day to help lower stress hormones and stabilize blood sugar. Protein smoothies, eggs with vegetables, savory soups and dinner leftovers are all good options.

Although there is much nuance and personalization involved in finding the right post-menopause weight loss strategy for you, these are basic principles to consider. If there is one place to start, it’s about framing this stage of your life as a joyous and powerful opportunity to build physical strength and emotional resilience.