Same goes for older people in general. Is it harder to lose weight because they simply move less? What’s happening that makes weight loss so much harder in 30s and above?
In: Biology
Calories out is affected by many factors, including basal metabolic rate (what you burn at rest) and physical activity.
Physical activity is pretty straightforward. People do tend to move less with age, for many reasons including injuries, changing work responsibilities, family responsibilities, less physical hobbies, etc. This usually starts in the twenties and thirties and worsens over time.
Basal metabolic rate also changes with age (for both men and women- it’s not just a menopause thing). Thyroid function tends to slow down a bit, which causes the body to burn fewer calories at rest. Decreases in estrogen and testosterone lead to decreased muscle mass. Since muscle burns calories at rest, this results in fewer calories burned even without changing exercise habits. The effect usually is small, and there isn’t a big change in metabolic rate right around menopause.
The degree to which menopause causes weight gain tends to be overestimated. The most rapid weight gain in women happens after their mid-20s, with slower but steady weight gain through late middle age. There isn’t usually a huge jump in weight at menopause, but statistically that is often when the years of steady weight gain adds up enough to cause problems. Once too much fat has accumulated in the body, insulin resistance and other metabolic derangements develop, which can in turn lead to more weight gain and difficulty losing weight. Menopause sometimes coincides with these changes, but usually isn’t the main reason for them.
The most obvious weight related effect menopause has is the abrupt drop in estrogen, which causes fat to redistribute from breasts/hips/thighs to the waist. I see many post menopausal women who have not actually gained much weight since menopause, but feel like they have because their clothing doesn’t fit anymore. It feels like the 40lb they gained over 20 years showed up at once. Other than giving a person artificial estrogen, there is no way to go back to that premenopausal shape, even with weight loss (though healthy weight loss is still important!). This can be very frustrating, even to women who aren’t overweight, but it is a natural part of aging.
Tl;dr: menopause isn’t usually the main reason for large amounts of weight gain, but it can make weight gain more obvious and uncomfortable. The best time to focus on making healthy food and exercise choices is probably in the mid-twenties, because that’s when weight gain tends to start. It’s harder to lose weight than it is to avoid gaining it in the first place.
Source: am a family doc who gets asked about this a few times a week.
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