While your patients in midlife may be somewhat prepared for symptoms that include mood swings, night sweats, and thinning hair, menopause can also lead them to gain weight unexpectedly. Because they have reached this transitional life stage, their go-to strategies for reducing weight may no longer be effective.
“Along with the loss of menstrual periods, the menopause transition is marked by phenotypic changes including body weight gain associated with increased fat mass and decreased lean body mass associated with reduced skeletal muscle mass and net bone resorption,” according to BJOG: An International Journal of Obstetrics and Gynaecology.
Preparing a plan to deal with this is particularly important for those treating Black women who face a different menopause experience, according to Dr. Alaa Gerais, a resident physician at the Neil Riordan Center for Regenerative Medicine. “Women of color also tend to go through menopausal symptoms at younger ages and for longer durations than white women,” she explained in a statement to Black Health Matters.
The hazard factors impacting the range of menopause onset include oral contraceptive use, smoking, and more.
Being open to developing a plan that caters to the demands of the patient’s lifestyle is key to helping them effectively handle this transition.
“Managing these issues is an important part of caring for women at mid-life, so it is incumbent on practitioners to have a clear understanding of the treatment options and how they may be adapted to an individual woman’s needs,” according to the Journal of Mid-Life Health.
We seek ways to advise your patient on weight gain during menopause. We’ve rounded up some methods below.
Educate Them
Empowering your patients through education allows them to be a true partner in managing their journey through menopause. This process can begin at the beginning of the menopause’s onset or even before it with predictive factors that can help you prepare your patient’s expectations.
Begin doling out advice and listening to their concerns during the perimenopausal period.
Talk them through how the effects of menopause might be showing up in their lives, and actively listen when they answer about their lifestyle.
Consider the best plan of action that they are most likely to maintain without drastically altering their routine.
Keep the advice focused on what best practices will work for the patient before you, and do not generalize it. “Provide counseling that focuses specifically on engagement in a weight loss intervention may enhance weight loss outcomes relative to more general weight loss advice,” reports the Journal of General Internal Medicine.
Have Them Hit the Weight Room
“Proper nutrition and exercise can help keep excess weight off, leading to a reduction of the fluctuation of estrogen, therefore, a decrease in menopausal symptoms. Exercises such as weight training can also strengthen bones, which is important in menopausal women due to decreased estrogen,” explained Dr. Gerais.
Danielle Rancourt, a registered dietitian, connected the lack of bone strength to the necessity of incorporating strength training into an overall wellness routine. “This is why strength training and adequate protein are so important at this stage,” she said.
Check-in with patients to determine what part of their fitness regime includes strength training. To make strength training more appealing, recommend incorporating methods that fit their goals in other areas of their lives. If they struggle to gain the appropriate nutrition, refer them to a nutritionist.
Advise Them to Get as Much Help as They Need
Reinforce that there is no need for those facing menopause to feel ashamed of this natural change. “If a woman is experiencing menopausal symptoms, she must speak to her doctor about the changes she is experiencing,” Dr. Gerais continued.
Work with their other providers to develop a plan that includes their mental and emotional health.
Consider Their Lived Experiences
Present a culturally informed medical opinion by considering the lived experience of your patient and how it might intersect with their transition into menopause. Other studies have found that some health risks associated with systemic racism contribute to the menopausal experiences of marginalized persons.
Find out what other kinds of support are available to help them achieve their goals.
Rancourt recommended “managing stress,” “prioritizing sleep,” and “seeking help from a qualified women’s health provider to manage your symptoms” as well. Insomnia can lead to difficulty managing weight, including the type of weight gain associated with menopause. If they express difficulties, I in achieving the appropriate results, refer them to a nutritionist.
A 2022 study published in Women’s Midlife Health found Black women were “50% more likely than White women” to experience vasomotor symptoms that can impact sleep and recovery. Consider this when making recommendations.
According to a Women’s Health Initiative Study, the risk of developing insomnia was greater in women who consumed high glycemic index (GI) foods bread, pasta, baked goods, and white rice) and anything containing added sugars (sugary beverages, sweets) versus low glycemic index (GI) plant foods such as most fruits and vegetables, legumes and beans, nuts, seeds, and whole grains.
Bottom line: You may have to assist your patient in navigating the new realities she will face in mid-life, and some of the adjustments she may need to make. Weight gain and the distribution of fat may be among them. Start guiding her early, whenever possible, especially knowing that your Black patient may have a different experience.
