by Cassie Story, RD, Nutrition Subject Matter Expert
Many women notice changes in their body during their 40s and 50s, even when their weight has not changed significantly. Clothes may fit differently, the waistline may feel less defined and weight that once settled around the hips and thighs may begin to accumulate around the abdomen.
These changes are not simply a matter of getting older. Menopause can affect body composition and where the body stores fat, creating changes that may occur even when the number on the scale remains relatively stable.
Aging and Menopause Both Affect Body Composition
Understanding these changes can be challenging because menopause occurs during a stage of life when other age-related changes are happening as well.
As we age, muscle mass naturally declines unless steps are taken to maintain it. Physical activity patterns may change, sleep can become more disrupted and the body may require slightly fewer calories than it did at a younger age. All of these factors can influence body composition over time.
Menopause adds another layer to the picture.
As estrogen levels decline, the body becomes more likely to store fat in the abdominal area. This includes visceral fat, which is stored deeper within the abdomen and surrounds internal organs. Research suggests that this shift toward more central fat storage occurs independently of many normal aging processes.
As a result, two women may weigh the same before and after menopause while having very different amounts of muscle and fat, as well as different patterns of fat distribution.
Why Abdominal Fat Is A Concern
Not all body fat affects health in the same way.
Visceral fat is more metabolically active than fat stored directly beneath the skin. Higher amounts are associated with an increased risk of insulin resistance, type 2 diabetes and cardiovascular disease.
For this reason, healthcare providers often assess more than body weight or body mass index (BMI) when evaluating health during midlife. Other measures can provide important information, including:
- Waist circumference
- Blood pressure
- Blood sugar levels
- Cholesterol levels
- Physical activity
- Muscle strength
Together, these factors offer a more complete picture of cardiometabolic health than weight alone.
Don’t Overlook Muscle Health
Conversations about menopause often focus on increases in body fat, but maintaining muscle is equally important.
Muscle supports strength, mobility, balance, bone health and metabolic health. During and after menopause, preserving muscle mass can help support physical function and overall health.
Resistance training is one tool that can help maintain muscle over time. This may include free weights, resistance bands, weight machines or bodyweight exercises such as squats, wall push-ups and step-ups.
Protein also plays an important role in supporting muscle health. Including protein-rich foods throughout the day, combined with resistance exercise, can help maintain muscle mass as the body ages.
What Can Help During Menopause?
Menopause is a normal stage of life, and changes in body composition are common. While these changes cannot be completely prevented, several habits may support overall health during this transition:
- Include resistance training on a regular basis.
- Stay physically active in ways that fit your abilities and preferences.
- Build meals around vegetables, fruits, protein-rich foods, whole grains and other fiber-rich foods.
- Prioritize sleep whenever possible.
- Keep up with recommended preventive care and health screenings.
- Talk with a healthcare professional about significant or concerning changes in weight, body composition or health.
The Bottom Line
Menopause can change where the body stores fat and may also contribute to a gradual loss of muscle mass. These changes can occur even when body weight remains relatively stable.
Because of this, the scale alone cannot provide a complete picture of health during midlife. Looking at factors such as muscle strength, waist circumference, blood pressure, blood sugar and overall physical function can offer a better understanding of health during and after the menopause transition.
