Menopause and Obesity in Women

There are relatively few data on changes in adiposity and fat distribution associated with menopause in women. This is an important issue because of the relationships that have been noted between obesity and cardiovascular disease (5), and obesity and certain cancers (56,57) in postmenopausal women. As noted above, body weight reaches its maximum in women very near the time of menopause, and there is an increase in relative adiposity for any given weight or BMI. While some studies find that the increase in weight accompanying menopause is more related to age than menopause itself (58,59), others have noted specific menopause-related increases in BMI, overall adiposity, central adiposity and intra-abdominal adiposity (60-64). A recently published longitudinal study that followed 35 women aged 44-48 for 6 years (65) found that those women who experienced menopause during the period of follow-up lost significantly more FFM (—3 vs. —0.5 kg), and had greater increases in fat mass (FM; 2.5 vs. 1.0 kg), waist-to-hip ratio (WHR; 0.04 vs. 0.01) and insulin (11 vs. —2 pmol/L). The changes were associated with greater reductions in physical activity and resting energy expenditure in the postmenopausal women. In two randomized, placebo-controlled studies in which postmenopausal women were prospectively studied for 2-3 years, hormone replacement therapy prevented the accumulation of abdominal adiposity while having no effect on FFM (63,66).

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