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Common Medications May Cause Weight Gain in Postmenopausal Women

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Key Takeaways

  • Some common medications prescribed to postmenopausal women may cause weight gain as a side effect.
  • This is a concern because excess weight can bring heath concerns, including hypertension and osteoarthritis.
  • Lifestyle changes can help, and a first step may be talking with your doctor.

Older women who are taking medications like antidepressants, beta-blockers, and insulin may be more susceptible to weight gain as a side effect according to a recent study in Menopause.

Tracking weight change over a three-year period with medication usage, researchers observed that those who used medications for controlling depression and anxiety, Type 2 diabetes, and high blood pressure were more likely to experience steady weight increase compared to women of the same age range who didn't take these medications.

The findings may inform future recommendations by doctors and influence how postmenopausal women choose to shift their behavior depending on the medications they are prescribed.

The Link Between Medication and Weight Gain

Researchers looked at a cohort of 76,252 postmenopausal women aged 50 to 79 participating in the Women's Health Initiative clinical trial, a long-term national health study focusing on strategies for preventing heart disease, breast and colorectal cancer, and osteoporosis in postmenopausal women.

During a 3-year follow-up period, the average BMI increase was 0.37 kg/m2 in women taking at least one of these medication types, compared with an increase of 0.27 kg/m2 in women who weren't. The average waist circumference was 1.10 cm in women on medications, versus 0.89 cm for women not on medication.

Although the published research does not specify which medications caused the most weight gain, or the effects of short-term usage compared to using medications over the years, previous research has noted that some medications may prompt water retention, shortness of breath —which may limit exercise—or increased inflammation.

Other research has noted that some medications prescribed to treat blood pressure, depression, type 2 diabetes, and other issues, can lead to significant weight gain. However, the researchers also noted there are several alternatives to the majority of these medications that result in weight neutrality and even weight loss. The researchers suggested that physicians and other healthcare professionals should keep this side effect in mind when prescribing the meds, and over years of usage, to minimize medication-related weight gain by switching to weight-favorable meds.

More Weight, More Risks

Having excess weight is a concern for everyone, because it raises the risk for many serious conditions, according to the Centers for Disease Control. This includes:

  • High blood pressure
  • Type 2 diabetes
  • Stroke
  • Osteoarthritis
  • Gallbladder disease
  • Sleep apnea
  • Many types of cancer
  • Mobility issues

The hormonal changes of menopause make women more likely to gain weight, especially in the abdomen, and that's problematic since belly fat has often been linked to increased heart risk. Experiencing menopause and potentially gaining additional weight from certain medications may feel frustrating and even disheartening, but there are some strategies worth investigating. Talking with the doctor who prescribes the medication about other alternatives can be a solid first step.

Focus on Lifestyle

Part of the challenge for some women may not only be dealing with weight gain but also figuring out how to talk with their doctors about making lifestyle changes part of their standard medical care.

"Doctors are not really trained in how to prescribe something like exercise as opposed to a pill or medical treatment," says Cindy Lin, MD, a clinical associate professor in Sports & Spine Medicine at the University of Washington Medicine in Seattle. In a recent presentation for the virtual American College of Sports Medicine conference, Lin talked about "exercise as medicine," for all patients, not just older adults.

Cindy Lin, MD

"Doctors are not really trained in how to prescribe something like exercise as opposed to a pill or medical treatment."

— Cindy Lin, MD

Lin said that it's especially crucial for this patient population to have discussions about lifestyle habits and ways to implement preventive strategies such as diet changes, increased activity, lower stress, better sleep, and other factors that go into weight gain and good health overall.

Lin suggests both patients and physicians consider referrals to specialists who can help, such as dietitians, physical therapists, and certified personal trainers.

Strategies to Consider

Although having comprehensive education and programs from healthcare providers can be helpful, ultimately it comes down to individuals to pursue those lifestyle change suggestions. Fortunately, there are a number of healthy habits that women can try, without having to necessarily switch their medication.

Here are a few tips for managing postmenopausal health shifts:

  • Strength training to build muscle mass since women lose this more quickly after menopause, and it can increase your resting metabolic rate to help you burn more calories.
  • Address sleep issues, since poor sleep quality—common during menopause—can lead to less fat loss and decreased muscle gain.
  • Reduce stress, since hormones related to stress are also connected to increased accumulation of fat, especially in the belly.
  • Eat enough protein and a healthy amount of calories, and talk to a dietitian if possible to understand the amount of protein, carbs, and fat that is the best fit for you.

Like all types of weight loss, diet and exercise will play a prominent role, but with postmenopausal women, it's often helpful to start with mindset, according to trainer Ronnie Lubischer, CSCS.

Ronnie Lubischer, CSCS

"Try and look at it instead as a chance to totally reset your health for the long term, and that's more important than just losing weight.

— Ronnie Lubischer, CSCS

"The largest factor that affects my clients, outside of the obvious hormonal changes that occur during menopause, is sheer mental frustration and a feeling that they're personally failing," he says. "Try and look at it instead as a chance to totally reset your health for the long term, and that's more important than just losing weight.

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