You might want to call it comparing pears and apples. Before women go through menopause, many of them carry more of their weight below the waist. This pear-shaped body type includes wide hips and thighs. During menopause and thereafter, pears often shift to apples, with more weight moving to the waist and belly.

What is this change in body shape about?

Some women refer to the change in body shape that can occur during perimenopause, menopause, and beyond as the great migration. Quite simply, it involves the redistribution of fat and body composition, with body fat storage shifting to the sides and front of the abdomen.

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As estrogen levels decline, fat cells in the abdomen store more fat. This results in an increase in belly fat and a decline in lean body mass. Weight gain is often but not always part of these changes. One concern is that excess weight gain at midlife increases the risk of cardiovascular disease, type 2 diabetes, high blood pressure, some types of cancer, and osteoarthritis. Weight gain also is a source of frustration and stress for the women now faced with unwanted belly weight.

How to manage changes in body shape naturally

First of all, it’s important to mention that changes in body shape and weight during the menopausal years can be challenging even when women make huge efforts to reverse it. These changes can begin when women are in their mid-to-late 40s and continue into postmenopause.

According to Dr. Fatima Cody Stanford, an instructor in medicine at Harvard Medical School, “Women often assume that they are the source of the problem when it comes to anything regarding their weight.” However, she notes that hormonal fluctuations and other bodily shifts associated with menopause are involved.

That does not mean, however, that women have no tools to take on the challenges of body changes. Some turn to hormone therapy, but it is not recommended, as it is associated with significant health risks, including a greater chance of developing breast and other hormone-related cancers as well as heart disease. Therefore, an understanding of the natural choices women can make can empower them as well as protect their health. Here are a few tips.

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• Choose long-term lifestyle changes. Fad diets that are complicated or involve eating plans that are not sustainable or practical should be ignored. Instead, choose healthy, natural, proven plans such as the Mediterranean diet, DASH, or plant-based options.
• Reduce calories, increase movement. This is basic information, but it’s often ignored. Choose nutrient-dense foods, which are often lower in calories and help you feel fuller longer. Engage in physical exercise daily, even if it’s only taking a brisk walk for 20 minutes. However, it’s recommended you get some vigorous workouts every week and strive for activities you enjoy, such as dancing, tennis, jogging with friends, or attending aerobic classes.
• Sleep. You need physical exercise to kick up your metabolism and burn calories, but you also require 7 to 8 hours of sleep every night to allow your body to rejuvenate, repair, and restore. Insomnia and other sleep problems are more common during menopause, and this contributes to weight gain. Too little sleep can result in too much fat around the midsection. Adopt better sleep habits.
• Adopt strength workouts. The loss of muscle mass during menopausal years can be reversed if you take up some strength training. Building muscle mass boosts your body’s ability to use energy, which means you burn more calories. Pick up some hand weights, exercise bands, or get involved with a gym. Strength-building exercises should be done twice a week.
• Manage stress. Unmanaged stress has a way of adding weight to your waistline. Daily stress management practices such as meditation, visualization, yoga, tai chi, and deep breathing are highly recommended to keep stress under control.
• Check your meds. If your weight gain started around the time you began to use a new medication, it’s worth talking to your doctor about it. Weight gain is a common side effect of some medications used to treat menopausal symptoms.
• Practice acceptance. No one is saying you should throw in the towel, but it’s wise to adjust your expectations. You aren’t twenty anymore, and some bodily changes and weight fluctuations occur with menopause and aging. Do what you can to maintain a healthy lifestyle and enjoy your bodily transition the best way you can.

When should you see your doctor?

If you are experiencing significant weight gain or encountering symptoms or health issues that are having a negative impact on your quality of life, consult your healthcare provider. He or she can examine you for the possibility of an underlying health problem.

Bottom line

Changes in body shape beginning with perimenopause can be challenging physically and emotionally. You can learn to embrace the changes while also taking natural steps to manage and live with them in a healthy way.