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Women, Life Stages, and Weight Gain by Jordan Rubin

The prevalence of obesity in women has almost doubled in the last 20 years and some studies indicate that women may be more prone to gain weight at three key times in their lives-- at puberty (the onset of menstruation), after pregnancy, and around menopause, according to research presented at the North American Association for the Study of Obesity (NAASO).

Charles Billington, M.D. is the president elect of NAASO and professor in the Department of Medicine at the Minneapolis VA Medical Center. He indicates that “identifying key stages and causes of weight gain will be critical for developing prevention programs to stop or slow down this trend"—the noted increase of obesity in women.

Menstruation: The first of these stages, menarche (the onset of menstruation), may play a role in obesity development--according to studies conducted by researchers at Tufts University School of Medicine which indicate that early menarche may contribute to the risk of obesity later in life as well as being a risk factor for breast cancer and cancers of the reproductive system.

"Puberty (menarche for girls), the hormonal transition of adolescence, has been identified as a potentially critical period in the development of obesity," said Aviva Must, Ph.D., associate professor of the Department of Family Medicine and Community Health, Tufts University School of Medicine, Boston, Mass, the lead investigator for the studies. Early age at menarche, together with other indicators of early biological maturity, has been shown to be associated with increased adult body mass index (BMI). Girls who have an early age of menarche have the highest childhood BMIs. This may be the link between early menarche and future obesity risks.

After Pregnancy: According to researchers at the University of Alabama, retaining weight following pregnancy may also increase the risk of obesity in women. "Weight gain after pregnancy may reflect changes in lifestyle behaviors rather than physiological changes associated with giving birth," said Delia Smith West, Ph.D., associate professor of Medicine, University of Alabama at Birmingham, Birmingham, Ala. She adds, "Obesity prevention programs that focus on changes in diet and physical activity patterns offer promise for reducing weight retention after pregnancy."

Around Menopause: There are studies which have looked at what is the "usual" amount of weight gained as women age. Among women in the "Nurses Health Study," monitored for up to 24 years, the average weight gain since age 18 was 26.5 pounds. Of that, only 6.6 pounds had been gained after menopause. We may tend to think that menopause is the "prime time" for weight gain, but it may closer to the perimenopausal years when weight is added. Perimenopause is the stage of a woman's reproductive life that begins several years before menopause. It usually starts in a woman's 40s, but can start in the 30s as well.

One four year study of 336 women aged 35-47 found that women aged 45-47 were less likely to gain ten or more pounds than the 35-39 year olds. Nanette Santoro, MD, director of reproductive endocrinology at Albert Einstein College of Medicine in the Bronx, N.Y. emphasizes the importance of navigating the perimenopausal years: "It may be that how you go through your perimenopausal years determines your health for the rest of your life.” It will also influence how you approach and go through menopause and subsequent weight gain. Weight gain during menopause may be significantly prevented by long-term changes in dietary intake and increased physical activity, according to findings of the Women's Healthy Lifestyle Project, a five-year, randomized clinical trial, funded by the National Institutes of Health.

Laurey R. Simkin-Silverman, Ph.D., assistant professor of Epidemiology and Psychiatry and Health Services Administration, Department of Epidemiology, University of Pittsburgh states that “post-menopausal women have higher levels of body fat and central adiposity than other women the same age”, adding that “the weight that many women gain during menopause is particularly troubling because it is associated with increased cholesterol, high blood pressure and insulin resistance."

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