Menopause Fat Gain and Muscle Loss

You’re definitely not alone and a lot of women notice fat gain and muscle loss with menopause, even while staying super active. Sometimes it’s just about small tweaks, like upping protein (especially tough on a vegan diet), keeping strength training heavy, and making sure recovery is solid. You’re already doing so much right, so don’t get discouraged also it’s more about adjusting than starting over.

Hello, fellow breast cancer survivor!

I also had breast cancer (stage III) at age 44, bilateral mastectomies (no reconstruction), 6 months of chemo (which put me into menopause), 6 weeks of radiation, 7.5 years total on two different anti-estrogen drug routines.

Your exercise activity sounds great. Is that something you've been doing for a while, or is it new or resumed post-treatment? I had to work my way up to a similar amount of exercise, and that took a while post-treatment TBH.

One thing that occurs to me: Have you been tested for a thyroid condition? That's something that becomes commoner in women as we age, and there's some evidence that the incidence is higher among women who've been treated for breast cancer. If not, and you can arrange that, that's something to consider - plus any other blood tests your doctor might suggest given your symptom set, of course. I was diagnosed post-treatment as severely hypothyroid. While it took time to find the right medication dosage - it has to be increased gradually - it made very real improvements for me in energy level and quality of life, including joint discomfort.

I'll preface this next by saying I've been vegetarian for 51 years myself, so I'm not asking out of believing mythologies about veganism: How's your protein intake? Other diet-relevant micros? Protein is a thing that increases in importance as we age, and muscle mass depletion can be a side effect of some forms of breast cancer treatment, increasing that importance.

Shooting for at minimum 0.6g of protein per pound body weight is a good idea, and ideally up to 0.8-1 gram (more if aggressively weight training). Yes, that's more than the WHO or USDA/NIH minimums. For you, that lowest level would be 83g daily, with 110-138 potentially offering additional benefits. As we age, it also becomes more important to spread the protein through the day, rather than focusing it in just one or two meals, because we tend to metabolize it less efficiently than we did when younger.

As a long-term vegan, I'm sure you're aware of needing to supplement B-12, be attentive to other micros like calcium, iron, etc. Again, recovering from cancer and treatment can make that attentiveness even more necessary. You're probably familiar with this site, but I'll mention it because it's one I've found helpful in dialing in nutritional details, even as a vegetarian, since its content is less about advocacy and more about evidence-based nutrition, with content from registered dietitians:

https://veganhealth.org/

As another thing we have in common, I also have knee issues. I took spinning classes regularly before the pandemic (when my gym closed), got a stationary bike at home for regular use at that point, but my most favored activity is rowing - on water when I can, machine when I must. I can do a variety of things, but need to avoid anything that involves high impact or torque on my knees.

Weight gain is directly all about calories, but nutrition can have indirect effects. Menopause can have some impact on where fat is stored, and affect fat gain through things like sleep disturbance thus fatigue reducing movement, possibly in very subtle ways. Though I'm not recommending it as a lifestyle 😉, twitchy people have been found in research to burn up to low hundreds of calories more daily than otherwise similar more placid people. I mention that to illustrate how small and even unnoticed changes in activity patterns can have a surprisingly large effect on body weight.

If your weight has increased by 5 pounds over 4 months, and if that gain is body fat, that would imply a calorie surplus of only around 150 calories a day on average, which is pretty small. In food terms, it's a dollop of creamy dressing or less than a full serving of peanut butter; it's pretty small in activity terms, too.

If you want to think about intentional strategies to increase daily life movement, outside of intentional exercise, there's a thread here where many MFP-ers offer their tactics for doing that:

Those kinds of things can help mitigate any subtle changes in activity that might result from low-level fatigue.

If none of that is new to you or helpful, my apologies. I'd like to help, and it's the few things I can think of right now that might be relevant.

Best wishes!

Yeah, cancer and cancer treatment were a rotten hobby. 😆

One comment on your reply:

One week of logging isn't long enough to tell what's going on. It's normal for weight to fluctuate up and down by multiple pounds from one day to the next, even one week to the next, for many different reasons . . . most of which boil down to either differences in water retention, or waste in the digestive tract. Since you're on various drugs that manipulate hormones, that could be extra weird. I figure 4-6 weeks on a new eating/activity routine is needed for anyone to get enough results to see the average weekly weight trend more realistically, or whole menstrual cycles for those who have them.

In addition - and I hate to say it - if the app says we're in a deficit, that doesn't mean we're in a deficit. It's just a starting guess at a deficit. MFP, other calorie calculators, even fitness trackers are just giving us estimates that would be about the average for demographically similar people. Most people are close to average, but a few are noticeably off (higher or lower), and a rare few are surprisingly far off. That 4-6 week experiment gives us feedback on how close to average we are as individuals - lets us personalize the goals.

Based on 10+ years of calorie logging/weight logging, my calorie needs are hundreds of calories daily off from what both MFP and my good/brand model fitness tracker estimate. That's rare, but it can happen. Most people find MFP and that same tracker to be much closer for them than they are for me. After I had a few weeks of experience data, I was able to adjust my calorie goal so that my weight results became pretty predictable.

MFP will probably be close for you, once you have enough logging data to know . . . but the results will tell the story, either way.

Best wishes!

I am in the same boat. I injured my Achilles tendon back in 2021 and was in a boot for four months and not allowed to train for any distance event for the following year. When i started up again, I had a hard time walking even one mile. My hips would tighten up and heart rate get as high as it did when I was jogging a 13:30 pace (my pace is now around 33:00). I also lost my strength and went from lifting 40 pound dumbbells for upper body (chest, biceps, back, and 20 pounds for shoulders) to 12 pounds and 5-8 for shoulders. I can go a bit heavier for legs but can no longer step up on the bench. I have also gained a crazy amount of weight that has done nothing but go up no matter what I do. I am also 5'8 and was 140 pounds when doing marathons. It crept up with menopause to 180 despite marathons, and I ballooned up to 245 after the foot injury. To add to it, I was diagnosed with ME/CFS and advised not to exercise anymore because exercise—at least at the level I was doing it— is harmful in ME/CFS. I am not sure how much of my weight gain and weakness is due to menopause, the foot injury, deconditioning, or ME/CFS. It is likely from all of the above. I was on and off steroids for various reasons too.

Most of my weight is around my belly. I decided to try Wegovy in June and so far I am down to 229 however I am still very deconditioned and weak. I get just as sore lifting those 12 pound weights as I did when lifting 40 and my hips still seize up around the 1 mile mark. I'm not sure if that will every change at this point, but yes I feel menopause has a lot to do with it