There are many phases in a woman's life, menarche, menstruations, pregnancy, postpartum and menopause. Each phase comes with its own challenges, and changes the way of looking at life. However, narrowing to one, today we are focusing on weight gain after menopause. Gaining weight is a common concern for many women are approaching menopause. This period brings hormonal changes, shifts in activity levels and effects of aging. All of these contribute to weight gain. However, not everyone experiences weight gain during menopause, and individual experiences may vary greatly.

Menopause and Its Life Phases

Before diving into the specifics of weight gain, it’s helpful to understand the terminology associated with menopause:

• Premenopause refers to the period between puberty and the commencement of perimenopause.
• Perimenopause is the transitory period before menopause, characterized by fluctuating reproductive hormones.
• Menopause is defined as the absence of menstrual cycles for 12 consecutive months.
• Postmenopause is the period following menopause; typically used interchangeably with "menopause."

Hormonal Changes and Weight Gain

Hormones influence weight fluctuations after menopause, specifically how fat is distributed and how the body controls hunger.

Fat Content and Distribution

The hormonal fluctuations of perimenopause and menopause influence where fat is stored in the body:

Perimenopause: During this phase, estrogen levels fluctuate while progesterone levels decline steadily. In early perimenopause, higher estrogen levels can promote fat storage in the hips and thighs as subcutaneous fat, which generally carries fewer health risks.

Menopause: As estrogen levels drop significantly, fat storage shifts to the abdominal area as visceral fat.

This type of fat surrounds internal organs and is associated with health risks like:

• Insulin resistance
• Type 2 diabetes
• Heart disease
• Other metabolic issues

Appetite Regulation

Lower estrogen levels during perimenopause can have an impact on appetite management. A 2019 analysis found that decreased estrogen may diminish satiety signals, making you feel less full after meals. This might lead to increased calorie consumption and weight gain.

The Effect of Age on Weight

Weight gain during menopause is attributed to more than just hormonal changes. Several elements come into play throughout the aging process:

Increased fat content and decreased muscle mass: These changes affect the body's resting energy expenditure (REE), which means fewer calories are expended when at rest.

Lower activity levels: Fatigue, sleep difficulties, and menopause-related symptoms can all lead to a decrease in physical activity, further reducing REE and increasing weight.

Managing Weight Gain During Menopause

If you are concerned about weight gain during menopause, a variety of strategies can help you manage it effectively. It is usually recommended that you speak with a healthcare practitioner before developing a specific approach.

Dietary modifications

Focus on a well-balanced diet that includes less carbohydrates, more fiber, and less added sugar and salt.

Include nutrient-dense meals to boost overall health.

Physical exercise

Regular exercise helps to maintain muscle mass and reduce body fat. Strength training, aerobic, and flexibility exercises are quite beneficial.

If you have osteoporosis, see your doctor about safe activity options.

Rest and Stress Management

Prioritize sleep and relaxation to combat fatigue and stress, both of which can contribute to weight gain.

Mindfulness practices or yoga may help reduce stress levels.

A cigarette after stress. Chewing tobacco during the day. Smoking to “calm the nerves”

But modern science is forcing us to confront the difficult truth; Tobacco does not treat mental health symptoms, in fact it quietly deepens it.

As Oncologists and physicians, we often see patients who say, “smoking makes them feel normal.” However, in reality, what they are experiencing is nothing more than the temporary relief from nicotine withdrawal not genuine emotional regulation.

Nicotine Creates A Cycle of Temporary Relief And Dependence

When we smoke or chew tobacco, nicotine stimulates dopamine release in the brain, creating a short-lived sense of relaxation or control. But overtime it leads to brain depending on nicotine to achieve the same baseline feeling again and again. The result is a vicious cycle of dependence, irritability, anxiety, and worsening emotional resilience.

Several large studies now show that long-term tobacco use is associated with higher rates of anxiety, depression, sleep issues and substance dependence. A 2023 review published in BMJ found that smoking cessation will result in improvements in both anxiety and depression and an improved mood with benefits comparable to antidepressant treatment in some individuals.

Also read: Lung Health After 40: Natural Changes, Warning Signs And Ways To Protect Your Lungs

Tobacco May Worsen Anxiety, Depression And Sleep Problems

This has serious implications for the urban Indian population in regard to the increasing prevalence of mental exhaustion, lack of social support, digital overload, work-related stress and lack of sleep. Tobacco often enters quietly during vulnerable moments of college pressure, workplace stress, loneliness, grief and gradually shifts from “social habit” to psychological crutch.

Although they think they believe in tobacco, many of them use it, thinking that they are using it to cope with their emotional symptoms, when in fact they are making the symptoms worse.

Also, recognize the biology of tobacco use. For example, the use of nicotine will result in long-term changes in how well your body handles emotional stress because of the role of long-term nicotine exposure in altering the system of cortisol regulation and the stress response pathways in neurons. So, with time, it will become harder and harder for a person to control his/her emotional response to stress because his/her body will not be able to do it. Thus, tobacco has a negative influence on the recovery process from emotional responses to stress, rather than a beneficial one.

Also read: Air Pollution May Increase The Risk Of Painful Rheumatoid Arthritis Flares, Study Finds

How Nicotine Alters The Body’s Stress Response?

Tobacco is a significant preventable risk factor for oral, head and neck, lung, oesophageal, pancreatic and bladder cancers. When many patients arrive at cancer centres, the addiction to tobacco is already set, and it is even more difficult to quit while receiving cancer treatment.

This is why it is important to help move the conversation on tobacco beyond cancer. Now, it's more than just a public health issue; it also includes issues of mental health. Individuals experiencing emotional difficulties should not think that they are being judged. They have to learn to find alternative coping strategies, get psychological support early on in their lives, sleep well, exercise, be part of the community, and access timely medical support. The goal of this care is not just to support someone in quitting tobacco, but to provide support for them to stop needing tobacco in order to feel good.

By Dr Amit Chakraborty, Consultant Oncologist, Saifee Hospital, Mumbai

India is facing a growing burden of non-communicable diseases (NCDs), with hypertension and diabetes among the major health concerns.

Experts warned that the risk of both conditions rises after 40, often without noticeable symptoms. Increasing age, weight gain, reduced physical activity, stress, dietary habits, and metabolic changes can all contribute to the risk.

Having hypertension and diabetes together is particularly concerning, as their coexistence can increase the risk of heart disease, stroke, kidney damage, retinopathy, and other complications.

Why Risk Rises After 40?

Dr. Santosh Gupta, Associate Director - CTVS, Paras Health Udaipur, told HealthandMe that several factors contribute to the rising risk after 40.

“After the age of 40, the risk of hypertension and diabetes increases due to factors such as changes in metabolism, reduced physical activity, weight gain, stress and dietary habits. What makes both conditions particularly concerning is that they can develop silently, without noticeable symptoms, while gradually affecting vital organs,” he said.

He added that uncontrolled hypertension can damage the heart, brain, kidneys, and blood vessels, while diabetes can affect the kidneys, eyes, nerves, and cardiovascular system.

"When both conditions occur together, the risk of heart disease, stroke and kidney complications becomes even higher,” Dr. Gupta added.

Because both conditions can remain silent for years, people may have high blood pressure or blood sugar without knowing it.

Also read: Breastfeeding Can Help Reduce Mothers' Risk of Type 2 Diabetes, Breast Cancer and More

Hypertension And Diabetes Often Coexist

A recent hospital-based analysis found that hypertension and diabetes frequently occur together, with their coexistence rising sharply from around age 40 among Indians.

The study, conducted by the Department of Clinical Research and Preventive Health Program at Max Healthcare, analyzed health records of more than 56,000 adults who underwent preventive health check-ups between January 2021 and December 2024.

Nearly 5% of adults had both conditions. Their coexistence increased rapidly from around 40, continued rising until approximately 58 and gradually reached nearly 17% by around age 70.

People with diabetes were nearly four times more likely to have hypertension, while those with hypertension were about 2.5 times more likely to have diabetes.

Dr. Abhaya Indrayan, Biostatistics Consultant, Max Healthcare, said the findings support screening for both conditions rather than assessing them separately.

Why Screening After 40 Matters

Read More: Confused By Your Cholesterol Report? Here's What LDL And ApoB Really Mean

Experts said that preventive healthcare should go beyond checking for individual diseases. Adults over 40 should routinely assess key cardiometabolic risk factors, including blood pressure and blood sugar.

Screening can help detect hypertension, diabetes or prediabetes early, when lifestyle changes and treatment can help prevent or delay complications.

“This is why regular screening after 40 is important, even for individuals who feel completely healthy. A routine blood pressure check, fasting blood glucose or HbA1c test can help identify hypertension, diabetes or prediabetes at an early stage, when timely lifestyle changes and medical intervention can prevent or delay complications,” Dr. Gupta said.

“Screening should not be viewed only as a diagnostic exercise; it is an opportunity to understand one’s health risks and take corrective measures before the disease begins to cause irreversible organ damage,” he added.

How To Lower The Risk

Preventive care also involves addressing modifiable risk factors. Regular physical activity, maintaining a healthy weight, limiting salt, sugar and highly processed foods, getting adequate sleep and avoiding tobacco can help lower the long-term risk.

For those already diagnosed with hypertension or diabetes, regular monitoring and adherence to prescribed treatment are important to reduce the risk of complications.

With the risk of both conditions rising after 40, experts recommend making routine health checks part of regular healthcare—even when there are no obvious symptoms.

Amid the ongoing monsoon season, Delhi-NCR is seeing a rise in H1N1 influenza cases, with Delhi reporting 1,344 cases so far this season.

The figure is nearly six times higher than the 229 H1N1 cases recorded during the same period last year, The Times of India reported.

According to health officials, Delhi recorded around 4,000 influenza cases last year, most of them caused by H3N2. This year, H1N1 is the dominant strain. Both H1N1 and H3N2 are subtypes of Influenza A and spread mainly through respiratory droplets.

What Is H1N1 and Why Is Testing Important?

H1N1 is a subtype of Influenza A and can cause sudden fever, cough, sore throat, headache, body aches and fatigue. These symptoms can overlap with those of other seasonal influenza strains, COVID-19 and respiratory syncytial virus (RSV), making it difficult to identify the infection based on symptoms alone.

Dr Aijaz Ilmi, Senior Consultant – Metabolic Diseases, Pacific OneHealth Hospital, told HealthandMe that testing is particularly important when fever or respiratory symptoms persist or worsen, especially among older adults, young children, pregnant women and people with diabetes, obesity, heart or lung disease, or compromised immunity.

“With the current rise in H1N1 cases in Delhi, we are also seeing other seasonal respiratory infections, including Influenza A and B, COVID-19, RSV and other respiratory viruses. At the same time, the monsoon season brings an increased risk of mosquito-borne illnesses such as dengue.

“The key message is, don’t panic, but don’t dismiss a persistent fever as ‘just a viral’. Early recognition is particularly important in vulnerable individuals.”

H1N1 vs Other Respiratory Infections: How Are They Different?

H1N1 can be difficult to distinguish from other respiratory infections because many of them cause similar symptoms.

• H1N1 and other seasonal influenza strains: Both can cause sudden fever, cough, sore throat, headache, body aches and fatigue. Symptoms alone generally cannot determine whether the infection is H1N1 or another influenza strain.

• COVID-19: COVID-19 can cause fever, cough, sore throat, congestion and fatigue. Some people may also experience changes in or loss of taste or smell, while gastrointestinal symptoms can occur.
• RSV: RSV commonly causes a runny nose, cough and wheezing. It can be more severe in infants, older adults and people with certain underlying conditions. In young children, it can cause bronchiolitis and breathing difficulties.
• Dengue: During the monsoon, dengue can also cause fever, headache, body aches and fatigue, which may initially resemble a viral respiratory infection. However, dengue is spread by mosquitoes rather than respiratory droplets and does not typically cause cough or sore throat.

How Can H1N1 and Other Infections Be Prevented?

Dr Sharwari Sudhir Dabhade, Consultant - Internal Medicine, Diabetology & Endocrinology, Madhukar Rainbow Children's Hospital, told HealthandMe that prevention should focus on reducing exposure and maintaining good hygiene. Other measures to reduce transmission include:

• Washing hands frequently.
• Covering mouth and nose while coughing or sneezing.
• Maintaining good indoor ventilation.
• Avoiding crowded or poorly ventilated places when respiratory infections are circulating.
• If you have respiratory symptoms, limit close contact with others and wear a mask.
• Getting vaccinated against influenza, particularly if you are an older adult, young child or have an underlying health condition.
• Prevent mosquito breeding and take precautions to avoid mosquito bites to reduce risk of dengue.

When Should You Seek Medical Help?

Most viral respiratory infections recover with supportive care. However, should seek prompt immediate medical assessment in cases of

• breathlessness
• persistent high fever,
• chest pain,
• confusion,
• dehydration,
• falling oxygen saturation
• significant worsening of weakness.