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.

The bulge that appears when an internal organ pushes through a weakened muscle wall will not recede with rest or medication—it will, in most cases, grow larger and more uncomfortable over time. Surgery is the only definitive treatment. What has changed significantly in recent years is what that surgery looks like and what recovery from it requires.

Dr Rajesh Sharma, Director – General Surgery, Minimal Access & Bariatric Surgery, CK Birla Hospitals, Jaipur, in an interview with Health and Me, spoke about the introduction of robotics in hernia treatment and how it can benefit patients.

How hernia surgeries are becoming less painful

With advances in surgical technology, minimally invasive approaches have significantly improved patient outcomes. One of the most important developments in recent years is robotic-assisted hernia surgery using the da Vinci Surgical System. In robotic surgery, the surgeon operates from a console equipped with a high-definition, three-dimensional, magnified view of the surgical field. The robotic system translates the surgeon’s hand movements into extremely precise movements of miniaturised instruments inserted through small incisions. The system also filters natural hand tremors and provides a greater range of motion than the human wrist, enabling meticulous dissection and suturing.

For hernia repair, these capabilities allow surgeons to perform delicate steps such as accurate defect closure and optimal mesh placement, which are important for the long-term durability of the repair.

Benefits for patients

Robotic hernia repair offers several advantages for patients:

1. Smaller incisions and minimal scarring
2. Reduced postoperative pain
3. Lower risk of wound complications
4. Shorter hospital stay
5. Faster return to normal activities

Because the procedure is minimally invasive, most patients experience earlier mobilisation and quicker overall recovery compared with traditional open surgery. Robotic surgery is particularly useful in complex, recurrent, or large ventral hernias, where precise reconstruction of the abdominal wall is important. While not every hernia requires a robotic approach, the technology expands the surgeon’s ability to perform advanced minimally invasive repairs with improved ergonomics and visualisation.

The future of hernia surgery

The integration of robotic platforms such as the da Vinci system represents a major step forward in modern general surgery. By combining surgical precision with minimally invasive techniques, robotic hernia repair aims to enhance patient comfort, improve recovery, and deliver durable surgical outcomes.

The liver and heart are two of the most vital organs of the body, and although they perform very different functions, they are closely connected. When the liver is not functioning properly, it can place significant stress on the heart and circulatory system of the body.

Liver disease not only affects the digestion process, metabolism, and detoxification but can also trigger serious cardiovascular changes that may go unnoticed in the early stages. Understanding this particular connection is significant for timely diagnosis and better overall care.

The Liver-Heart Connection

The liver helps to regulate the flow of blood, fluid balance, cholesterol metabolism, and inflammation as well. When liver disease develops—whether due to fatty liver, hepatitis, cirrhosis, or alcohol-related damage—all these processes become disturbed.

As a result of the same, the heart may have to work harder to maintain circulation, while blood vessels may also undergo certain changes that impact blood pressure and delivery of oxygen as well.

Changes In Blood Circulation

In well-advanced liver disease, especially cirrhosis, the flow of blood through the liver becomes restricted. This can also increase pressure in the portal vein, a condition known as portal hypertension. At the same point in time, blood vessels in the rest of the body may also widen, causing a drop in effective blood pressure.

To compensate, the heart pumps faster and harder. With the passage of time, this constant strain can weaken cardiac function and even lead to a condition sometimes referred to as cirrhotic cardiomyopathy, where the heart does not respond normally under stress.

Fluid Retention And Heart Stress

Liver disease often causes the body to retain both salt and water. This can also lead to swelling in the legs, abdomen, and surrounding tissues as well. Extra fluid in the body increases the workload on the heart, making it more difficult for it to pump blood in an efficient way. In severe cases, this may also contribute to shortness of breath, fatigue, and worsening cardiovascular strain.

Inflammation And Metabolic Impact

Some of the conditions, such as non-alcoholic fatty liver disease, are also linked with diabetes, obesity, high levels of cholesterol, and high blood pressure – all of which are the major risk factors for heart disease. Chronic inflammation, well-associated with liver damage, may further increase the risk of atherosclerosis and other cardiac complications.

GLP-1 receptor agonist drugs such as Ozempic and Wegovy have shown significant benefits for people with diabetes and obesity. However, not everyone experiences the same results.

Now, a study suggests that this variation may be due to genetic resistance, which means that some people are biologically less responsive to these medications, making these drugs less effective.

Also Read: NAFLD to MASLD: Experts Explain Why This Common Yet Dangerous Liver Condition Got Renamed

The new study by scientists at Stanford University in the US showed that about 10 per cent of the general population carry genetic variants that lead to what the researchers called “GLP-1 resistance”.

The GLP-1- receptor agonist drugs typically work by mimicking the hormone GLP-1 (glucagon-like peptide-1), which naturally helps regulate blood sugar by stimulating insulin release. The process slows the emptying of the stomach and reduces appetite.

However, in individuals with certain genetic variants, the team found that higher levels of GLP-1 did not regulate blood sugar better.

The researchers noted that the findings, published in the journal Genome Medicine, may be key to developing new therapies for people with GLP-1 resistance.

“There are a whole class of medications that are insulin sensitizers, so perhaps we can develop medications that will allow people to be sensitized to GLP-1s or find formulations of GLP-1, like the longer-acting versions, that avoid the GLP-1 resistance,” said Anna Gloyn, professor of pediatrics and of genetics at Stanford Medicine.

The Gene Linked to GLP-1 Resistance

Also read: Foundayo: US FDA Approves Eli Lilly’s GLP-1 Weight Loss Pill

To zero in on the gene resistant to GLP-1 drugs, the team conducted experiments in humans. They traced this resistance to a PAM variant known as p.S539W.

PAM (peptidyl-glycine alpha-amidating monooxygenase) is an enzyme that is uniquely capable of activating many hormones in the body, including GLP-1.

While the researchers suspected that people with the PAM variant would have lower levels of GLP-1 in their blood, it actually increased levels of GLP-1. Although the exact mechanism is still unclear, experiments in both humans and mice confirmed signs of reduced response to GLP-1.

Analyzing diabetes drug trial data, they found that individuals with these variants were less able to lower their blood sugar levels even after six months of treatment. This suggests that despite having more circulating GLP-1, their bodies are less responsive to it.

“When I treat patients in the diabetes clinic, I see a huge variation in response to these GLP-1-based medications and it is difficult to predict this response clinically,” said Mahesh Umapathysivam, an endocrinologist and clinical researcher at Adelaide University in Australia.

“This is the first step in being able to use someone’s genetic make-up to help us improve that decision-making process,” he added.

Also read: Can Weight Loss Jabs Surge Divorce Rates? What Experts Are Saying

Importantly, participants with the PAM variants did not respond differently to other common diabetes treatments, including sulfonylureas, metformin, and DPP-4i.

The finding may help develop precision medicine, the researchers said. Knowing ahead of time who is likely to respond would help patients get on the right drugs faster, Gloyn said.

Reasons Why Ozempic May Not Help All People Lose Weight

Ozempic is primarily indicated for type 2 diabetes management. But some doctors may prescribe it for weight loss in appropriate patients without diabetes.

Previous research has shown that medical conditions such as sleep apnea, along with certain common medications, such as antidepressants, steroids, and contraceptives, can hamper the process of shedding extra pounds.

Another major reason that can hamper weight loss is the side-effects of these drugs that can prompt a person to halt their prescription mid-way.