How do I lose weight during menopause?

The menopause by itself is not a cause for either gaining or losing weight. Women who gain unwanted weight usually begin this in the years prior to the age of their menopause mainly because the food intake has exceeded their metabolic need. The ability to control weight depends on a multitude of physiological changes among which are events such as exercise, diet, type of food and apetite controlling hormones such as insulin, amylin, leptin (from fat cells) and ghrelin (from the stomach). All these physiological events and hormones feed back to the hypothalamus in the brain. The hypothalamus in turn controls the apetite centre and influences those mechanisms making weight control most difficult. Oestrogen has no known effect on weight control, but synthetic progestogens may occasionaly have an adverse effect on bowel motility and liver activity. However, because you have had a hysterectomy, you do not need to use a progestogen - you can take oestrogen alone (preferrably through the skin) and carry on with your present efforts of exercise, good and restricted diet and oestrogen therapy.
Good luck, but it does require patience, understanding and persistence (6-12 months)

Absolutely agree with Dr Wren's comment about weight gain caused by food intake exceeding metabolic need. Dietitians refer to this concept as energy balance: if more energy (calories) is going into the body than what is being used up through metabolism and physical activity then over time this leads to weight gain. To kick start the weight loss process you need to place yourself in negative energy balance, that is consume less energy than what your body is using up so it turns to your exisitng energy stores (fat stores) to make up the defecit. The best way to approach this is to be physcially active and reduce your calorie intake by following a diet high in fresh fruit and veg, wholegrains, lean protein and reduced fat-dairy products and low in saturated fat and excess sugar. Your local Accredited Practising Dietitian can help you make simple dietary chaanges to help with losing weight. To find your nearest APD go to this website http://dmsweb.daa.asn.au/dmsweb/frmfindapdsearch.aspx?

Have you had your Vitamin D levels checked? If you are having problems losing weight you need to be at an optimal level with Vitamin D. Not just within the range of normal but go for optimal, ie high end of the range. I suggest you go and see you GP and when you find out the result get a specific reading. Do not just accept an ansswer of “normal” but really go for the optimal! Good luck

It's frustating when your diet is good and your'e exercisíng, but that belly fat just doesn't want to leave you.Swimming is a great choice as an  'all body' exercise. With your running, incorporate Interval training- to rev up your meatbolic rate and burn more calories. During peri-menopause and menopause, hormones have a great impact on weight. OPTIMAL Vitamin D and OPTIMAL TSH levels are imperative.The HPA axis (hypothalmic-pituitary-adrenal axis) is a major part of the endocrine regulatory system. It is involved in energy storage and expenditure, stress reactions, mood and digestion.Adrenal fatigue is often a major contributor to weight gain. Brittle nails are often a sign of mineral deficiency. A Consultation with a Naturopathic Nutritionist or Naturopath will pinpoint hormonal imbalances and suggest support with specific vitamin/mineral and or herbal supplements.

Weight loss is a challenge at any time of life.  A negative energy balance is required - less energy in and more energy out.  Energy intake should come from a balanced diet of low GI carbohydrates, protein and poly and monounsaturated fats, vitamins and minerals.  A good water intake is also essential - at least 6 glasses daily - your body is 60-70% water which is needed for many body processes to occur.
Energy output should come from a variety of exercise modes - a mix of aerobic (running/swimming/walking/bike riding) and resistance exercise (a good balanced weights program).  Your body is very good at adaptation, so varying your exercise types regularly helps.
An accredited practising dietitian can help you with an individual meal plan to suit your lifestyle, food preferences and energy requirements for weight loss.
An accredited exercise physiologist can help you with and individual exercise program to suit you - it's no point doing exercises you hate.
Remember - be kind to yourself and focus on the positve aspects of your lifestyle

You have had a tough ride. Your health can only get better and you will feel better. Now your thyroid TSH levels are back to normal your metabolic rate will speed up. However, you must realise that when you reach menopause your metabolic rate does slow down. In addition with normal TSH levels the constipation should improve, as should your fatigue, gritty eye feeling and the brittle nails. In addition your mood should feel more positive.

What is it about menopause that makes it so hard to keep off the weight? It's likely a mix of factors related to menopause and aging. Continue reading below...

In animal studies, oestrogen appears to help control body weight. With lower oestrogen levels, lab animals tend to eat more and be less physically active. Reduced oestrogen may also lower metabolic rate, the rate at which the body converts stored energy into working energy. It's possible the same thing happens with women when oestrogen levels drop after menopause. Some evidence suggests that oestrogen hormone therapy increases a woman's resting metabolic rate. This might help slow weight gain. Lack of oestrogen may also cause the body to use starches and blood sugar less effectively, which would increase fat storage and make it harder to lose weight.  

The most common concerns expressed by my menopausal and postmenopausal patients are how easy it is to gain weight and how hard it is to lose weight. It's a real challenge, so much so that many women believe menopause causes a shift in the body that makes it impossible to lose weight. But is this really the case?

A recent study tried to answer the question by examining the eating habits of 419 overweight and obese menopausal and postmenopausal women. Some women were encouraged to make eating behaviour changes through regular meetings with nutritionists, exercise physiologists and psychologists while the other "controls" received only limited health education. After four years, 57 percent of the postmenopausal women encouraged to make lifestyle changes maintained at least a 3 kg weight loss compared with 29 percent of the controls.

What food changes worked best to get weight off and to keep it off? Eating more fish, low fat dairy, fruits, salads and vegetables but fewer desserts and sugar-sweetened drinks, as well as less lollies and chocolates, were key. Reduction of alcohol consumption was also very important.

I know you've probably heard this before. But now it's a proven fact. And so is the reality that increased weight affects most menopausal women, and that this increases the chances of high blood pressure, heart disease, diabetes and arthritis, particularly of her hips and knees.

The other thing that this study suggests: As you enter menopause and beyond, the rules for weight control are really the same as they are before menopause.

So how can you best use this information? Energy in versus energy out! Here are five steps you can easily take to lose weight in menopause and keep it off.

1. Make time to exercise daily. You don't have to run a marathon. Just 50 minutes daily walking or gardening or dancing.

2. Talkto a dietitian. You'll be amazed at the stuff in your refrigerator and cabinets that isn't good for you that can be swapped out for healthier choices. In addition you need to learn the impact of portion control.

3. Keep the sugar and processed food out of the house. Eat fresh – veges, salad, fish, lean meat, chicken, low fat dairy, fruit – but in the controlled amounts. Don’t snack, sit down and eat so you are mindful of what you are consuming.

Eat a balanced diet, exercise and sleep are the factors you should focus on to feel good and lose weight. Don't focus on the speed of weight loss, focus on making all the changes permanent lifestyle ones.

All great answers, yes I know it is frustrating I am in the same position, metabolism definitely changes during menopause. Try to vary your activities as was suggested above and adding 2-3 resistance workouts a week should help. The more muscle mass you build the more energy your body is burning during the day. Watch your portion sizes, sometimes it is not what you are eating as you say your diet is spot on, but how much, as yes it is energy in energy out. The other point not addressed is other than your exercise how much are you moving during the day. If you have a job where you are quite sedentary try to get out at lunch time and walk, take the stairs, stand instead of sit, move as much as you can during the day every bit will help.       

It is clear that everyone is different, but you may find this article a good starting point...

https://authoritynutrition.com/lose-weight-in-menopause/

Whether there is any current understanding of menopausal weight gain or not you and I and many other good, experienced health professionals who have commented have felt the impact themselves.

In my practice when we find someone who really struggles to lose weight I send them for metabolism testing via indirect calorimetry. This measures your energy expenditure at rest and during exercise - so at a wide range of heart rates. It also shows what fuel you are accessing for that energy. 

For the difficult ones we see that they may rarely if ever be able to burn their own body fat, instead burning glucose from food or from breakdown of their own muscle. This basically means you can store fat but can't burn it or rarely can burn it. 

Treatment usually involves high intensity interval training and some modifications to diet timing around exercise plus supplement. There is 2 podcasts worth listening to here: https://www.greatideas.net.au/beyond-bariatric-surgery/podcasts  Number 6 is a client who has had 2 bariatric surgeries and still struggled, Number 13 is the physiotherapist who carried out the testing. 

Find a weight management specialist dietitian who has body composition equipment and is knowledgeable in this area to work with.