Data from the National Health and Nutrition Examination Surveys[9] have led to a provocative suggestion that the end of a woman's reproductive life is associated with significant body weight gain. The prevalence of overweight women with a body mass index (BMI) of greater than 27.3 (BMI=weight divided by height squared, kg/m2) increased 14.4% from age 50 to 59 -- by far the sharpest increase after age 30 for either gender. Despite the sharp increase in overweight women in the perimenopausal years, however, analysis of data from women who had surgical oophorectomy and those who completed natural menopause have not revealed the magnitude of hyperphagia or increased body weight that one might be tempted to predict on the basis of the animal data or on the basis of such studies as those of Lyons and others[7] and Gong and colleagues.[8]

Only slight increases in weight and no changes in food intake have been detected in perimenopausal or postmenopausal women. For example, in 1 well-designed, longitudinal study, age-adjusted BMI increased from a premenopause value of 26.2 to 26.9 during perimenopause.[10] Similarly, women who remained premenopausal during a 6-year study increased fat mass by 1.0±1.5kg and decreased fat-free mass (lean tissue and bone) by 0.5±0.5kg, whereas women who entered menopause during the study increased fat mass by 2.5±0.2kg and lost 3.0±1.1kg fat-free mass.[11] Interestingly, the results of a recent placebo-controlled, randomized clinical trial indicated that oral conjugated equine estrogen therapy reduced postmenopausal weight gain. Placebo-treated women gained 2.1±0.4kg within 3 years, whereas estrogen-treated women gained 1.1±0.3kg during that same period; addition of progesterone to the estrogen had no effect.[12]

Finally, no reports have been published associating menopause with altered eating.