Obesity, is a global problem that impacts many adults as well as children. Obesity is a chronic complex disease defined by excessive fat deposits (specifically around the abdomen) that can impact health.


"Obesity can lead to increased risk of type 2 diabetes and heart disease, it can affect bone health and reproduction, it increases the risk of certain cancers according to the World Health Organization (WHO). Obesity influences the quality of living, such as sleeping or moving." (World Health Organization, 2025)



The term "overweight" or "obese"  is defined in adults, by the WHO and is defined by Body Mass Index (BMI) calculated by = weight (kg)/height² (m²).

  • overweight is a BMI greater than or equal to 25
  • obesity is a BMI greater than or equal to 30.


Increased abdominal fat (visceral fat) tissue can drive chronic inflammation that can quietly impact the heart, brain, liver, joints, and more. For women during the menopausal transition this becomes especially important as hormone changes already shift body composition and increase health risks.


Beyond just using BMI calculation, a measure of one's waist circumference and hip circumference and also calculating the Waist-to-hip ratio (WHR) is important.

  • Women should aim for a waist < 35 inches and a WHR < 0.8
  • Men should aim for a waist < 40 inchs and a WHR <1.0


Beyond the Scale: Obesity as an Inflammatory Condition


Visceral fat is especially harmful and dangerous as it is considered 'pro-inflammatory'. This means it releases hormones and protein signals that drive inflammation throughout the body. This elevated inflammation over time can damage blood vessels, alters hormone signalling, and disrupts organ function.


“Adipose tissue acts as an endocrine organ, producing inflammatory cytokines that contribute to metabolic and cardiovascular disease.” (Ouchi et al., 2011)



Obesity and it's impact on Heart, Brain and Organ Health


Heart disease remains the leading cause of death in women, and risk rises sharply after menopause. Obesity accelerates this risk in several ways:


  • Increases blood pressure by stiffening blood vessels
  • Raises cholesterol and triglyceride levels
  • Promotes insulin resistance, which damages arteries
  • Fuels inflammation, leading to plaque buildup and atherosclerosis


“Visceral obesity is strongly linked to cardiovascular morbidity and mortality, independent of BMI.” (Després, 2012)


Studies have found that women with higher visceral fat have smaller brain volumes and poorer cognitive function later in life.


“Obesity-related inflammation is associated with accelerated brain aging and higher risk of neurodegeneration.” (Arnold et al., 2018)



Obesity in Perimenopause and Menopause


Estrogen naturally protects the heart, brain, and blood vessels. As estrogen levels fluctuate in the perimenopausal phase and then declines during the postmenopausal phase, this protection weakens—making the inflammatory effects of obesity even more damaging.


This is why many women notice changes in body shape, especially abdominal fat gain, just as their cardiovascular and metabolic risks start to rise.


Natural interventions for obesity


Even modest improvements in body composition and lifestyle can dramatically reduce inflammation and protect your organs.


Prioritize movement daily – Strength training at least 2-3 times a week plus regular walking reduces visceral fat and supports cardiovascular and brain health. Aim for 150 minutes a week of exercise that is moderate intensity. This can be walking, hiking, cycling, swimming, etc. The most important thing is to move your body daily. Supporting optimal protein intake in the diet helps to preserve and build lean muscle which in turn helps to regulate blood sugar and metabolism. Dietary intake is key but also to incorporate resistance training is key.


Focus on a Mediterranean diet– This diet focuses on fibre-rich vegetables, lean proteins, omega-3 fats (salmon, chia, flax), and limit processed foods high in sugar and refined oils. You can download my MED Diet check list here.


Manage stress and sleep – Cortisol from chronic stress promotes fat storage and inflammation, while poor sleep disrupts glucose regulation.


Digestive health with optimal gut health and focusing on adequate fibre in the diet we also reduce inflammation in the body and the burden of inflammation. Ensuring your digestive health is optimal is key to overall health.


In my "Four Pillars complete foundational course for women" I discuss these key pillars of health that is important for all women to focus on. You can find the course here.


Pharmaceutical interventions


Medications such as the group of medications called GLP-1 and GIP are important considerations in some patient subgroups. The reason is, diet and lifestyle alone can not always make significant changes.  Talk to your primary care provider about medications for obesity. 


Hormone replacement therapy (HRT) can be a safe and an important factor to also consider in women who are suffering from symptoms related to the menopausal transition. If you are suffering from hot flashes, night sweats, vaginal dryness, poor sleep, etc. You may want to consider and discuss this treatment option with your primary care provider.  In some women, hormone therapy can help reduce diabetes risk as well as other health markers with proper whole body treatment.


Obesity is not simply about appearance or scale weight, it’s about inflammation that can quietly damage your organs over time (from your heart, brain, muscle, etc). For women in the menopausal transition this means paying attention to more than the scale.


By focusing on muscle, reducing visceral fat, and supporting whole-body health, you can lower inflammation and protect the organs that matter most for long-term vitality.


If you reside in Ontario and would like to free book a discovery call with Dr. Amy please book here.


To your best health,

Dr. Amy J. Tung, ND

Naturopathic Doctor | Menopause Society Certified Practitioner




References


Ouchi, N., Parker, J. L., Lugus, J. J., & Walsh, K. (2011). Adipokines in inflammation and metabolic disease. Nature Reviews Immunology, 11(2), 85–97.


Després, J. P. (2012). Body fat distribution and risk of cardiovascular disease: An update. Circulation, 126(10), 1301–1313.


Arnold, S. E., et al. (2018). Brain insulin resistance in type 2 diabetes and Alzheimer’s disease: Concepts and conundrums. Nature Reviews Neurology, 14(3), 168–181.


World Health Organziation https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight