Hot Flashes‏ May be Curbed by Weight Loss

Laurie Barclay, MD

July 09, 2014

A behavioral weight loss program for menopausal women is feasible, acceptable, and effective in producing weight loss and may also curb hot flashes among overweight or obese women, according to a randomized pilot study published online June 23 in Menopause.

"Although adiposity has been considered to be protective against hot flashes, newer data suggest positive relationships between hot flashes and adiposity," write Rebecca C. Thurston, PhD, from the Department of Psychiatry, University of Pittsburgh School of Medicine, and Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pennsylvania, and colleagues. "No studies have been specifically designed to test whether weight loss reduces hot flashes. This pilot study aimed to evaluate the feasibility, acceptability, and initial efficacy of behavioral weight loss in reducing hot flashes."

More than 70% of women report perimenopausal hot flashes, often associated with poor quality of life, sleep problems, and depression, lasting an average of 9 years or more.

Participants were 40 overweight or obese women who had 4 or more hot flashes per day. The researchers randomly assigned them either to receive a behavioral weight loss intervention or to a wait-list control group. The researchers used physiologic monitoring, diary, and a questionnaire administered before and after the intervention to compare changes in hot flashes and anthropometrics between conditions, using Wilcoxon tests.

The intervention appeared to be feasible, based on high study retention (83%) and satisfaction with the intervention (93.8%). Nearly three quarters (74.1%) of women reported that reducing hot flashes was a major motivator for losing weight.

Mean weight loss was 8.86 kg in the intervention group compared with a weight gain of 0.23 kg in the control group (P < .0001). The weight loss in the intervention group represented more than 10% of body weight and 5% of body fat.

The intervention group also had a greater reduction in questionnaire-reported hot flashes during a 2-week period (−63.0) than did the control group (−28.0; P = .03). However, other hot flash measures did not differ significantly between groups. There was a significant association between reductions in weight and reductions in hot flashes (r, 0.47; P = .006).

"This is encouraging news for women looking for relief for this bothersome midlife symptom," North American Menopause Society Executive Director Margery Gass, MD, said in a news release. "Not only might behavior weight loss provide a safe, effective remedy for many women, but it also encourages a health-promoting behavior. Since many of the women in this pilot study indicated their primary motivator for losing weight was hot flash reduction, we know that this could be a strong incentive for women to engage in a healthier lifestyle which provides numerous other health benefits beyond hot flash management."

Limitations of this study include small sample size, lack of active control, and insufficient power to detect intervention-associated changes in hot flashes.

"This pilot study shows a behavioral weight loss program that is feasible, acceptable, and effective in producing weight loss among overweight or obese women with hot flashes," the authors conclude. "Findings indicate the importance of a larger study designed to test behavioral weight loss for hot flash reduction."

A grant from the National Institute on Aging supported this study. The study authors have disclosed no relevant financial relationships.

Menopause. Published online June 23, 2014. Abstract

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