Probably a little of both. Whether you've been a health nut or a couch potato, you're going to find menopause a challenge. Your metabolism slows down as you get older, so you will gain weight if you don't cut calories and increase your level of exercise. No wonder women add an average of a pound a year during perimenopause. Many women find the extra weight is landing in places that are new for them, like the tummy. Part of the explanation is that after menopause, women tend to accumulate fat where men do--in the neck, chin and abdominal areas--perhaps because of shifting hormone levels. Your genes also help determine where fat accumulates on your body, as does your activity level. Even if you haven't gained weight, flabbiness could come from lack of exercise. As we get older, we tend to be more sedentary, which means less muscle and more fat. Changes in skin tone that come with the loss of estrogen can also make your abdominal area seem looser and flabbier.

You can improve much of this by watching what you eat and exercising more. While most doctors suggest 200 minutes of exercise a week to maintain your weight, midlife women need to do 300 minutes to achieve the same goal. One recent study of 164 overweight and obese women in Minnesota suggested that lifting weights may be one of the best ways to beat belly fat. Women who did supervised weight training for two years had only a 7 percent increase in intra-abdominal fat, compared with 21 percent for women who were just given exercise advice.

Fighting jelly belly is more than vanity. Some of the weight you gain at menopause will be stored as subcutaneous fat in the thighs, abdomen or elsewhere. And some will be stored as visceral fat, close to vital organs in your abdominal area. Subcutaneous fat and visceral fat differ not only in their location, but also in the danger they pose to your health. Laboratory studies of visceral fat cells have found that they're more active than subcutaneous fat cells. How this difference plays out in your body is still not clear, but there is an association between high levels of visceral fat and disease risk. Fatty acids and triglycerides very quickly move in and out of visceral fat cells, which are like short-term storehouses for fats. So if you're consuming excess calories, some of them will certainly be stored in visceral fat. On the other hand, this is the first place you'll lose weight when you slim down.

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