Exploring weight management beliefs during the menopausal transition (ME-WEL project): A qualitative comparative study based on Health Belief Model

Objectives: While most women experience weight gain during the menopausal transition, a subset successfully maintains a healthy weight. This study explores the determinants influencing different weight experiences during the menopausal transition, using the Health Belief Model (HBM).

Design: Qualitative design.

Methods: Semi-structured individual interviews with 62 Portuguese post-menopausal women were performed. Among them, 31 women maintained a normal weight from pre-menopause to post-menopause, with a variation not exceeding 5% of pre-menopausal weight, while another 31 women transitioned from normal weight in pre-menopause to overweight or obesity in post-menopause, with an increase above 7% of pre-menopausal weight. Deductive-dominant content analysis and multiple correspondence analysis were performed.

Results: Prominent differences exist between the Unhealthy Weight Gain Group (UWG-G) and the Healthy Weight Maintenance Group (HWM-G). The UWG-G lacks perceived susceptibility in pre-menopause and perceives obesity as stigmatizing. They prioritize immediate changes as benefits, while the HWM-G focuses on self-concept. Both groups face barriers like food cravings and weight loss challenges in middle-aged. For cues to action, the UWG-G emphasizes social support and self-care resources, while the HWM-G emphasizes age progression and healthy behaviour adherence. The HWM-G presents higher self-efficacy.

Conclusion: This study confirms the suitability of the HBM in understanding weight management beliefs among post-menopausal women, highlighting differences between women who maintain a healthy weight and those who experience weight gain during this life phase. This facilitates identifying key determinants (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy) crucial for future interventions in weight management.