Absolutely has changed.
In my 20s I was a slim, small busted hourglass with secondary pear. Concave tummy and any weight that I gained went straight to my thighs/ hips/ bottom. Buying jeans and trousers was soooooo difficult because I did not have a reliable alterationist. Waists of jeans and trousers were always too big; thighs often too small.
I gained weight in my 40s and became a softer, curvier hourglass. Buying clothes actually became a bit easier in some ways, because my weight was more evenly distributed.
Around menopause, I noticed that I'd started to gain weight on my tummy as well as thighs/ rear.
Then I started a more serious fitness program and began lifting weights. I lost 35 pounds. I am now a relatively slim hourglass/ rectangle, but instead of pear tendencies my tendencies are very slightly towards IT.
Note, I am not a true IT at all (and don't even have significant muscle mass up top, despite weights) but I do have a square shoulder line. The secondary IT tendencies result from changes in weight distribution at menopause (from hips to tummy) combined with the fitness program; these reduced the girth of my hips/ thighs, changing the overall profile.
I have gained about 10 pounds since my lowest weight 8 years ago. (Stress, thank you! Ugh.) I carry this weight fairly evenly across my body but any extra seems to settle in the tummy area now, and when I lose it again, experience tells me, that tummy pudge will be the last to go.
The changes are not drastic in my case. But they're significant enough that certain styles that once seemed a slam dunk are a bit more complicated for me. Take a knife pleated skirt where the pleats start at the top. In my 20s, I'd have worn a skirt like that with ease, and loved it!
Last year, I bought one of those skirts and tried to wear it. But no matter what, I never felt good in it so after five or six attempts, I passed it on to my stepdaughter.
Note that I weighed less than when I'd have worn that skirt with ease. And my waist was only bigger by about one inch. It has to do with more than just how much you weigh or even one measurement. It's how everything combines....