Menopause Weight Gain: Why It Happens and What To Do About It

If you’re of a certain age, you may be noticing that the eating and exercise habits that have worked your whole life suddenly aren’t cutting it anymore. The scale is creeping up. Your clothes are fitting differently. And the pounds are stubbornly determined to settle around your midsection.

You’re not alone.

“Weight gain is common before menopause and can be even more challenging after menopause,” says women’s health specialist Lynn Pattimakiel, MD.

But that doesn’t mean menopause weight gain is inevitable.

We talked with Dr. Pattimakiel and Pelin Batur, MD, both board-certified menopause practitioners, about what’s behind those body changes — and what you can do about them.

Why menopause can cause weight gain

Let’s start with a little clarification: Menopause itself is technically one point in time — when you’ve gone 12 consecutive months without a period.

“The stage leading up to that is called perimenopause,” Dr. Batur clarifies. “And that’s often when weight changes begin.”

On average, menopause happens at age 52. But perimenopause can start much earlier — often four to five years before menopause.

Here’s what may be working against you.

• Hormonal changes: Your estrogen levels start to dip during perimenopause, and that can come with changes in your body shape. “Hormonal shifts can affect the way your body stores fat,” Dr. Batur says. “You may notice fat storage shifting away from your hips and thighs and into your stomach.” Some people call this “menopause belly.”
• Slowing metabolism: Your metabolism naturally slows as you get older. So, regardless of your stage of menopause, age itself can make it harder to maintain your weight.
• Loss of muscle mass: Age also tends to bring a gradual loss of muscle mass. As you lose muscle, your body burns fewer calories. That can make it easier to gain weight over time.
• Sleep changes: Menopause symptoms like hot flashes and night sweats can disrupt your sleep, which affects the hormones that help regulate your mood and physical health.
• Chronic health conditions: “You don’t want to blame everything on menopause,” Dr. Pattimakiel says. “Talk with a healthcare provider to rule out other causes for weight gain.” Common culprits include diabetes, sleep apnea, thyroid problems, depression and polyendocrine metabolic ovarian syndrome (PMOS, formerly PCOS).

Can you prevent perimenopause weight gain?

Losing weight or maintaining your weight can be harder during perimenopause, but that doesn’t mean it’s entirely out of your hands.

“Being persistent is more important than working for quick results,” Dr. Batur emphasizes. “With a slow, steady approach to diet and exercise, you can incorporate changes over the long haul as part of a healthier lifestyle.”

These strategies can help.

Prioritize nutrient-rich foods

Focus on an eating pattern built around whole, minimally processed foods.

Dr. Pattimakiel offers these tips:

• Include lean protein in your meals, like chicken, turkey, fish, lentils, low-fat yogurt and eggs (particularly egg whites).
• Eat vegetables regularly.
• Cut back on processed foods and added sugars.
• Be mindful of starchy carbohydrates, like bread, pasta and baked goods.
• Drink sparkling water, unsweetened tea and black coffee instead of soda and specialty coffee drinks.
• Limit or avoid alcohol.
• Eat larger meals earlier in the day, rather than late at night.

Keeping a food journal can help you get a clearer picture of what, when and how much you’re eating. And it may help you identify less-than-healthy patterns you haven’t noticed.

Keep moving

Physical activity becomes especially important as your metabolism and body composition change.

A general goal is 150 minutes of aerobic exercise and two strength-training sessions per week.

Dr. Batur recommends:

• Cardiovascular exercises, like walking, running, cycling and biking, to burn energy and support your heart health
• Strength training (think free weights, weight machines, push-ups and squats) to maintain and build muscle
• Yoga or Pilates to support flexibility, muscle tone and bone health

Manage menopause symptoms

No doubt about it, menopause symptoms, like hot flashes, mood changes, vaginal dryness and insomnia, can wreak havoc on your life. What’s more, they can make it harder to concentrate on eating well, exercising and following other healthy habits that can help you maintain your weight.

Medication-free remedies for menopause relief, like lowering stress and eating a healthy diet, can make a difference. And so might menopausal hormone therapy (also called hormone replacement therapy or HRT), which can help improve your sleep and overall quality of life.

But HRT isn’t right for everyone. Whether it makes sense for you depends on your menopause symptoms, health history, and individual risks and benefits.

Talk with a healthcare provider for personalized advice to manage your menopause symptoms.

When to talk to a healthcare provider

If you’ve made sustainable changes to your eating and activity habits and are still gaining weight, it’s worth bringing it up with a healthcare provider.

Your healthcare team can also help identify less obvious barriers. Maybe knee pain makes exercise difficult. Perhaps your mental health is keeping you from living your best life. Or it could be that your schedule makes planning meals challenging.

Finding the reason you’re struggling is often more useful than blaming yourself — or chalking it all up to menopause.

“It’s easy for life to get in the way, so it’s a matter of figuring out what works for you,” Dr. Pattimakiel encourages. “Weight gain after menopause can feel inevitable, but it doesn’t have to be.”