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Like many aspects of ageing, menopause has long been stigmatised and the lack of open dialogue means many people get stuck with unanswered questions about their health during this phase of life.
In this article, we’ll take a closer look at the topic of menopausal weight gain, a big source of confusion for many. One comprehensive review of research on midlife women found that subjects gained an average of half a kilo each year throughout their 40s and 50s. Why does this happen? And is weight gain during menopause a foregone conclusion? Read on for a science-backed guide to how menopause may affect your weight and metabolism, along with compassionate expert advice for supporting your health during this stage of life.
What is menopause, exactly?
Menopause refers to the natural and permanent end of a woman’s menstrual cycle – something many of us will hardly be complaining about – and usually occurs between the ages of 45 and 55. Perimenopause is the stage when periods become irregular and can last several years in the lead up to menopause. Post-menopausal refers to a woman who hasn't had a period for 12 months or more.
Hormonal changes and symptoms of menopause
As the transition to menopause gets under way, levels of certain hormones begin to decline. And let’s just acknowledge: The resulting symptoms usually aren’t much fun. Still, knowing what’s in store can help you better navigate this phase of life and many menopausal symptoms do resolve once the body adjusts, says Dr. Stephanie Zeszutek, an OB-GYN. Here, Dr. Zeszutek explains the major hormonal shifts of menopause and some effects you might notice:
- Progesterone: This hormone is generally the first to wane during perimenopause. This can set the stage for weight gain, plus vaginal dryness and menstrual spotting. Mood changes also may occur, along with a heightened susceptibility to depression or anxiety.
- Oestrogen (estrogen): The next hormonal shift is typically a reduction in oestrogen, which can result in lower lean body mass (a.k.a. muscle), an increased percentage of body fat and a greater resistance to the hormone insulin, which may lead to elevated blood sugar. Lower levels of oestrogen also contribute to symptoms like hot flashes and headaches and may play a role in depression risk, as well.
- Testosterone: Levels of this hormone actually drop throughout your adult life. At menopause, testosterone is typically about half what it was at its peak. Testosterone helps retain lean muscle mass, so declining levels are associated with an increase in body fat, particularly in the belly region.
The link weight gain and menopause
Weight gain after age 40 isn’t just a menopausal phenomenon. People across the board, regardless of their biology, tend to add kilos as they get older. “Evidence suggests that midlife weight gain may actually have more to do with ageing than hormones,” Dr. Faubion says. Here’s a deeper dive into the factors that may contribute to weight gain in middle adulthood:
- Slower metabolism: “This is a major reason that people gain weight as they age,” Dr. Faubion says, in large part due to an age-related loss of muscle mass. Studies show that adults tend to lose a small measure of muscle every year starting around age 30 and the rate of loss picks up over time. Since muscle burns more energy than fat, losing muscle mass may result in a lower metabolic rate—and extra kilos if a person’s eating habits and activity do not change accordingly.
- Sleep issues: Remember those menopausal symptoms we mentioned earlier—anxiety, hot flashes, night sweats? Any one of them can make it tough to sleep soundly, Dr. Faubion says. Research has found that poor sleep may affect weight by impacting appetite, dialling up the desire for sugary foods and dampening a person’s motivation to exercise.
- Heightened stress: Due to factors such as economic uncertainty, middle-age adults nowadays experience more stressful days than their 1990s counterparts did, according to a study published in American Psychologist in 2020. Other research has found a positive correlation between levels of the stress hormone cortisol and body fat. Cortisol may also raise levels of the hormone ghrelin, which increase appetite and can set off cravings for energy-dense foods.
- Being less active: The number of adults over 50 not engaging in any form of exercise increases with age. Multiple factors likely contribute to this trend—everything from busy schedules to the presence of other health issues.
6 tips for managing weight after menopause
Gaining weight with the onset of menopause is a common experience. Your doctor can help you assess your weight with respect to your overall health. Whether you’re trying to lose or maintain weight, the following simple strategies may be useful in supporting your wellness journey during this life stage.
1. Prioritise protein
Research suggests that eating more protein throughout the day may help you maintain your lean muscle as you get older. Protein-rich foods—such as fish, eggs, legumes, lean meat and poultry—also play a key role in making meals feel satisfying, which could make you less likely to get the munchies at other times.
2. Eat meals mindfully
On busy days, it can be tempting to multitask as you quickly eat a breakfast wrap or poke bowl. But you may find your meal more satisfying if you are fully present while enjoying it—a practice known as mindful eating. One small study found that when people heard a prompt to focus on the aroma, flavour and texture of their lunch, they ate fewer snacks later that afternoon than volunteers who didn’t receive the audio nudge. In addition to savouring every bite, try setting aside some time in your day to enjoy your meal without distractions and lay down your fork between bites.
3. Put the scale in perspective
Gentle reminder that nobody’s body stays the same forever. “Give yourself a little grace,” Dr. Faubion says. “Understand that there will be body changes with age and that’s OK.” Your body has taken you through the decades and now that you’re entering a new era, it still needs care and nourishment. Even if you are working toward a weight-loss goal, try to be just as intentional in treating yourself with kindness. Try taking a moment before bed to thank your body for the things it helped you do that day, or jot down some favourite aspects of yourself and put the list by your mirror to serve as a daily affirmation.
4. Reduce stress
You can’t remove all stressors from your life, but you can learn new tools for effectively handling stress. Hint: It’s not about pretending everything is perfect; it’s about coping with your circumstances in a healthy way. Figuring out what works for you might take some exploration or a shift in perspective. Some people benefit from journaling; others ease stress by listening to music, spending time in nature, taking a break from screens, or meeting up with friends for a chat. Increasing your physical movement may also help. In a nutshell? A good stress reliever is an activity that helps you feel less overwhelmed—and better equipped to face life’s challenges.
5. Level up your sleep game
In addition to helping you wake up energised and refreshed, high-quality sleep supports long-term weight management, according to a 2017 literature review in the journal Sleep Medicine Clinics. Even if you can’t avoid every hot flash, creating a consistent bedtime routine and setting up your sleep environment can help optimise your rest time. About an hour before you’d like to be asleep, try winding down by dimming the lights, taking a bath or reading a good book. Your bed’s comfort factor matters, too—if your mattress feels lumpy or your pillows are flat as pancakes, some upgrades might be in order.
6. Build your strength
While all physical activity is beneficial, strength training in particular may be important during menopause. That’s because it builds muscle, which can help offset some of the muscle loss you’d otherwise experience as you age, Dr. Zeszutek says. Aim to incorporate muscle-strengthening exercises that target major muscle groups (think: legs, back, abdominals, chest, shoulders and arms) at least twice a week. If you’re new to strength training, try starting with simple exercises that use just your bodyweight. You can always invest in resistance bands or other equipment down the road.
Can hormone replacement therapy (HRT) help you lose weight?
At this point, there’s no solid evidence that taking or using hormones in prescription form can make a meaningful difference on the scale. That’s because an HRT regimen of oestrogen—or a combination of oestrogen and progesterone—is aimed at improving quality of life, not melting weight. “It’s used to manage menopausal symptoms such as hot flashes, night sweats, mood changes and vaginal dryness,” Dr. Faubion says. Your doctor can help you determine whether HRT is a good choice for you by ensuring you fully understand the potential benefits and health risks.
How can you get rid of menopausal belly fat?
There’s no magic formula or food that can specifically target the size of your mid-section. “You can’t spot-reduce fat,” Dr. Faubion says. Here’s what can help reduce belly fat: steady, sustainable weight management that happens holistically. That encompasses the tips in this article—getting good sleep, moving your body regularly, and managing stress—as well as eating nutritious meals and snacks filled with a diversity of whole foods.
Bottom line: Can you lose weight during menopause?
Maintaining a healthy weight before and after “the change” is totally possible. “Just because you’re going through menopause doesn’t mean you have to gain weight,” Dr. Zeszutek reaffirms. Lifestyle tweaks such as prioritising sleep and stress management, eating plenty of lean protein, and adding strength training to your fitness routine can help keep you healthy in multiple ways after menopause—on and off the scale.