The change. Sounds like a low-budget horror film, doesn’t it? (Cue the screeching violins.) But let’s skip the suspense: all we’re talking about here is menopause, a normal life phase marked by a predictable pattern of hormonal shifts, and for some people, shifts on the scale too.
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. “Menopause can feel like someone changed the rules of your body and forgot to tell you,” says Stephanie S. Faubion, MD, director for Mayo Clinic's Center for Women's Health and medical director for The North American Menopause Society.
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 middle-aged women found that subjects gained an average of 1.5lb each year throughout their 40s and 50s. Why does this happen? And is weight gain during menopause inevitable?
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?
First things first: menopause refers to the life stage when a person is no longer menstruating. It officially begins 12 months after you get your final period, which generally happens between the ages of 45 and 55. Menopause can also occur with surgery that removes the ovaries, a procedure sometimes performed as part of a hysterectomy.
For age-related menopause, the two- to eight-year period leading up to that milestone is known as perimenopause. This phase is marked by declines in levels of ovarian hormones and, for many people, the start of some noticeable symptoms and changes, including with respect to weight.
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 Stephanie Zeszutek, DO, FACOG, an OB-GYN and assistant professor at Touro College of Osteopathic Medicine in New York.
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: The next hormonal shift is typically a reduction in oestrogen output, 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.
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 between menopause and weight gain
Here’s the thing: weight gain after age 40 isn’t just a menopausal phenomenon. People across the board, regardless of their biology, tend to add pounds 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 age:
- 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 pounds if a person’s diet 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 snooze soundly, Dr. Faubion says. Research has found that poor sleep may affect weight by cranking up appetite, dialing 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 (and conducted before the pandemic hit, we should note). 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 stokes appetite and can set off cravings for energy-dense foods.
- Being less active: Activity levels tend to reduce as we get older. 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. (Added pounds aren’t always a medical concern.) 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 the body hold on to muscle as you get older. Protein-rich foods - such as fish, eggs, beans, and 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 scarf down 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 noshed on fewer snacks later that afternoon than volunteers who didn’t receive the audio nudge. In addition to savouring every bite, try setting aside a designated spot to enjoy your meal without distractions, and lay down your fork between bites.
3. Put the scale in perspective
Gentle reminder: nobody’s body stays the same forever. “Give yourself a little grace,” Dr. Faubion says. “Understand that there will be bodily 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 towards a weight loss goal, try to be just as intentional in treating yourself with kindness. Take 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. ID your stress-busting strategies
You can’t remove all stressors from your life (wouldn’t that be amazing?), 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. 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. Creating a consistent bedtime routine and setting up your sleep environment can help optimize your zzz's. About an hour before you’d like to be snoozing, try winding down by dimming the lights, taking a bath, and/or cracking open a good book. If you have control of a thermostat, adjust your bedroom temperature to about 18°C, a thermal sweet spot that seems to keep sleepers comfortably warm without overheating. 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. The CDC recommends muscle-strengthening exercises that target major muscle groups (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 pounds. “It’s used to manage menopausal symptoms such as hot flashes, night sweats, mood changes, and vaginal dryness,” Dr. Faubion says. Your GP 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?
Take this truth bomb as permission to quit those “fat-melting” diets forever: there’s no magic formula or food that can specifically target the size of your midsection. “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, like getting good sleep, moving your body regularly, and managing stress, as well as eating a nutritious diet filled with a diversity of whole foods.
The upshot: 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, both on and off the scale.
This article was reviewed for accuracy in August 2021 by Angela Goscilo, MS, RD, CDN, manager of nutrition at WW. The WW Science Team is a dedicated group of experts who ensure all our solutions are rooted in the best possible research.