5 Reasons You Gain Weight During Menopause and What to Do About It

As we expect (and maybe even look forward to) our menstrual cycle slowing and stopping as we shift through perimenopause to menopause, the other effects of this hormonal change may not be as welcome. “The most common side effects during menopause are hot flashes, insomnia or difficulty sleeping, brain fog, depression, anxiety, low libido, weight gain and vaginal dryness,” explains Nicole Ibarra, RD, LD. While none of these symptoms are exactly fun to deal with, weight gain may be one of the more frustrating, with potential long-lasting, harmful effects.

“Weight gain during menopause is common, due to hormonal shifts, age-related muscle loss and changes in metabolism, but it’s not just about appearance,” says Jennifer Gilliland, M.S., RD, LD, CDCES, PCC, explaining that, “increased abdominal fat is linked to higher risks for insulin resistance and type 2 diabetes, heart disease, inflammation, metabolic syndrome, osteoarthritis and joint issues.”,

But just because your risk increases doesn’t mean you’re powerless when it comes to your weight and health. Keep reading to understand why menopause triggers weight gain and how to take proactive steps to maintain a healthy weight and protect your long-term health.

1. Your Estrogen Declines

Estrogen offers some protection against abdominal fat, as premenopausal women are more likely to have higher percentages of subcutaneous fat than fat around the midsection. “Once the ovaries stop making estrogen, women start to gain weight in the places that men do,” says Brooke Bussard, M.D., explaining that this android pattern puts fat stores around the midsection, rather than on the hips and thighs like we see with the gynoid pattern. Or in other words, women are more likely to transition from “pear-shaped” to “apple-shaped” in how they carry their weight. 

While hormone replacement therapy is a highly individualized treatment with its fair share of pros, cons and formulations, one small study found that women using (any combination of) HRT experienced a smaller increase in fat mass during a six-month period compared to those who did not use hormone replacement therapy.

2. You’re Losing Muscle Mass

While the exact role that estrogen plays in muscle strength and mass is multifaceted, declining estrogen during menopause isn’t doing your muscles any favors. “As women age and go through menopause, there tends to be a loss of skeletal muscle mass (lean body mass) and a decline in resting metabolic rate (RMR),” says Gilliland.

Muscle burns three times the energy that fat does, so as muscle mass decreases, so does the amount of energy your body burns, at rest and while active. And while menopause may be responsible for some of this muscle loss, the aging process in general plays a large role, as muscle mass and strength can decline at a rate of 3% to 8% every 10 years after your 30s.

3. You’re Moving Less

Whether poor sleep, health concerns or a growing load of responsibility is getting in the way, physical activity can be harder to fit in as we get older. “Beyond muscle loss, women often experience a decline in overall physical activity, both spontaneous (everyday movement) and structured exercise,” says Gilliland. 

Being intentional about maintaining or increasing your physical activity levels while in the perimenopause and menopause period could help reduce weight gain and other symptoms of menopause, like insomnia, bone loss and mood disruptions.

And if you’re hoping to combat weight gain by eating less rather than moving more, you may want to rethink your strategy. Research has found that calorie restriction may increase the rate of bone deterioration, which could lead to an increased risk of fractures, something older women are already more susceptible to.

4. Your Sleep Quality Declines

If you can’t get a good night’s sleep, you’re not alone. Up to 80% of women in perimenopause experience hot flashes and night sweats, which, along with insomnia, can disrupt your sleep patterns, increasing the risk of weight gain, explains Bussard.

While poor sleep may make it more difficult to stick to your workout routine, it can also wreak havoc on your diet choices, which, combined, can make maintaining your weight even more difficult. “Poor sleep disrupts our hunger and satiety hormones and causes appetite to increase during the day,” says Bussard.

5. Your Stress Levels Soar

As if mood changes, poor sleep and hot flashes weren’t enough, life doesn’t stop during perimenopause and menopause. “At this stage of life, many women are caregivers to their own parents, their children are starting to leave home, they’re working full-time and are nearing retirement, so finances are constantly on their mind,” says Ibarra. While this stress is often felt emotionally and mentally, it’s also changing the body in physical ways that may make weight gain a bigger concern. 

Elevated stress can release cortisol, inflammatory molecules and other compounds that disrupt our normal biological processes. High cortisol levels may increase hunger and stress-eating, while also contributing to the storage of fat in the abdominal area.

How to Prevent Weight Gain During Menopause

“Managing weight through balanced nutrition, movement and targeted lifestyle changes is not about dieting, it’s about protecting long-term health, energy and quality of life during and after the menopause transition,” says Gilliland. Here are expert-approved strategies to manage a healthy weight: 

• Prioritize protein: “Protein is an important nutrient to get at each meal to support lean muscle mass. [It can] help keep you full and can help to manage blood sugar levels with regular balanced meals,” says Ibarra. 
• Start a strength-training routine: Bussard recommends two to three days a week of strength-training sessions, as a regular routine will help preserve and build muscle, which is important for metabolism.
• Get serious about managing your stress: High stress levels increase numerous compounds in the body that can influence everything from eating behaviors to how your body stores fat. To help regulate your weight during menopause, Gilliland recommends mind-body practices like yoga, breath work, walking or therapy to help keep your stress in check. 
• Optimize your sleep: Bussard recommends seven to nine hours of sleep each night to help regulate cortisol levels and hunger hormones. Creating a consistent bedtime routine and practicing sleep hygiene are essential. 
• Eat more fiber: “Fiber slows digestion, reduces insulin spikes and helps control appetite, making weight gain less likely,” explains Gilliland. Make grains, vegetables, fruit, legumes, nuts and seeds a regular part of your diet.

Our Expert Take

As estrogen levels dip during perimenopause and menopause, many women notice unwanted changes—especially weight gain around the belly. Hormonal shifts, muscle loss, stress and poor sleep all play a role, but experts say there’s plenty you can do to protect your health. Focusing on strength training, getting enough protein and fiber, managing stress and improving sleep can all help reduce abdominal fat and support you through this period of your life.