What causes menopause weight gain?

Key Points

• Weight gain is a common occurrence for women in menopause.
• Menopausal weight gain is typically caused by changes in metabolism that aren’t necessarily connected to menopause itself.
• There are steps you can take to mitigate menopause weight gain with both diet and physical activity.

Menopause is a natural part of aging that occurs after menstrual cycles have stopped for 12 months. It typically occurs between the ages of 45 and 55, though some women experience it earlier or later. Menopause occurs due to decreasing levels of estrogen, which can lead to some uncomfortable symptoms. Menopausal symptoms include hot flashes and night sweats, difficulty sleeping, low mood, poor memory, low libido, and more.

Many women experience weight gain in perimenopause, during menopause, or post-menopause. It is a common side effect, but it can be frustrating to feel like you gained weight “overnight” and nothing you try effectively combats it. While menopause weight gain is normal, there are steps you can take to minimize it and maintain a healthy weight as you age.

Let’s talk about what causes menopause weight gain.

What causes menopause weight gain?

It is quite common to gain weight during menopause, though it is not exclusively due to menopause itself. The hormonal changes of menopause change your fat distribution, making it more likely for weight gain to appear around the midsection, rather than the thighs or hips. In fact, belly fat accounts for 15-20% of overall weight in postmenopausal women, compared to 5-8% in premenopausal women.

Your body weight can also change due to lifestyle and age factors. As you age, you lose muscle, and with less muscle mass, your metabolism slows down. This means you can eat the same amount of food you always have and gain weight instead of maintaining it.

Additionally, menopausal symptoms like low mood, hot flashes, or poor sleep can make it harder to maintain a healthy lifestyle. All of these effects collectively add up and can lead to weight gain. 

What are the risks of menopause weight gain?

Menopause weight gain, while normal, does not come without risks. Extra weight, particularly abdominal fat, which is known as visceral fat, correlates with an increased risk of several health conditions, including:

• Type 2 diabetes
• Breathing problems
• Insulin resistance
• Blood vessel and heart disease
• Dementia
• Worsened menopausal symptoms

Extra body weight and obesity also raise your risk of some kinds of cancer, including breast, endometrial, and colon cancers.

How can I avoid weight gain during menopause?

While gaining weight during and after the menopausal transition is common, there are some steps you can take to prevent excess weight gain:

• Make typical healthy choices: focus on whole foods, minimize added sugar, minimize alcohol
• Prioritize sleep and a consistent sleep schedule
• Concentrate on overall wellness; stress seems to be a precipitating factor in hot flashes
• Do regular physical activity (recommendations below!)
• Talk to your doctor about hormone therapy if your symptoms don’t improve
• Eat healthy

The Mediterranean diet is one popular choice for people managing their midlife health. It has been shown to reduce the risk of osteoporosis, dementia, some cancers, metabolic syndrome, and cardiovascular syndrome. It is anti-inflammatory and low in sugar, all of which helps support long-term health.

Remember that even if your weight feels difficult to control, you will not gain weight indefinitely. Your weight will naturally stabilize. Weight gain is typically the most consistent during perimenopause and the first few years after your final menstrual cycle.

Another step you can take is to work with a registered dietitian for weight management.

How a registered dietitian can support you during menopause

If you are struggling to manage your diet and weight before, during, and after menopause, a registered dietitian can help. RDs are licensed healthcare professionals who are qualified to give you medically informed nutritional guidance and work alongside your care team to help you manage your weight and feel as good as possible.

Adjusting your diet has greater implications beyond your weight. It can help improve menopausal symptoms and help you feel better overall. Your RD can work with you to understand your symptoms, recommend changes to your diet, and track your changes to see what’s working. They can help determine if you should eat fewer calories, how many carbohydrates you should eat, what lifestyle changes you need to make, and your ideal activity level.

You can find a qualified dietitian near you who specializes in women’s health with Fay Nutrition. Fay makes it easy to connect to trusted providers who are covered by your insurance. You will be matched with an RD or RDN who is covered by your health insurance and meet with them weekly to discuss your goals and monitor your progress. Click here to get started.

How to stay active during menopause

Maintaining a high enough activity level is critical for menopausal women. While fitness, of course, influences weight, it has broader impacts that are even more important. Exercise helps with joint pain, back pain, fatigue, sleep, mood, and depression. It also helps maintain and increase bone mass, particularly from strength training and higher-impact activities, which is critical in middle age.

Exercise also strengthens your cardiovascular system – important given visceral fat’s correlation with heart disease – and lowers cortisol levels. Reducing stress is a key factor in weight loss and maintaining a healthy weight.

You should aim for 2.5 hours (150 minutes) of moderate aerobic activity per week.

“Moderate” means your heart rate is higher and you can talk somewhat easily but can’t sing. Brisk walking, moderate bike rides, strength training, and water aerobics are all considered moderate activities. Yoga, pilates, and stretching are low impact, while cardio activities like running, swimming, and aerobics are high impact.

Here are some exercise options to meet your weekly goals:

• Sports like tennis, pickleball, basketball, and volleyball
• Strength training using weights, elastic bands, machines, or bodyweight
• Walking and hiking
• Running, cycling, stair climbing, and swimming
• Yoga, pilates, or tai chi

The best exercise is what you enjoy and can do consistently. It is ideal to do a mix of different styles of exercises to avoid overdoing it on any one front. Too much high-impact fitness might have adverse effects, while too much low-impact activity might not offer enough benefit.

Remember: it’s never too late to start! Find what you enjoy and strive for consistency rather than perfection.

Can hormone therapy prevent weight gain?

As your body produces less estrogen and progesterone, you may experience uncomfortable menopause symptoms, such as:

• Hot flashes
• Night sweats
• Trouble sleeping or insomnia
• Mood swings, low mood, or irritability
• Vaginal dryness or discomfort during sex
• Excessive need to pee

If your symptoms become unmanageable and show no signs of improvement, your doctor may recommend hormone replacement therapy (HRT). HRT is usually estrogen or a combination of estrogen and progesterone, and it can come in pill, patch, cream, or vaginal tablet/insert form.

HRT typically helps relieve hot flashes, vaginal dryness, and other symptoms. It can also reduce your risk of osteoporosis and improve your mood and other health risks. It might also redistribute fat and can help with sleep, which has a strong correlation with weight.

That said, hormone therapy is not specifically correlated with weight management. HRT is meant to help with menopausal symptoms and has not shown any meaningful connection with weight. However, with improved symptoms, you may find your weight easier to manage if your overall health feels better.

Find a menopause dietitian

If you’re struggling to deal with menopause weight gain and don’t know what to do next, don’t panic. There are dietitians available who can help assess your current diet, activity level, and overall lifestyle to make informed recommendations on what changes to make.

When you work with a Fay Nutrition dietitian, you get a partner in your weight loss journey. You will meet weekly to discuss your progress, share any difficulties you’re experiencing, and talk through solutions. You can rest easy knowing your care is in the hands of the most qualified nutritional health provider.

Find a registered dietitian near you today with Fay Nutrition.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.