Menopause and weight gain

Weight gain during perimenopause and menopause is common, with at least 50% of women citing it as a side effect. Changes to your physical appearance can be unsettling, especially when navigating other menopause symptoms such as hot flushes, night sweats and mood swings. However, being kind to yourself at this time, and accepting your body for how it looks can help with your mental health.

Even when embracing the differences that occur during this life transition, it’s normal to want to take positive steps to improve your well-being. If you want to minimise weight gain in menopause or lose menopausal belly fat, there are a range of lifestyle changes that can help.

Does menopause cause weight gain?

Weight gain and menopause often correlate. However, weight gain isn’t usually a result of menopause alone. It is more likely to be down to a range of factors that result from natural ageing, hormonal changes and life circumstances:

Loss of muscle mass

As we age, the amount of muscle we have reduces. It decreases around 3-8% per decade from the age of 30, with the rate of loss increasing after the age of 60.

This impacts metabolism because it takes less energy to maintain fat than it does to build and maintain muscle mass. This means that your body needs fewer calories to function. As most people continue to eat as they always have, this can result in incremental weight increases of 0.5 kg-1 kg per year.

Oestrogen, fat distribution and appetite

During perimenopause, the level of oestrogen in the body declines and at menopause, it reaches a permanently depleted state. As oestrogen plays a key role in regulating fat storage and how it is deposited in the body, reduced levels can affect your overall body shape.

It’s more likely for fat to be stored around your waist rather than on your hips and thighs, which is why some people dub this change as ‘menopause belly’ or ‘menopause tummy’. In postmenopausal women, visceral fat (fat stored internally around your body organs) increases from around 5-8% of your total body weight to 10-15%.

Oestrogen can also suppress your appetite. So with less of it in your body, how hungry you feel can change, leading you to eat more than you did before menopause.

Life stressors

Many women juggle other responsibilities and pressures during perimenopause and menopause. Almost 80% of menopausal women are in work and of these, 25% also have a caring role (looking after elderly parents or children, for example).

This can make it more challenging for menopausal women to put their own well-being first. They may not have the time or energy to make nutritious meals or exercise for instance, or not be getting the amount of sleep that they need. All of this can make weight gain more likely.

Menopause symptoms

77% of women experience symptoms of menopause and of these, nearly a quarter report their symptoms as severe.

Mood swings, anxiety, insomnia, hot flushes and night sweats in menopause can all have an adverse effect on your physical and mental health. As a result, it’s not uncommon to end up in negative cycles including:

• Emotional eating
• Disordered eating
• Sedentary behaviours

However, these can make menopause symptoms worse, which then perpetuates the cycle, leading to weight gain.

What is the average weight gain during menopause?

According to evidence from the SWAN study and The Healthy Women’s study, women gain around 1.5kg per year on average during menopause, resulting in an overall gain of 10kg by the time they reach post menopause.

How long does menopause weight gain last?

Although putting on weight during menopause is common, most women don’t continue to gain weight, finding that their weight stabilises eventually. The perimenopause and the first few years after your final menstrual period tend to be where you’ll see the most pronounced amount of weight gain.

Risks associated with belly fat

There are health risks associated with being overweight and an increase in belly fat during menopause can increase the chance of specific health problems including:

• Heart disease
• Type 2 diabetes
• Endometrial cancer
• Breast cancer
• Dementia
• Breathing difficulties
• More severe menopause symptoms

How to prevent weight gain during menopause

There isn’t one particular method that will stop you from putting on weight during menopause, especially as everybody is different due to their genetics, medical history, and daily routine.

However, the best way to prevent weight gain during menopause is to pay attention to your lifestyle by adopting behaviours that generally contribute to overall wellness such as:

• Exercising regularly
• Eating a balanced, healthy diet
• Avoiding crash dieting
• Limiting alcohol
• Managing stress
• Getting enough sleep

How to lose weight during menopause

If you do find that you have gained a few kilograms during perimenopause and menopause, you may feel that losing a bit of weight will help you to feel your best. There are a range of things you can do, and easy changes you can make to help you lose weight, many of which can also help reduce menopause symptoms:

• Eat a varied menopause diet full of lean meat, soya products, oily fish, low GI carbohydrates, fruit and vegetables, beans and pulses and calcium sources
• Do a minimum of 150 minutes of exercise per week - this can be split up into shorter sessions
• Read food packaging labels, paying attention to protein, fats, and carbohydrates
• Swap sugary drinks for water, no-added-sugar squash or the occasional sugar-free soda
• Reduce your portion sizes – swapping to a smaller plate can help
• Get enough good quality sleep
• Keep to structured mealtimes
• Plan your snacks, pick healthy, filling options
• Limit or completely exclude alcohol

Why am I losing weight during menopause?

Losing weight naturally during menopause isn’t as common as weight gain during menopause. However, the hormone fluctuations that occur can result in changes that make you less inclined to eat and therefore, lose weight:

• Mouth and taste changes: The onset of menopause can result in some women experiencing burning, tingling or numbness in their mouth. In addition, oestrogen receptors in the mouth can affect your sense of taste. This may mean you don’t enjoy the food you used to.
• Digestive issues: Declining oestrogen and progesterone can cause gastrointestinal issues such as bowel discomfort, abdominal pain and bloating
• Mood changes: Depression and anxiety can reduce your appetite for several reasons. You may lose interest in food, not have enough energy to cook, experience gastrointestinal upset, and forget to eat because your thoughts are overwhelming.

Rapid or unintentional weight loss can be a sign of an underlying health issue. It’s important to speak to your doctor if you’re losing weight during menopause without trying to.

HRT and weight

Hormone replacement therapy (HRT) is the most common treatment for managing menopause symptoms. Although many women fear that taking HRT and weight gain during menopause go hand in hand, there is little evidence that suggests that this is true.

In fact, there are studies which demonstrate a link between HRT and a significant reduction in postmenopausal weight and fat mass gains.

What else can help with weight gain during menopause?

Aside from lifestyle changes like diet and exercise, other methods to help manage weight gain during menopause include:

• Medications: In some cases, doctors may prescribe medications like metformin (commonly used for type 2 diabetes) to help with weight management. GLP-1 medications such as Mounjaro or Wegovy, can also support weight loss. GLP-1 medications can only be prescribed to individuals with a BMI above 30kg/m², and can also have side effects. If you are considering GLP-1 medication, you should consult your doctor, or go through a suitable and safe provider.
• Stress management: Menopause can increase cortisol levels, which contributes to weight gain. Techniques such as mindfulness, yoga, meditation, or even cognitive behavioural therapy (CBT) can help manage stress and reduce the impact of menopause on weight.
• Supplements and herbal remedies: Some supplements and herbal remedies for menopause, like omega-3 fatty acids or vitamin D, can support overall metabolic health.

When to see a doctor

Speaking to a professional is a personal choice but it may be a good idea to see a doctor about menopause-related weight gain if:

• Your weight gain is rapid or unexplained
• It’s contributing to other health concerns
• It is causing emotional stress, low self-esteem, or affecting your mental health
• Despite making changes to your diet and exercise routine, you're struggling to manage or lose weight
• You're experiencing other disruptive symptoms like hot flushes, night sweats, or sleep problems

At Menopause Care, our menopause doctors, nurses, dieticians and CBT specialists have a wealth of knowledge about how menopause can impact the mind and body. If you want some tailored advice and support about menopause and weight gain, book a consultation with a menopause doctor.