Unfortunately, one of the less celebrated hallmarks of menopause is weight gain. It is estimated that the average woman gains about 1 pound per year during the menopausal transition, which typically begins in the 40s and can continue into the 60s. While some weight gain is expected and biologically driven, it’s important to know when it becomes a health concern – and what you can do about it.
What Causes Weight Gain in Menopause?
The hormonal shifts during menopause, particularly the drop in estrogen, play a key role in how and where your body stores fat.
- Fat redistribution: Pre-menopause, women tend to store fat in the hips and thighs. After estrogen levels decline, fat tends to settle around the abdomen.
- Muscle loss: Aging and menopause together contribute to the loss of lean muscle mass, which decreases your resting metabolic rate (you burn fewer calories even at rest).
- Changes in insulin sensitivity: Hormonal changes may also affect how your body processes glucose, making it easier to gain weight.
- Lifestyle shifts: Fatigue, sleep issues, and mood changes common in menopause may reduce physical activity or increase emotional eating.
When is weight gain in menopause a concern?
Let’s be clear – gaining a few pounds during menopause is normal. Weight gain becomes a concern when it starts to affect other areas of our health by causing:
- Elevated blood pressure
- Increased cholesterol levels
- Higher fasting glucose or A1C readings
- Joint pain or reduced mobility
- Fatigue or mood disturbances linked to weight gain
If these signs are present, it’s time to take a closer look – not just at the number on the scale, or your body in the mirror, but at your broader health picture.
What can you do to combat weight gain in menopause?
The good news: you can take action, and it doesn’t require drastic or unsustainable measures. Lifestyle adjustments are your most effective tools.
1. Focus on Nutrition
Small, consistent changes can lead to big long-term benefits. Consider:
- Prioritizing whole foods: fruits, vegetables, legumes, and whole grains.
- Choosing lean proteins to support muscle retention (think fish, poultry, tofu, legumes).
- Cutting back on processed carbs and sugars.
- Watching portion sizes – especially as metabolism slows.
- Limiting your consumption of alcohol or even those sugary “mocktails.”
2. Move More
Exercise isn’t just about burning calories – it’s about preserving muscle, supporting your bones and joints, and boosting mood.
- Aim for at least 150 minutes of moderate exercise per week.
- Include strength training 2–3 times weekly to maintain or build muscle.
- Don’t forget mobility and flexibility work, like yoga or stretching, to support joint health and reduce injury.
- Throw in a few balance moves, such as standing on one foot, to prevent falls.
Even brisk walking counts. The goal isn’t perfection, it’s consistency.
“Isn’t there a drug for that?”
It’s tempting to think drugs like hormone replacement therapy (HRT) or weight loss medications might be the quick fix, but here’s the scoop:
- Estrogen replacement is not prescribed for the management of weight. HRT comes with risks and is used in women experiencing multiple disruptive symptoms. If you’re experiencing these symptoms alongside weight gain, it may be worth discussing hormone therapy with your provider:
- Hot flashes
- Vaginal dryness
- Insomnia
- Painful intercourse
- Significant mood swings
Weight loss medications are also not typically recommended for menopause-related weight changes unless other medical criteria are met (e.g., obesity-related health risks or a BMI above certain thresholds).
While society may say otherwise, a little weight gain during menopause is normal. When it begins to affect your health markers or quality of life, it’s worth paying attention to. By understanding the causes and taking a proactive approach through nutrition, movement, and smart healthcare choices you can feel strong and healthy through midlife and beyond.
And remember, you’re not alone in this. Your Women’s Health team at Northfield Hospital + Clinic is here to guide, support, and help you find what works best for your body.