Metabolism surprises during menopause: how to keep your healthy weight
Menopause brings a host of changes – and unfortunately, weight gain is often one of them. Suddenly, your favorite clothing doesn’t fit anymore, even though you’re not eating more than before. So-called visceral fat appears around your inner organs. This article explains how menopause affects metabolism and offers strategies to help you manage your weight.
Weight gain in menopause: a common experience
Menopause isn’t just a time of hormonal shifts; it’s also a period when many women experience unwanted weight gain. Studies show that around 60% of women gain weight during menopause. Especially frustrating is that this added weight tends to settle in the belly area – a spot that’s often hard to tackle.
Why do we gain weight? Hormones and metabolism in menopause
Falling estrogen levels significantly impact fat distribution and metabolism. Before menopause, women tend to store fat around their hips and thighs. However, as estrogen decreases, this distribution changes, with more fat accumulating in the abdominal area—this is known as visceral fat. This type of fat occurs in the inner abdominal cavity and can lead to health problems, as visceral fat is linked to an increased risk of cardiovascular disease and diabetes.
Another factor is the gradual loss of muscle mass. From the age of 30, women lose around 3-5% of their muscle mass per decade, which lowers the body’s basal metabolic rate. Muscles are metabolically active tissues that burn calories even at rest. As muscle mass decreases, calorie consumption drops – even if you’re eating the same amounts as before. This “creeping weight gain” can feel like it’s happening for no reason.
Hormonal changes during menopause result in muscle loss and increased belly fat. With up to 400 fewer calories burned daily, weight gain becomes almost inevitable, even if diet remains unchanged. However, targeted nutrition with high protein and fiber, regular exercise, and strength training can counteract this process.
Symptoms and effects: what’s happening in the body?
Weight gain often sneaks up over time. First, jeans start to feel snug, and then the scale shows a few extra kilos. The loss of muscle mass also increases body fat percentage, which doesn’t just make it harder to maintain weight—it also impacts health. In particular, the so-called visceral fat, which accumulates around the organs, raises the risk of cardiovascular disease and insulin resistance (a precursor of diabetes). So, managing weight isn’t just about fitting into your favorite clothes but also about prioritizing long-term health.
Diagnostics: simple but effective
You can monitor unintended weight gain during menopause at home. The easiest way is to measure your waist-hip circumference, where a ratio of less than 0.8 is desirable. Your doctor might conduct a physical exam and check your blood to rule out other causes for weight gain, such as thyroid issues. Modern fitness tools can also help by tracking calorie expenditure and activity levels. These devices often also monitor sleep patterns, which can also play a role in weight management. Keeping a food diary is another useful tool to reveal hidden calorie sources.
What you can do: treatment options
Lifestyle changes: the foundation for balance and well-being
Managing weight during menopause might feel like fighting an uphill battle, but small, consistent changes can lead to big rewards. It’s not about perfection—it’s about progress. Here are some helpful tips to guide you along the way:
Nutrition: Eating well during menopause isn’t about starving yourself or following complicated rules. It’s about finding a sustainable way to nourish your body and support your health. Here’s how you can build a plate that loves you back:
Prioritize protein: Protein is like your body’s superhero—it fights muscle loss and helps keep you full. Aim for about 1.2 grams per kilogram of body weight. Think eggs, lean meats, tofu, or your favorite legumes.
Focus on fiber-rich, gut-healthy foods: Fiber-rich foods like fruits, vegetables, nuts, seeds, and legumes are essential for nourishing your gut microbiome. The more variety, the better! Good gut bacteria thrive on fiber and support your metabolism, while the less-friendly bacteria can trigger sugar cravings and an appetite for simple carbs. Fiber also helps regulate digestion and keeps you feeling satisfied longer.
Incorporate healthy fats: Don’t fear fats—they’re not the enemy! Healthy fats from avocados, olive oil, and nuts are like a hug for your hormones and heart. They also keep you feeling satisfied longer, so you’re not reaching for that snack five minutes later.
Limit simple carbohydrates and sugars: Simple carbs are like fair-weather friends—they give you a quick high, then leave you crashing. Swap them out for whole grains and complex carbs that stick around longer and keep your energy steady. And if possible: steer clear of sugary soft drinks!
Try intermittent fasting: Think of intermittent fasting as giving your body a little vacation. One popular method is the 16:8 approach—fast for 16 hours (mostly while sleeping, don’t worry!) and eat during an 8-hour window, like noon to 8 p.m. This gives your body time to focus on burning stored fat and even tidying up old cells. But don’t worry—there’s no fasting police. If this doesn’t suit you, that’s okay! Be sure to monitor your protein and fiber intake during your eating window.
Balance macronutrients: Life is about balance, and so is your diet. Try shifting the scales a bit—less on carbs, more on fats and proteins. It’s not about cutting out entire food groups; it’s about finding a ratio that works for you and helps you feel energized and strong.
Exercise: Let’s be honest—exercise can feel like a chore. At least in the beginning. But the key is finding something you enjoy and are able to stick to. Weight training is crucial during this phase of life. Two to three sessions a week can make a difference. And remember, you don’t need a fancy gym membership to start moving—your body is your best equipment!
Stress management: Stress doesn’t just mess with your head—it messes with your waistline too. High cortisol levels can lead to belly fat, which nobody asked for. Try yoga, meditation, or even just five minutes of deep breathing (yes, just sitting still counts!). Your mind and body will thank you.
Treatment options for therapeutic support
Sometimes, lifestyle adjustments alone aren’t enough. In these cases, non-hormonal and hormonal treatment options can help:
GLP-1 agonists (e.g., semaglutide): Originally developed for diabetes, this class of drugs has proven effective for weight loss. They boost satiety and help regulate blood sugar. Studies show that GLP-1 agonists can aid in weight reduction, but long-term side effects are still being studied. Always consult a healthcare provider before starting these medications.
Menopausal hormone therapy (MHT): Menopausal hormone therapy (MHT) can play a positive role in supporting metabolism, especially when symptoms like hot flushes and sleep disturbances hinder healthy weight management. Studies indicate that MHT can stabilize energy balance and reduce the risk of visceral fat accumulation. While MHT is not primarily recommended for weight loss, it can be a valuable aid in managing weight through menopause.
Making informed decisions about these treatments should always be done with your healthcare provider to weigh the benefits and potential risks effectively.
Sources:
Davis SR et al. Writing Group of the International Menopause Society for World Menopause Day 2012. Understanding weight gain at menopause. Climacteric. 2012 Oct;15(5):419-29. doi: 10.3109/13697137.2012.707385.
Verma A et al. A comprehensive evaluation of predictors of obesity in women during the perimenopausal period: A systematic review and narrative synthesis. Diabetes Metab Syndr. 2024 Jan;18(1):102933. doi: 10.1016/j.dsx.2023.102933.
Jull J, Stacey D, Beach S, Dumas A, Strychar I, Ufholz LA, Prince S, Abdulnour J, Prud'homme D. Lifestyle interventions targeting body weight changes during the menopause transition: a systematic review. J Obes. 2014;2014:824310. doi: 10.1155/2014/824310. Epub 2014 May 26.