Why Menopause Causes Weight Gain — and How to Manage It

Menopause is a natural life stage. But for many women, it brings noticeable physical changes, including with their weight. Some women find that their weight shifts or increases during the years leading up to and after menopause.

Why Menopausal Weight Gain Happens

If you feel like your favorite pants feel more snug or notice the number on the scale slowly climbing in the lead-up to and during menopause, you aren’t alone. Maria Sophocles, MD, a gynecologist and menopause expert in Princeton, New Jersey, says weight gain can be a common side effect of menopause.

“During the menopausal transition, between 60 percent and 90 percent of women gain weight,” says Sophocles. “Even with no increase in calorie intake, women gain on average 1.5 pounds (lb) yearly.”

Hormonal Changes

Hormones are the culprit behind menopausal weight gain, not your diet or activity level. Dr. Sophocles says that with the loss of estrogen, fat gets deposited in the abdomen and can lead to the “menobelly” that women find infuriating.

“The loss of both estrogen and testosterone also results in loss of muscle, and this contributes further to weight gain,” she says. “Muscle requires more calories to maintain, and when we have less muscle, we need fewer calories. If we eat the same level of calories, we gain fat.”

Metabolic Shifts

As hormones shift, women can also feel the impact on their metabolism and the body’s ability to efficiently use fuel for energy.

“Our metabolic rate simply decreases as we age,” says Dr. Sophocles. “We burn calories at a slower rate and so generally need fewer calories, but few women know this or know they need to reduce calorie intake to adjust for the slower metabolism of menopause.”

Natural Aging

In addition to hormones and metabolism, natural aging plays a role in weight gain.

"The aging process is typically marked by a reduction in physical activity, leading to less muscle and a lower metabolism,” says Lisa Talamini, RDN, a registered dietitian-nutritionist in the San Diego area. “The dip in estrogen accelerates that process, decreasing muscle and bone mass and shifting body fat from the thighs and hips to the abdomen, which also raises heart risks.”

Sleep Issues

A lack of sleep can also greatly impact women’s weight, especially leading up to and during menopause. Dr. Sophocles says that for women, lower estrogen and lower progesterone levels can affect sleep in many ways, including:

• Temperature regulation issues, leading to the hot flashes and night sweats that can interrupt sleep
• Difficulty falling asleep
• Night waking
• Deep-sleep disruptions

“Progesterone releases GABA in the brain, which has a sedative effect,” she says. “Without progesterone, you’re much more prone to sleep problems.”

Additionally, added weight can increase the chances of sleep apnea, leading to further sleep disruption.

“People with disrupted or inadequate sleep consume 200 to 500 calories a day more than those with good sleep, and they often eat high-carb foods,” she says. “Poor sleep also slows metabolism. It causes fatigue, leading to lower productivity, a poorer mood, and reduced energy and willingness to exercise. Sleep is, in my opinion, the single best ‘biohack’ for an overall healthy life, as it affects every other pillar of health, including nutrition, movement, social connectivity, and sex.”

Tips to Manage Menopausal Weight Gain With Diet

You might feel like the odds are against you when it comes to weight maintenance throughout menopause, but you can take some steps to manage the increased risk of weight gain.

Consider following the Mediterranean diet. “Besides being known for promoting successful weight loss, the Mediterranean lifestyle has been shown to lower inflammation, diabetes, and heart risk, support bone and brain health, and possibly reduce menopausal symptoms,” says Talamini. “Importantly, it does limit foods that are high in saturated fat, added sugar, and sodium, which may contribute to inflammation and menopausal symptoms, weight gain, and chronic disease risk.”

• Pause before eating.
• Engage your senses to experience the appearance, smell, flavor, and texture.
• Eat slowly and without distractions like the television, phones, or multitasking
• Notice hunger and fullness signals, stopping when comfortably satisfied.
• Reflect without judgment. Don’t label foods as good or bad.

How Exercise Can Slow Menopausal Weight Gain

During menopause, you might feel low on energy at times. But more movement is key to offsetting weight gain and preserving bone and muscle strength during menopause.

Denise Chakoian, a certified fitness trainer in Rhode Island, suggests the following steps to get the most out of exercise to manage weight during menopause.

1. Add resistance training two or more days a week to build lean body mass, improve bone strength, and prevent age-related muscle loss. Don’t be afraid to add weight and reps as you build strength.
2. Incorporate compound movements into your exercise, including squats and deadlifts, to burn calories and build muscle.
3. Add cardio through walking or light jogging.

It can be tempting to skip the workout when you’re tired, but exercise can have a positive impact on your overall health during this stage of life. For those times when the couch seems more tempting than the trail, Chakoian advises adding the workout first thing in the morning and eliminating lengthy workouts.

“Energy and motivation tend to crash later in the day during menopause, so getting it done early means you're not fighting your own body,” she says. “Even a short walk before breakfast counts and sets a completely different tone for the rest of your day.”

“Just stay consistent and don't overthink it,” says Chakoian. “Showing up regularly matters way more than having a perfect plan.”

How to Get Better Sleep With Menopause Symptoms

Menopause is known for its hot flashes and night sweats, all of which can impact sleep. A lack of quality sleep can negatively impact your overall health, including body weight.

“Environmental modifications, such as a cool bedroom and breathable materials, and avoiding triggers are standard first-line approaches,” says Francesco Callipari, MD, the medical director of the Carolyn Rowan Center for Women’s Health and Wellness, and system chief operating officer for the ob-gyn service line at Mount Sinai in New York City. “Hormone therapy can also reduce vasomotor symptoms (hot flushes, night sweats) frequency by approximately 75 percent for the appropriately selected patient.”

And while you might feel like you can deal with it, you shouldn’t have to. Plus, continually not getting enough sleep may have lasting effects.

“Menopause-related sleep disturbances, particularly from vasomotor symptoms (like hot flashes and night sweats), can adversely affect weight through multiple mechanisms,” says Dr. Callipari. “Sleep fragmentation during menopause has been shown to worsen cardiometabolic outcomes, including effects on glucose metabolism and heart rate.”

Can Hormone Therapy Help With Menopausal Weight Loss?

“Menopausal hormone therapy (MHT) is not directly indicated for weight loss but may prevent the buildup of fat around the organs and abdomen associated with menopause,” explains Dr. Callipari. “However, these benefits were not preserved after stopping the MHT.”

“HRT facilitates health. By improving sleep (which in turn boosts energy), shifting away from fat deposition in the belly, and increasing metabolism, HRT can support weight management,” adds Dr. Sophocles. “HRT is most helpful in combination with healthy eating, regular exercise, and good sleep habits.”