Menopause and Weight Gain: What to Expect

Menopause is an expected transition, but many women are surprised at what it brings. The more you understand what is coming, the better equipped you will be to make informed choices. And that will make the transition as smooth as possible.

Weight gain during and after menopause varies from person to person. The issue is not the transition to menopause. Rather, the issue is the symptoms of menopause. Some symptoms are related to weight gain. And some women experience the symptoms of menopause more than others.

During menopause, the ovaries stop producing most of their estrogen. This gradual decrease in estrogen results in the typical symptoms of menopause, such as hot flashes, night sweats, insomnia, and mood swings. Eventually, the menstrual cycle becomes irregular and stops altogether.¹

Menopause also affects weight and its related health issues. What's more, menopause is a “perfect storm” for weight gain around the stomach.²

Why does menopause affect weight gain?

Here are some of the key reasons menopause is related to weight gain:

Menopause changes your metabolism and hunger

Estrogen regulates hunger, fat storage, and metabolic rate. Estrogen decreases hunger, and regulates your metabolism. But when estrogen levels go down during menopause, those signals are no longer there.³

As a result, metabolism decreases, and appetite goes up. You may feel more hungry, more often. And, you may eat more. This contributes to weight gain that many women experience after menopause.⁴

Menopause changes the way fat is stored on the body

For women, fat is typically stored under the skin in the hips and thighs, or it can be stored in the stomach. But following menopause, body fat starts getting stored in the stomach region more often than in the hips and thighs.²

Stomach fat is different from other fat. It is also referred to as "visceral fat." Visceral fat is more dangerous than fat just under the skin (subcutaneous fat). It produces more inflammation, and also affects organs such as the liver. This shift in where the body stores fat can put women at a higher risk for chronic diseases. The risk of heart disease, diabetes, high blood pressure, and certain types of cancer goes up. Menopause puts you at risk of the unhealthy kind of weight gain.⁵

Menopause affects sleep

Menopause can lead to nighttime hot flashes and less sleep. Getting less sleep changes appetite hormones, and increases cravings for comfort food. Cravings and fatigue can make healthy eating hard.^6,7

How can you manage menopause-related weight gain?

Expecting these changes is the first step. If you know they are coming, you can make more informed choices. And there are many evidence-based treatments you can use.

Prioritize good nutrition

Nutrition is a fundamental part of managing weight and health. Consulting with a nutritionist or a dietitian is a good first step. Sometimes, managing your food and healthy eating is challenging. The symptoms of menopause and aging make healthy eating difficult. In that case, you and your doctor may also consider medications or bariatric surgery to help.

Get regular exercise

Physical activity has been shown to alleviate hot flashes, improve mood, and reduce stress and anxiety levels. It can also help keep your weight under control. Exercise also supports bone health, which is crucial as women may experience a decline in bone density during menopause.⁸

Consider hormone replacement therapy

Hormone replacement therapy may be an option that is right for you. Hormone replacement therapy is a medicine that gives your body estrogen. While it is not a treatment that will prevent weight gain, there is some evidence that shows it may redistribute weight around the stomach. It also may help with other menopause symptoms, like sleep, that can help with weight management. Talk with your doctor about what is right for you and whether hormone replacement therapy is a treatment option.⁹