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Writer's picturePAmela Sloop

Weight Gain…Is it Worse After Menopause?

Updated: May 22

I have been a Women’s Health Care provider for many years. Every day I talk to women

about their health, and if there is one problem that women despise and that comes up

time and time again, it is weight gain, especially in the over 50 set. And it is not just the pounds, it is how the weight is distributed. It seems to gravitate right to that middle section. It comes on easier and comes off MUCH harder.


From a recent article found on the Mayo Clinic Website and written by the Mayo Clinic

staff, it is reported that on average, post-menopausal women gain 1.5 pounds a year,

with a shift in body shape and fat distribution (July 8, 2023). This shift is towards fat

accumulation around the middle. It is widely known that weight gain around the middle may increase cardiovascular risk factors, impact the insulin mechanism and increase risk of certain types of cancers. It can also make hot flashes and other menopausal symptoms worse.


Why does this happen? Factors may be directly and/or indirectly associated with the

actual drop in estrogen during menopause. Some of it is simply the aging process. As

you age, you naturally have some muscle loss and increase in fat. It’s harder to build

and maintain muscle, and muscle burns more calories than fat. Often there is also an

associated decrease in physical activity which contributes as well.


Before menopause, estrogen levels are higher. Estrogen helps you maintain muscle

mass and strength and helps determine where your fat is distributed (breast, butt and

thighs). After menopause, with the drop in estrogen that goes along with it, you get a

decrease in lean muscle mass. Estrogen also plays into appetite regulation; without it

you are hungrier. The decrease in estrogen may also cause disturbances in your sleep

pattern and this can predispose you to increased weight gain and decreased energy to exercise.


What Is the best way to combat this menopausal weight gain?

  • A combination of different lifestyle modifications is usually what it takes to combat this menopausal weight gain and belly fat. It’s not just dieting. It has to do with aesthetics (how you look) but also your health. You must be persistent; it probably won’t come off like it did in your younger years.

  • Exercise is very important. A combination of aerobics or cardio and strength training is good. Usually, 150 minutes of aerobic training per week (30 minutes 5 days a week) and at least 15 minutes twice a week of resistance is ideal BUT every bit counts, so do what you can. Examples of aerobic exercises include brisk walking, swimming, bicycling, elliptical or even heavy housework. Examples of strength training include resistance bands, climbing stairs or lifting weights.

  • Work on your sleep. Working out earlier in the day is better for nighttime sleep. Avoid working on your phone or laptop and watching TV close to bedtime. Because light exposure at night can suppress your melatonin, dial down the lights in your bedroom. Work towards getting a consistent bedtime and wake up time, this helps you normalize your Circadian Rhythm, making it easier to fall asleep and wake up. Find some bedtime rituals that work for you. Drinking Chamomile Tea, using a calming essential oil linen spray, warm baths and deep breathing exercises are good examples of relaxing bedtime rituals. Melatonin or CALM (a calcium and magnesium preparation) gummies may help you rest, but make sure you clear it with your healthcare provider before taking any supplements.

  • Diet. You must find one that works for you and that you can stick to. You need to clear any diet with your own health care provider to make sure it is appropriate for your circumstances. The number of calories do count, but what kind of calories is important too. A Mediterranean style diet is a type of diet that is good for menopausal age women. It includes lots of vegetables, fruits, fish and lean poultry, olive oil and other healthy fats such as avocado but limits red meats. The DASH diet is similar but restricts sodium. It is good for people who also have high blood pressure and is heart healthy. THE MIND diet is sort of a cross between the two and is good for brain health and limiting cognitive decline. It has an emphasis on fish, whole grains, berries, nuts and dark leafy greens.

  • Fiber is important. Diets high in fiber keep you full longer. Limiting alcohol is also important in weight loss. Too much alcohol can disrupt your sleep pattern and contribute to weight gain in that way. It is empty calories and overindulging can lead to multiple health problems. One thing that I found that I like were the “mocktails” that used adaptogens instead of alcohol to relax you. You can find more information about these on our resource page.

  • Stress reduction. Stress affects weight loss in several different ways. It causes issues with sleep, often influences food choices and increases cortisol, a hormone that is linked to increased abdominal fat and inflammation. It is also linked with changes in insulin metabolism. Finding hobbies or activities you enjoy and spending time doing things you like are important when working on weight.

  • Hormone Replacement Therapy is another option for help with menopausal weight gain because it may help with increasing lean muscle mass and increase your metabolism. HRT is not right for everyone, but for the appropriate patient, it can help with sleep, mood, energy, glucose metabolism, cholesterol, bone health and abdominal weight gain.


While it is true that losing weight after menopause may present more of a

challenge than losing weight in your 20-30’s but that doesn’t mean that you can’t

do it, it just might take a little more work and a little more time. Discuss options

with your healthcare provider, many have programs to help you with weight loss

and hormone replacement.

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