The truth about menopause weight gain
It’s common — but not inevitable. Learn what’s newly influencing your weight and get simple strategies for managing it.
Menopause can be a time when it feels like no matter what you do, the scale keeps ticking up every time you step onto it. Even people who never struggled with managing their weight may notice it’s more difficult to stay at their size. It’s not in your head: Women gain an average of 1.5 pounds each year throughout their 40s and 50s. In particular, many women notice more “visceral fat,” the term for fat that accumulates around the belly area. Here’s why it happens, and how to handle it.
What causes weight gain during menopause?
People across the board, regardless of their biology, tend to gain weight as they get older. “Evidence suggests that midlife weight gain may actually have more to do with aging than menopause directly,” says Dr. Stephanie Faubion, M.D., the director for the Center for Women's Health at the Mayo Clinic, medical director for The Menopause Society, and member of the WeightWatchers Scientific Advisory Board.
Here’s why it happens:
Slower metabolism: “This is a major reason that people gain weight as they age,” Faubion says, in large part due to an age-related loss of muscle mass. Research shows that adults tend to lose a small amount of muscle every year starting around age 30, and that the rate of loss accelerates over time as well. Since muscle burns more energy than fat, losing muscle mass may result in a lower metabolic rate and weight gain.
Poor sleep: Menopause symptoms like anxiety, hot flashes, and night sweats can make it tough to sleep, Faubion says. Research has found that poor sleep may affect weight by ramping up appetite.
Stress: Higher levels of the stress hormone cortisol are linked to more body fat; cortisol may also raise levels of the hormone ghrelin, which stokes appetite.
Less exercise: According to the CDC, one in four U.S. adults over 50 don’t engage in any form of exercise, a percentage that rises with age.
Medications to manage weight during menopause
Menopause hormone therapy (MHT), commonly known as hormone replacement therapy (HRT), has been shown to reduce the tendency toward abdominal fat accumulation and to support muscle mass maintenance — but the effects are modest, so it’s not prescribed for weight loss. But when MHT is combined with GLP-1 agonists like semaglutide (Wegovy and Ozempic) and tirzepatide (Mounjaro and Zepbound), the results are far more significant. A recent study showed postmenopausal women who used MHT with a GLP-1 had approximately 30% greater weight loss than those using a GLP-1 alone. Talk with your healthcare provider to see if either medication (or both) are right for you.
Lifestyle changes to manage weight during menopause
Healthy habits can make a difference — from what you eat to how (and how often) you move to how you face stress. Consider these the basics:
1. Prioritize protein
Research suggests that eating more protein throughout the day may help the body hold on to muscle as you get older and experts recommend aiming for 1-1.2 grams of protein per kg of body weight. Protein-rich foods — such as fish, eggs, beans, and lean meat and poultry — also play a key role in making meals feel satisfying.
Learn more about getting enough protein
2. Eat mindfully
On busy days, it can be tempting to multitask as you quickly eat a breakfast wrap or poke bowl. But you may find your meal more satisfying if you are fully present while enjoying it — a practice known as mindful eating. Studies have found that when people heard a prompt to focus on the aroma, flavor, and texture of their lunch, they ate fewer snacks later that afternoon than those who didn’t receive the cue. To savor every bite, try enjoying your meal without distractions, and lay down your fork between bites.
3. Be kind to yourself
Gentle reminder: Nobody’s body stays the same forever. “Give yourself a little grace,” Faubion says. “Understand that there will be body changes with age, and that’s OK.” Even if you are working toward a weight-loss goal, try to be just as intentional in treating yourself with kindness. Take a moment before bed to thank your body for the things it helped you do that day.
4. Work on reducing stress
You can’t remove all stressors from your life, but you can learn new tools for effectively handling the stressors. Some people benefit from journaling; others ease stress by listening to music, spending time in nature, taking a break from screens, exercising, or meeting up with friends for a weekly hang. A good stress reliever is an activity that helps you feel less overwhelmed — and better equipped to face life’s challenges.
5. Get serious about sleep
High-quality sleep supports long-term weight management. About an hour before you’d like to be snoozing, try winding down by dimming the lights and putting away your phone (it emits blue light that can keep you awake). Then, adjust your bedroom temperature to about 65°F, a thermal sweet spot that seems to keep sleepers comfortable without overheating.
6. Build your strength
While all physical activity is beneficial, strength training in particular may be important for menopause. That’s because it builds muscle, which can help offset some of the muscle loss you’d otherwise experience as you age. The CDC recommends muscle-strengthening exercises that target major muscle groups at least twice a week.