How to Lose the Meno 10: Tips for shedding peri/menopause weight

Medically reviewed by Dr. Brad Jacobs MD

Weight. The struggle is real, especially once we hit our mid-to-late 40s. Just when we see light at the end of the menstrual bloating tunnel, we’re blindsided by...The Meno 10, a.k.a. Menopause Belly, a.k.a. the seemingly unexplainable poundage that suddenly starts cleaving to our midsections in midlife. It’s not like most of us are trying for 6-pack abs anymore. Okay, some of us (raises hand) never did. But is a soft-yet-streamlined tummy too much to ask for?

There actually are several explanations for our midlife, mid-body weight gain. One is simply the aging process. Another is dwindling estrogen. Together, they cause our muscle mass to wane and our metabolism to slow. So we find ourselves gaining weight, even if we’re eating the same foods and maintaining the same level of exercise. And we’re unable to lose it with our go-to diet and fitness tricks that worked in the past. One other possible explanation is hypothyroidism. This condition shares many symptoms with peri/menopause and the onset is often in midlife. So it’s wise to check in with your doctor if you think you might be experiencing perimenopause symptoms. A quick lab test can rule out thyroid issues.

In our 40s and 50s, we’re also entering a time of elevated stress. Our jobs may become more demanding; our family relationships more complex; our finances more strained. We may be caring for children and/or aging parents. And we may be doing it all on our own, or with very little support. All this stress can add even more pounds.

And then there’s sleep. When we’re repeatedly awakened by night sweats or bathroom runs or a head that just won’t turn off, our health suffers. We have less energy to get the exercise we need. We don’t eat as well. Our stress levels increase, as does our weight.

Since the same old same old doesn’t work so well anymore, now is a good time to make some adjustments to our daily lifestyle. And not just for the sake of vanity. Weight gain—especially in the belly area—can increase our risk for heart disease, type 2 diabetes, stroke, and some cancers.

Change It Up

The most obvious place to start is diet. If we consume more calories than we burn, we’re not going to lose weight. That said, there are many approaches we can take here. It’s important to keep in mind that an approach that might work well for one person won’t necessarily work for everyone. Because for any lifestyle adjustment to work, we have to stick with it for the long haul. And different people find it easier to stick with different adjustments. So if one of the reccos below doesn’t work for you, don’t despair. Just try another.

Change How Much You Eat

This is one of the most common approaches, but also one of the hardest to stick with. When our bodies have been accustomed to eating a certain number of calories every day, our brains will release appetite hormones when we reduce our calorie intake. These hormones trigger the hungry feeling, along with its friends, cranky and spacey.

But if you can push through the daily flood of appetite hormones for a few months until your brain gets used to this new regime, this could be a solid approach for you. Just don’t limit your calorie intake too much, as that could actually slow your progress. The Mayo Clinic suggests women need about 200 fewer calories per day in our 50s than we needed in our 30s and 40s. So if you’ve been sticking to 2000 calories/day, you’d want to aim for 1800.

Change What You Eat

Avoiding “empty calories” like those found in alcohol, carbs, and foods with refined sugars can go a long way toward helping you maintain a healthy weight. And without leaving you hungry. Just swap out the empty calories with healthy calories in fresh produce, protein, and healthy fats. Preliminary evidence suggests that this will result in significant and sustained weight loss, as well as reduce your risk factors for heart disease and type 2 diabetes.

You can take this up a notch at mealtime by making sure there’s more produce on your plate than protein. Fascinating fact: eating 7 servings (about 8 ounces, total) of vegetables per day may reduce the risk of dying prematurely by as much as 42%. And it works incrementally; every serving of vegetables reduces your risk of dying by 6-8%.

Another fascinating fact: alcohol and refined sugars tend to exacerbate hot flashes—and when consumed in the evening, night sweats. So particularly for women nearing or in menopause, there’s a lot of up-side of changing what we eat. And because this diet approach keeps the body and brain feeling satisfied, it’s a lot easier to maintain. If you’ve begun and bailed from more diets than you care to count, this might be a successful approach for you.

Change When You Eat

There’s a lot of press right now around intermittent fasting. This is more about rescheduling your calorie intake than restricting it. With this approach, you alternate between periods of eating and fasting. Among the numerous ways to fast intermittently are:

  • The 24-hour Method: Fast for 24 hours, one or two non-consecutive days per week.

  • The 5:2 Method: Similar to the 24-hour Method, only instead of completely fasting, limit calorie intake to 500-600 on the 2 non-consecutive days.

  • The Crescendo Method: Fast for 12-16 hours on two or three non-consecutive days every week.

  • Modified Alternate Day Fasting: Eat normally every other day. On fasting days eat 400-500 calories.

  • The 16/8 Method: Restrict eating to one 8-hour block every day by skipping breakfast. Fast the other 16 hours. 

  • The 14/10 Method: Just like the 16/8 Method, only a bit more achievable. Eat during a 10-hour block every day and fast for 14 hours.

Intermittent fasting works for a few reasons. While not its main intent, it does tend to limit calorie intake. Because when the urge to snack falls during a fasting phase, oh well! But it also gives the body more time to break down and use up all of the carbs and sugars it’s been storing in fat cells to use as energy. Once they’re gone, the body starts burning through the actual fat. In addition, fasting allows the body to discard poorly functioning cells or cellular parts. So your body just works better.

The medical community is still exploring the benefits of intermittent fasting as they pertain to weight loss and disease prevention. But we already know it can help combat several peri/menopause symptoms. Here’s how: 

The act of digestion increases our core body temperature. And that can make us more prone to hot flashes and night sweats. If we limit the hours we eat, we limit the hours spent digesting. And less time spent digesting can reduce our hot flashes and night sweats. Fewer night sweats can improve our sleep, which can lead to less stress, which brings us back around to better weight management. It’s a beautiful circle of midlife wellbeing.

Intermittent fasting is another diet adjustment that can be hard to maintain for the long haul. But if you’re also motivated by studies that have linked the practice to everything from improved cognition to longer lives, this may be an approach you’ll want to consider.

It’s always smart to consult with your doctor before getting started on any new weight-loss plan. 

Work It Out

Next up: exercise.

Just when our lives are getting exponentially busier, we also need to dial-up our fitness regimen. Exercise can feel like another demand being placed on our already jam-packed schedule. But with a subtle shift in mindset, it can become the coveted me-time we’re longing for. And bonus: A recent study showed that women who were physically fit were 88% less likely to develop dementia.

If running or gym workouts aren’t your bag, try going after something on your bucket list: tango dancing, kayaking, mountain climbing.

If you can’t break away from the office or family, work in your workout by dropping for a plank every day, lunging from point A to point B, and clearing email while in a wall sit. Park further away from your chosen destination. Dance while doing chores. Take the stairs. Another exercise study found that among adults age 60 or older, just taking a brisk walk 15 minutes/day reduced their chance of dying by 22%. A bunch of incremental exercises can add up over the course of a day. For some immediate, positive reinforcement, strap on a fitness tracker and watch your steps add up.

Or, get it all out of the way in 20 minutes with a High-Intensity Interval Training (HIIT) session several times a week. You can find guided HIIT videos online and bang them out in the comfort of your own home.

The point is, getting more exercise doesn’t have to be drudgery or a big production. It just has to get you moving more. And its benefits go far beyond weight management. You’ll probably notice improvements in your sleep and stress level, too. More on that below.

Sleep It Off

As counterintuitive as it seems, the less we sleep, the more weight we put on. Get this: during a solid eight hours of sleep, the average person loses about one pound of body weight—most of it in the form of H2O we breathe out. Talk about cleansing breaths!

But peri/menopause can really mess with our sleep patterns, what with night sweats and midnight runs to the bathroom. And that’s assuming we’ve managed to turn off the churn in our heads long enough to fall asleep in the first place. The good news: solutions exist for all of these sleep blockers.

Night Sweats

There absolutely are lifestyle changes you can make to reduce night sweats. But there are also hormone, pharmaceutical, and herbal options that can help mitigate your personal climate change crises. Let’s take a look at them all:

  • Diet modifications that can reduce night sweats include cutting back on or eliminating caffeine, alcohol, and spicy foods—especially in the evening, as they all raise your core body temperature. As we mentioned before, allow yourself plenty of time to digest your last meal before going to bed.

  • Hormone Therapy (HRT) gets at the root of the problem, by replacing the estrogen that has kept your inner thermostat (and pretty much everything else in your body) in check for most of your life. HT got an undeserved bad rap in the early ‘00s, when data from the Women’s Health Initiative (WHI), which studied hormone use in women whose average age was 63, was extrapolated to healthy women in their 40s and 50s. But about a decade later, WHI reaffirmed the use of HRT for women under age 60. Depending on your health history, HRT could be the most effective solution to your night sweat > sleep > weight issues.

  • Prescription meds like Gabapentin and some SSRIs, in very low doses, can also reduce hot flashes and night sweats for a more restful night’s sleep.

  • Herbal supplements also work well for some women. Published research shows that Maca, Siberian Rhubarb, Black Cohosh, and Schisandra Chinensis may provide relief from hot flashes.

Urinary Urgency

As dwindling estrogen causes the muscles in our pelvic region to start losing their oomph, our best bet for staying out of the bathroom at night (aside from dehydration, which we definitely do not recommend) is to replace that estrogen. Delivered right to the vagina via a tiny suppository, this method of HRT is effective and safe for just about all women. It also has the added benefit of keeping the vag nice and moist, which can make sex more comfortable. Which might make you want to have sex more often. Which burns calories. And could help you sleep better. Who can’t get behind that weight management tactic?


We already know that dialing up our physical activity helps improve our sleep. Both because it wears us out and acts as a great stress release valve. For best results, schedule your workouts during the first half of the day, as vigorous exercise close to bedtime can rev you back up. If evening is your only available time, try some gentle yoga, stretching, and meditation—all great stress reducers.

You’ll also do yourself a big favor by developing a soothing nightly bedtime ritual. Some people refer to the tips below as “sleep hygiene.” But that sounds a little too much like a dentist appointment, which is not soothing. So we’re sticking with “bedtime ritual.”

  • Turn off all screens one hour before bedtime.

    The light they emit wreaks havoc with your natural melatonin and can make REM sleep harder to achieve.

  • Save stressful conversations for the morning, when you’re fresh. Otherwise, you could stew on them for hours in bed.

  • Take 5-10 minutes for meditation, prayer, or gratitude practice right before bed. Let the day go and thank it for the good things it brought you.

  • Go to bed and wake up at or near the same time every day. Then your mind and body won’t have to guess when to wind down or rev up.

You can support your bedtime ritual with natural supplements like Lemon Balm, Valerian, and Melatonin. These help calm the inner dialog so you can fall asleep faster. We recommend checking with your doctor before taking any supplements, as some come with adverse drug interactions.

Be Gentle With Yourself

Now, anyone who has ever made and abandoned a New Year’s resolution (i.e.: all of us) knows that lifestyle changes are really, really hard to maintain. Baby steps are the name of the game here. Start by eating your favorite meals, but dial up the veggie portion and dial down the meat portion. Get off the bus a few stops early or park at a less convenient parking lot to get more steps in every day. Go to bed at the same time each night for a couple of weeks and see how it feels. The more you can incorporate your new habits into your daily rituals, the easier it will be to stick with them.

Also, consider inviting some of your meno besties to jump on your bandwagon. Making changes is always easier when you have support, inspiration, or even a bit of healthy competition.

It can take time for the benefits of lifestyle changes to kick in. So you probably won’t get the immediate gratification you may experience with a prescription med. And if you give up alcohol or trade the hangout for the workout, your social life may take a hit. But once you get in the groove, and then start feeling results, you won’t want to trade in your renewed sense of wellbeing for anything.

About Us

The Cusp provides personalized menopause care. Our doctors have deep expertise and a broad treatment toolkit, offering natural and medical therapies to help you feel better.