Medically reviewed by Dr. Tamara Neuhaus MD

Weight Gain During Perimenopause - Tips on How to Lose It

I’d always had a pretty good relationship with my weight—not obsessed with it, but not neglectful of it either. Then at 48, I started packing on pounds around my middle for no reason that I could tell. Suddenly, my weight became my main focus. I became self-conscious with my partner of 12 years, uncomfortable in my clothes, and worried about my health. - Raina, 50

What is it?

The Meno 10. Menopause Belly. These are charming names describing the sudden increase in belly fat (visceral fat) that we notice in peri/menopause. When you have plenty of estrogen in your system, your body fat is drawn to your breasts and hips. Once the estrogen starts to dry up, the fat collects in your middle. And this isn’t the easy-to-shed fat that lies just beneath the skin. This fat’s deeper inside you. You need some of it there to protect your organs. But too much can increase your risk for heart disease, type 2 diabetes, stroke, and some cancers.

Why does it happen?

There actually are several explanations for this midlife, mid-body weight gain. One is simply the aging process. Another is dwindling estrogen. Together, they cause your muscle mass to wane and your metabolism to slow. So you may find yourself gaining weight, even if you’re eating the same foods and maintaining the same level of exercise. 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 hypothyroidism. Increased stress and poor sleep—both of which go hand-in-hand with the peri/menopause experience—can also cause you to gain weight.

What can you do about it?

There are three approaches you can take to reclaim your ideal weight, and they work best when they work together: eat differently, move more, and sleep better.

Eat Differently

Notice we didn’t say, “Eat less.” Though that is an option. It’s just a hard one to stick with. But changes to what you eat (produce, lean proteins and plant-based fats) and/or when you eat (intermittent fasting) can be just as effective and easier to maintain for the long haul.

Move More

Exercise doesn’t have to be a big, sweaty production. You can work in your workout by dropping for a plank every day or clearing email while in a wall sit. Park further away from your chosen destination. Dance while doing chores. Take the stairs. A bunch of incremental exercise 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.

Sleep Better

Menopause has a lot of little tricks for keeping you up at night: the urgent need to pee, pajama-drenching night sweats, and the churn of stressful thoughts that can come with midlife responsibilities. Urinary urgency can be treated easily and safely with vaginal estrogen. Boom. There are several ways to treat night sweats, ranging from hormone therapy to lifestyle adjustments. Read about them all in our Hot Flashes & Night Sweats round-up. And you can manage stress by getting regular exercise (see above) and creating a soothing, screen-free bedtime ritual every night, that incorporates 5-10 minutes of meditation, prayer, or gratitude practice. It also helps to go to bed and get up at the same times every day. Then your mind and body won’t have to guess when to wind down or rev up.

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At The Cusp, we provide expert menopause care. We are a comprehensive, convenient virtual healthcare service dedicated to help you feel better.