Weight changes through the perimenopause and menopause transition are so common they may feel inevitable. And a little bit of hormonal weight gain isn’t a bad thing – it can even be protective.

However, how much our weight changes and where new gain is deposited as fat can have impacts on our health.

During the menopause transition, weight begins to settle in the stomach area rather than on hips and thighs, and that can lead to health problems.

In a study in the UK, researchers discovered that women who carried more weight around their middle “had a 10% to 20% greater risk of heart attack than women who were just heavier over all.” And excess belly fat may pose a greater danger to women than to men.

Is your concern over weight gain taking an unhealthy turn?
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Clearly, managing weight is important. It’s also really hard. So we turned to Nicole Negron, Functional Nutritionist and Women’s Health Consultant, for help understanding the weight gain and how-tos to manage our weight for better health.

Is hormonal weight gain real?

Nicole: Yes! For example: Estrogen shifts location and production as we age. What this means is when we are in our younger, more fertile years, estradiol is produced primarily in the ovaries and helps to keep us leaner. As we age, estradiol decreases and the hormone estrone becomes our dominant hormone during our pre-menopausal/post-menopausal years. Estrone is produced in our fat cells and adrenal glands, forcing fat to store in strange and uncomfortable locations in the body, like the belly.

I eat and exercise the same way I always have; why doesn’t it work anymore?

Nicole: It’s important to recognize that weight gain is often a warning sign of a deeper hormonal imbalance. When a woman gains weight, this can be a sign that her blood sugar and insulin levels are unstable, affecting her other fat-burning hormones of thyroid, testosterone, estrogen, and cortisol.

Hormones begin to fluctuate in women 35 and over. This means estrogen and progesterone are no longer dancing together harmoniously. Progesterone begins to decline, and we become estrogen dominant – this slows down our metabolism and turns on the hormone estrone (our fat-storing hormone). When estrone becomes dominant and progesterone begins to decline, testosterone can also take a dive, causing your blood sugar to become unbalanced and your weight to increase.

The functional approach is to change your food, lifestyle, and fitness routines to accommodate for this change in hormones. What once worked for our consistently balanced hormones will not work for a physiology that is changing.

OK, so how do I need to change how I eat to help with the hormones and weight gain?

Nicole: There is no one-size-fits-all approach. That said, as a general guideline, during the menopausal transition, I encourage my clients to eat more, not less. The name of the game is FAT, FIBER, PROTEIN at every meal, and eating meals a little closer together.

Often my clients tell me that they are starving. So eating every 2.5 to 3 hours is perfectly fine. Fifty percent of your plate should be a mix of greens and veggies; the rest is a fat like avocado and protein the size of the palm of your hand.

Secondly, and you’re probably not going to like this, is to avoid caffeine. Caffeine causes a spike in cortisol, so if you're not sleeping at night, as hard as it can be, caffeine should be the first thing to go – especially after 12:00 pm. Not getting enough sleep can be a risk factor for weight gain, so you really want to be sure you’re doing everything you can to get quality sleep.

Can I eat or exercise to make my hormones work for me rather than against me?

Nicole: The short answer is yes. To understand where you should start, I always suggest to test, not guess.

Food is always the most functional step to hormone balance. In order to get your hormones to work for you, getting your insulin and blood sugar under control is essential. Food comes first, exercise second. Taking a food sensitivity test is going to be essential, as most inflammation comes from foods our bodies are not particularly friendly with.

Bear in mind that tests can be expensive, so another good way to see what foods are affecting you most is to take the top inflammatory foods, remove them from your diet for 60 days, and then reintroduce one food item at a time. It's very time-consuming but very effective, as most women walk away with a clear understanding of what foods have the greatest effects on their health. 

An experienced nutritionist can help you manage an elimination test, determine which other tests might benefit you, and understand what your results mean for your diet and exercise plans.

OK, I’ll test, but until the results are in, is there one diet or eating plan you think is the best/healthiest?

Nicole: My work is all about food and how to leverage food for proper hormonal balance. Most of my clients are on some form of a Paleo Diet. Since I have clients that have autoimmune issues, such as thyroid dysfunction, they tend to be on an autoimmune paleo diet, but the ratio of how they consume their food is very individual. Which means they do not consume…

• Citrus Fruits (except for lemons)
• Corn
• Dairy
• Eggs
• Gluten
• Nightshade vegetables (tomatoes, potatoes, eggplant, peppers)
• Yeast (fermented foods/drinks)
• All Grains
• All nuts and seeds
• Alcohol
• Caffeine
• Sugar

This is very challenging, but for some, it can be incredibly effective. This diet may not be necessary or sustainable for everyone, so it’s important to test and work with a nutritionist to understand which foods do and don’t support your hormonal health.

Additionally, I tell my clients to make a few simple lifestyle changes that can really have a positive impact on weight and overall wellness:

1. Drink water with lemon or apple cider vinegar first thing in the morning.
2. Consume breakfast within 1 hour of waking to maintain proper blood sugar.
3. Switch to weight training and avoid jarring exercise such as running.
4. Eat fat, fiber and protein with every meal
5. And most importantly, RELAX!

I feel really fatigued all the time, so it’s hard to exercise. How do I fix that?

Nicole: One of the common things I notice with my clients when they’re transitioning, is they are under enormous stress in menopause – and stress can be exhausting.

Women in this stage (and in every stage, really) need to focus on reducing stress. We need to take things off our plate to allow healing during times of depletion.

Taking adaptogens can be very helpful with regulating stress. Rhodiola rosea is one of my favorite adaptogens. It’s been clinically studied to help sustain levels of neurotransmitters such as serotonin, dopamine, and norepinephrine. It’s amazing for helping with depression but should not be taken concurrently with an SSRI.

As fatigue subsides, energy returns and motivation returns. You’ll feel better and be able to do even more. Exercise is a great stress reliever and sleep promoter, so getting back to regular exercise is incredibly helpful.

Am I at the mercy of my hormones?

Nicole: Not at all! Hormones do so much in our bodies that it can seem like they’re in charge, but you’re not “at the mercy” of your hormones if you know what to do.

Hormones are like plant seeds. For that plant to grow, you need soil, sun and water. So, for the hormones to work optimally they need good exercise, good nutrition, and good sleep. All of these lifestyle interventions help your hormones function optimally.

Alternatively general stress, emotional stress, and physical ailments all affect your hormone levels negatively. The more you know, the more in control you’ll be.

You can take control of your health. Your body wants to be healthy, even though right now it might not seem that way. Working with a nutritionist or dietitian can help you identify the foods, exercise, sleep, and supplement regimes that work best for you, so don’t wait to get back in balance and feel better.

Have you worked with an expert or on your own to have a more hormone-friendly diet? What changes did you make, and how did they impact your health and menopause symptoms? We'd love to hear about it in the comments here or on our community forums, so please share!