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 abdominal 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 overall. And, excess belly fat may pose a greater danger to women than to men.

Clearly, managing weight is important. It’s also really hard. So, we asked Gennev’s Monika Jacobson who is a Registered Dietitian Nutritionist, and Nicole Negron who is Functional Nutritionist, to help us understand how hormones are related to weight gain, and how to manage our weight for better health.

Is hormonal weight gain real?

Monika explains, “As women age, metabolism naturally slows down and this is partially due to a decline in estrogen. Additionally, stress (both physical and mental/emotional stress) causes a release of cortisol into the body which can lead to an increase in food cravings, difficulty sleeping and often resulting in weight gain. It’s also common for fat to accumulate around the abdomen during menopause when previously fat settled into other parts of the body. This is all very normal and natural although it can make some women uncomfortable with these changes.”  

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

Hormones begin to fluctuate in women 35 and over. This is a very normal and natural physiological transition of the body. These hormonal fluctuations have an impact on how the body utilizes energy which in turn, may affect the way body fat is stored.   The functional approach is to change your food, lifestyle, and fitness routines to accommodate for this change in hormones. What once worked before menopause may require some adjusting to see changes.  

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

OK, so how do I adjust my diet to account for normal hormone and weight changes?

Nicole shares that there is no one-size-fits-all approach. But as a general guideline, during the menopausal transition, she encourages her clients to eat more, not less. The name of the game is FAT, FIBER, and PROTEIN at every meal.  

"Plan to eat meals a little closer together (like every 3-4 hours) to stabilize blood sugar and prevent overeating later in the day,” says Monika. "A balanced plate consisting of ½ plate vegetables, ¼ plate fiber-rich carbohydrates and ¼ plate lean or plant-based protein with some healthy fat, is the best approach for sustainable nutrition.  

And when sleep is insufficient or not restful, this can lead to increased cortisol which can result in food cravings, making it harder to maintain weight. It’s also more difficult to exercise when feeling tired and fatigued.  Since not getting enough sleep can be a risk factor for weight gain, you really want to be sure you’re doing everything you can to get quality sleep.  

Gennev Dietitian Tip: If you suspect caffeine or alcohol may be impacting your sleep quality, consider a trial of cutting back or eliminating these and see what happens.  

You may also want to consider speaking with a Gennev menopause specialist to address other ways hormones may be impacting your sleep, and lifestyle approaches that can help you get quality rest.  

Is there one diet or eating plan that can best support my body during menopause?

Monika explains, “Time and again, research indicates that a Mediterranean style of eating best supports the health of most people, including women in any stage of menopause. This is due to the natural variety of nutrient-dense whole foods like fiber-rich vegetables and whole grains, healthy unsaturated fats and lean protein while limiting processed foods, high saturated fat and added sugar.”  

By following the Mediterranean diet lifestyle, these foods will help optimize health by reducing risk of heart disease, improve or prevent systemic inflammation, lower risk for Type 2 Diabetes and maintain a healthy weight for your body type. Learn how to get started with the Mediterranean Diet with our article How to Eat the Mediterranean Diet Way.

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

It’s difficult to prioritize exercise when you feel that deep fatigue, especially when you've experienced multiple nights of poor sleep. Try setting small, attainable goals around movement instead of going for intense exercise expectations that you may just want to avoid. Try a 20-minute walk at a pace you are comfortable with.  Or, try splitting up your exercise into multiple sessions such as a 10-minute stretch in the morning, 15-minute walk at lunch time and a 10-minute strength session with body weight at home in the evening.  

Gennev Dietitian Tip: Gennev’s Vitality supplement is a game-changer for improving energy in many women. More energy = more likely you’ll feel up for exercising.  

Nicole shares, “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.

Monika notes, “As menopause-related fatigue improves, you’ll likely have more energy and motivation to move your body again. It’s a bit of a cycle. Better energy leads to higher motivation and likelihood of exercising which can often lead to improved sleep and waking feeling more rested and energized the next day ready to do it again.”  

Am I at the mercy of my hormones?

“Not at all!” says Nicole. “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.

Take control of your health. Your body wants to be healthy, even though right now it might not seem that way. When you work with Gennev’s integrated care team, you will be connected with a Registered Dietitian Nutritionist who 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.

The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev's telemedicine doctors before beginning any new treatment or therapy.


Gennev Staff

March 27, 2023

Medically Reviewed By

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