Many women in menopause find their standard eat-and-exercise routine no longer works for maintaining weight. The reality is, in menopause, you’ve probably lost some muscle mass, and with it the higher metabolism that burns more calories faster. On average, midlife women gain 1.5 pounds (0.7 kg) per year. Managing your weight in menopause is simply more difficult.

Metabolism and weight gain in menopause

Body fat produces estrogen, so a little extra of the former means more of the latter to ease your transition and help protect your bones, brain, and heart. That said, menopause also directs your body to put more of the excess weight on your belly, rather than it landing on your hips, thighs, and buttocks, as it did in your reproductive years. Belly fat is more problematic, because it can contribute to heart disease and metabolic syndrome. So, if you find you’re gaining more than you’re comfortable with, there are things you can do to re-rev metabolism and maintain a healthy weight.

A smart first step we always recommend is talking with a doctor or a Registered Dietitian to find out what is truly a healthy weight for you. Talk about any risk factors you have for exercise and ask if any of your medications may be contributing to weight gain and could be safely swapped out for another without that side effect. Generally, doctors won’t prescribe medications or procedures for moderate weight gain, as better lifestyle choices and acceptance of your post-menopausal body are the healthiest paths (hard as we know those can be!) A weight gain of 10-15 pounds during the menopause transition is typical. And if you are lean going into post-menopause, weight gain may actually be protective.

Lifestyle modifications for weight management

At this stage of life, your body requires fewer calories to function - so if you eat the same amount that you did in pre-menopause, you’re likely to gain weight. Also, perimenopause can suppress leptin (the satiety hormone), and ramp up ghrelin (the hunger hormone), making you feel hungrier. We’ve rounded up the eight lifestyle changes that have proven effective in supporting weight management for the Gennev community.

Embrace your changing body. The biggest lifestyle tip we suggest is to embrace and accept your changing body. It may be a little softer and rounder in spots, and that’s perfectly normal and OK. It’s important to first focus on health. Looking good is great; feeling good is even better.  

Optimize your diet. Obviously, this is a biggie. Now is the time to really pay attention to nutrients first and foremost to support brain, bone, and heart health in the years ahead. Fortunately, good food and beverage choices for those tend also to be good choices for minimizing menopause symptoms, including weight gain. Not so much a “diet” as an eating pattern, the Mediterranean diet is the most healthful for women in menopause. It focuses on lots of veggies, plus fruits, whole grains and lean proteins. This style emphasizes eating things closer to their natural state (minimally processed) for the highest nutrient density and ease/efficiency of absorption.

The DASH diet has similar advantages to your body; in fact, it was devised specifically to help treat or prevent hypertension. In addition to many of the same foods advocated under the Mediterranean diet, DASH also advocates limiting salt. Protein, healthy fats, and fiber are how your body reaches satiation and stays there longer, so be sure you include enough of each.

Food journaling. If you eat the same amount that you did in pre-menopause, you’re likely to gain weight. When we’re stressed or our hormones are doing strange things, it can be difficult to have a real idea of what we’ve consumed during a day. Keeping a journal helps us get a clearer picture of our eating (and snacking) habits. BONUS: Journaling may also be a way to uncover food sensitivities that didn’t exist previously and that cause other issues like gas or inflammation.

Hydration. Believe it or not, what we think is hunger is often dehydration. Remember, you should be drinking half your body weight (in ounces) every day, so before you have a snack or seconds, drink some water and see if you’re still hungry. If you are, eat! Hydration is so good for us, and you may need more of it if you’re dealing with night sweats and hot flashes.

Sleep. There is a very strong association between not getting enough sleep and weight gain. And yes, sleep is a bear to get during perimenopause and menopause, so do the very best you can to practice smart sleep hygiene and maximize your chances of a good night’s sleep.  

Exercise. Even if you’ve been a dedicated exerciser, you may find that your usual routine no longer has the effects it once did when it comes to controlling weight. Changing up the balance of cardio vs strength training can help in lots of ways, to help you manage weight, sleep better, manage stress, and put some healthy demands on your bones. It’s important to keep moving in menopause and beyond for both the emotional as well as physical health benefits.

Mindfulness. “Mindfulness” is the art and science of being fully present and in the moment, and when it applies to eating, it can really help you eat better and less. Being mindful when menu planning and grocery shopping adds to the bounty of goodness this practice delivers because you won’t get home to discover some bags of empty calories, salt, sugar, chemicals, and saturated fat mysteriously ended up in your cart. Mindful eating means not doing other things while eating— no TV, no Internet, no phone calls or emails. Instead, be aware of the now:the smell of your food, the colors, the sizzle of heat, the shine of glaze. As you eat, note not just the taste but the mouthfeel and texture. Try to experience the component flavors: is there a hint of thyme? The more aware you are, the slower you’ll eat and the better you’ll recognize when you’re satiated.

Try Green Tea. Green tea has helped many women with menopause symptoms, including weight gain. Possibly the catechins in green tea accelerate metabolism ever-so-slightly or boost the burning of calories. There isn’t sufficient research to say how or even if green tea works its magic, but it might be worth adding a cup to the early half of your day (it’s caffeinated, so maybe drink before noon and stick to no more than one or two cups per day).

If weight gain continues to trouble you, it’s important to speak with your doctor before it becomes a serious health risk. They can advise of medical interventions that may be right for you based upon your individual weight management goals.

Menopause, body weight and shape changes

Gennev recognizes that the body weight and shape changes which occur with aging and the menopause transition often leave women feeling uncomfortable in their bodies and concerned for their long-term health. Based on current research we know diets work, but with caveats. Most diets leave most women feeling deprived and frustrated to only gain back the weight they lost (and sometimes more). Through our team’s experience working with countless women and accounting for the physiological and metabolic changes that occur during menopause, we have developed the following approach to address these three important components.

Start with YOU - understanding you as the individual, your place in the menopause transition, your current habits, concerns, and goals is our starting point. Our Integrated Care team meets you where you are and supports you along the way to feeling better in your body:

  • Assess current and past nutrition habits and relationship with food and body
  • Listen to your health worries and questions
  • Account for your lifestyle, resources, time, and energy available
  • Address where you are in the  menopause transition and the influence that has on recommendations

Cater to menopause physiology - the changing hormones during peri and post menopause result in a physiological and metabolic state which is different from pre-menopause. Strategies that work with rather than against these changes offer greater benefit and long-term sustainability. They include:

  • Meeting protein needs
  • Assessing carbohydrate intake and adjusting to account for blood sugar response
  • Incorporating anti-inflammatory foods/Mediterranean-style nutrition
  • Movement that feels good (and ideally includes resistance training)
  • Rest/recovery/rejuvenation/mobility

Activate the Gennev menopause mindset - a proprietary combination of cognitive behavioral therapy, abundance mindset, and motivational interviewing that supports women in embracing what can be rather than wishing for what was.

  • Empower with knowledge
  • Self-compassion
  • Mindful/intuitive eating
  • Living forward with more peace and confidence, and less resistance

With this approach some women will lose weight, and some women will find that they are exactly where they are supposed to be. All women will gain the health benefits of implementing habits supportive of metabolic and physical health as this stage of life.  

We understand how frustrating it feels to not get the results you want when you have been working so hard. We invite you to try a different approach and learn how Gennev’s Integrated Care Team can support you with your weight loss goals.

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

August 3, 2022

Medically Reviewed By

Dr. Leasa Lowy

Board-Certified Obstetrician and Gynecologist

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