How to manage weight gain in perimenopause and menopause - our top tips!

Are you in perimenopause or menopause, and struggling to manage your weight?

You're not alone!

Menopause is a natural phase in life, marking the end of a woman's reproductive years. It's technically diagnosed after 12 months of no menstrual periods, or can be diagnosed based on hormone levels in women who do not have periods due to medical or surgical reasons.

Perimenopause is the time of hormonal transition that occurs before menopause and can last from months to years.

Both perimenopause and menopause can cause a variety of physical and emotional changes (see our in-depth blog post here)

But one of the most challenging symptoms can be unwanted weight gain - even in women who don't normally struggle with their weight.

And while the numbers on the scales aren't as important as overall health and well-being, the type of fat that tends to accumulate during menopause (belly fat, also known as visceral fat) isn’t just annoying — it can have health risks too.

A study published in the European Heart Journal, found that menopausal weight accumulation around the middle — even if you haven’t gained a single kilo — puts you at greater risk for cardiovascular disease, as it's associated with poorer metabolic health and type 2 diabetes. Weight gain during menopause is also shown to affect health related quality of life sexual function. So it’s a topic we need to pay attention to!

And while there aren't any magic cures or quick fixes (despite the marketing), there are many evidence-based things that can help to maintain a healthy weight during perimenopause and menopause, and achieve a healthy weight if you’re struggling with it.

In this blog post, we'll explore factors that contribute to weight gain during menopause, help you understand what's going on with your body, and give you our top practical tips to combat it.

WHAT CAUSES WEIGHT GAIN IN PERIMENOPAUSE AND MENOPAUSE?

There are a variety of factors that can cause weight gain during the menopausal transition, we’ll run through each of them below.

Hormonal Changes

One of the main culprits behind weight gain during menopause is the hormonal and metabolic changes that occur as a result of reduced estrogen and progesterone production. As we progress through perimenopause and menopause, oestrogen and progesterone levels begin to fluctuate, and eventually drop, as our ovaries slow down.

To take a deep dive into the hormone and health changes that occur during menopause, check out our blog post here.

Estrogen plays a crucial role in regulating body fat distribution, metabolism, and insulin sensitivity, and with its decline during menopause, our body tends to store more fat, particularly around the abdomen, leading to an increase in overall body weight, and a more 'apple' shaped body. Some research suggests that oestrogen may help to regulate appetite, so a drop in oestrogen leads to greater hunger signals (ie we making us feel hungrier, so we eat more)

Insulin Resistance

Hormonal changes during menopause can also contribute to insulin resistance, a condition where the body's cells become less responsive to insulin, leading to high blood sugar levels. To learn more about insulin resistance, read our blog post here

Oestrogen makes our cells more sensitive to insulin, meaning they are able to take up and use glucose from our bloodstream to use for energy. As oestrogen levels drop, many women become relatively less sensitive to insulin, which can elevate blood sugar levels and promote weight gain around the tummy. One recent study published in the Lancet journal, showed that post meal blood sugars can be up to 40% higher after menopause, with the same food!

Insulin resistance can make it harder to lose weight, and promote further weight gain; while weight gain can worsen insulin resistance - creating a vicious cycle! It’s one of the most common reason women struggle to lose weight during their late 40s, 50’s and 60’s..

Slowed Metabolism

As women age, our metabolic rate can decrease slightly, meaning we burn fewer calories at rest. Researh shows that women in menopause burn roughly 200-220 fewer calories per day than women younger than 30, and this reduces even further after age 60. This decline in metabolism, combined with hormonal changes, can lead to weight gain if dietary and activity levels remain unchanged, as we need less calories for energy - so any extra ones are accumulated as fat. Part of the slowing in metabolism is due to muscle loss and fat gain (as muscle burns more energy than fat), and part of it is hormonal. Studies show that most women will naturally start to gain weight as they enter perimenopause, and gain an average of 0.7kg/year in their 50’s.

Muscle Loss

From around age 30, women (and men!) start gradually losing muscle mass at a rate of 3-8% per decade, via a process called sarcopenia. Sarcopenia is an ageing process due to a natural reduction in hormones, as well as a tendency to be less active as we age.

Oestrogen, DHEA, progesterone and testosterone also promote muscle growth, so as levels drop during perimenopause and menopause, this process can speed up, meaning we can lose up to 0.5% of our muscle mass per year (which gets replaced with fat, at a rate of 1.7% per year)!

Reduced physical activity as a result of busy lives, fatigue, pain, or other reasons leads to even more muscle loss.

As muscle burns more calories at rest than fat, and also plays a key role in glucose and insulin metabolism, this loss can further contribute to weight gain.

Sleep deprivation

Sleep disturbances are incredibly common in perimenopause and menopause, due to night sweats, aches and pains, higher stress levels, and dropping oestrogen and progesterone (all of which impact sleep cycles and quality).

And lack of sleep can have a huge impact on weight, as it in increases blood sugar and insulin levels, increases cortisol (stress hormones), makes us more likely to crave high-calorie fatty sweet foods, and even increases our appetite! To learn more about how sleep works, and how it affects health, check out our blog post here

Changing gut microbiome

This is an emerging area of research, but early studies show that during menopause, our gut microbiome can start to change - leading to a lower gut microbiome diversity and a shift toward greater similarity to the male gut microbiome. The drop in oestrogen and progesterone may also cause increased intestinal permability (aka ‘leaky gut’). These changes may contribute to an increase in body weight during menopause, as well as increased levels of inflammation - but more research is needed.

Lifestyle Factors

Changes in lifestyle habits can also play a significant role in menopausal weight gain. Often during perimenopause and menopause, we are juggling work, family, and other responsibilities, leaving little time for self-care.

This can lead to reduced levels of exercise, poorer dietary choices, increased stress, and disrupted sleep patterns - all of which can contribute to weight gain. It can be a perfect storm, and many women report struggling with this in our clinics!

Emotional Eating

Hormonal changes in perimenopause and menopause can affect mood in many women - causing symptoms such as mood swings, anxiety, and depression, as well as poor sleep. Oestrogen and progesterone have a direct impact on mood and anxiety levels, and as these drop, mood symptoms are extremely common. Serotonin (happy hormone) levels also often change, further affecting mood. It’s why there is a marked peak in women experiencing anxiety or depression for the first time during their 40’s and 50’s, and is well recognised as a symptom of perimenopause.

In some women, mood changes can lead to comfort eating or emotional eating, in an attempt to feel better - which can also affect weight. The weight gain that occurs can also trigger feelings of negativity, self-criticism, low mood, loss of confidence, and a negative body image - which can lead to more comfort eating - a cycle that can be hard to escape.

Genetics

Genetics can also influence how a woman's body responds to hormonal changes during menopause. Some women may be genetically predisposed to gain more weight during this phase, especially those who are predisposed to insulin resistance- making weight management efforts more complex.

SO WHAT CAN WE DO ABOUT IT?

Now we've explored WHY weight gain occurs in menopause, let's look at WHAT we can do about it!

While there are many quick fixes, detoxes, and magic cures promised online, in reality these don’t usually work - as they promote short term drastic changes that are usually unsustainable in a busy life (not to mention expensive, hard work, and sometimes even dangerous).

But taking a lifestyle medicine approach to menopause, using a holistic approach DOES work - it’s backed up by science, manageable, balanced, and safe - plus it’s creating healthy habits that last!

It’s what we use in our clinics and courses, and we see it transform lives - you just need the right information, guidance, and support ❤️

Let’s look at these one at a time now.

Balanced Nutrition

To eat for healthy weight in perimenopause and menopause, we want to eat in a sustainable balanced way that:

• minimizes insulin resistance

• provides adequate nutrients for good health

• gets enough healthy protein to stabilise blood sugar levels and build muscle

• reduces inflammation (which can help symptoms, and therefore the ability to live a healthy lifestyle)

• promotes a healthy gut microbiome

In general, research consistently backs a whole food, Mediterranean-style plant-focused diet, rich in fruits, vegetables, whole grains, lean proteins, and healthy fats to do all of these. In one study for example, women who followed a Mediteranean diet for two months (and did not change any other areas of lifestyle), lost about 3.6kg, and reduced their waist circumference.

Plant focused Mediterranean diets are high in fibre (to keep us full, feed our good gut bugs, and stabilise blood sugar levels), have good levels of lean (mostly plant-based) protein such as beans and legumes, are rich in beneficial compounds such as phytoestrogens (to promote healthy hormone balance), and are anti-inflammatory.

These are also what we teach in our Reboot course and Nutrition course - check these out if you’d like to learn more!

Some other tips for nutrition include:

• Embrace Whole Foods: Focus on consuming nutrient-dense foods like fruits, vegetables, whole grains, lean proteins, and healthy fats. These provide lots of healthy nutrients, reduce inflammation, and promote overall health and well-being (as well as better mental health - check out our blog post on eating for mood here)

• Watch Portion Sizes: As metabolism slows down during menopause, it's essential to be mindful of portion sizes. Pay attention to hunger cues and eat until you feel satisfied, not overly full. We have more tips on mindful eating in our blog post here.

• Stay Hydrated: Drinking an adequate amount of water can help control appetite and support overall health. Aim for at least eight cups of water per day, a good way to judge this is if your urine is fairly clear.

• Limit Alcohol Intake: Alcohol can disrupt hormone levels and contribute to weight gain. Ideally the less alcohol the better (as it also affects heart health, brain health, and cancer risk), but if you drink, do so in moderation, ideally limiting to a maximum of 7 standard drinks per week or less.

• Think Good Carbs Rather Than No Carbs: Low-carb diets have gained popularity in recent years as a quick way to lose weight, yet cutting back carbs too much can play havoc with hormone levels, and end up being high in unhealthy (saturated) fat and low in fibre and other nutrients. Women tend to become more sensitive to carbs during perimenopause and menopause, due to changing insulin levels, but this doesn't mean to have to cut them out, as carbs are an important healthy food group! Instead focus on eating good (whole grain) carbs rather than refined (white carbs), as these contain fibre to slow down glucose absorption and help you feel full. Be aware of portion sizes too - using the wellness plate guide below. Carbs should be around 1/4 of your meals (this includes starchy root veges), with 1/2 your plate being ground veggies, and 1/4 being lean proteins to help balance blood sugar. Western diets are traditionally very high in refined carbs, which doesn’t help!

• Be Aware Of Snacking: Snacks can contribute significantly to overall calorie intake over the day, and also are often more likely to be ultra-processed foods (junk foods), refined carbs, or high in sugar. Try to be mindful about what and when you're eating - eating for hunger rather than emotion or boredom and aim for good quality snacks that contain protein and healthy fats, such as nuts, fruit, and whole grains.

• Limit Caffeine: While moderate coffee intake has potential health benefits, high caffeine intake can exacerbate sleep disturbances and increase anxiety, and can also increase cortisol (stress hormone levels), all of which can impact on weight. Stick to 2 cups per day or less (and avoid adding sugar or sweeteners if possible), and if you're still struggling with symptoms try cutting it out altogether and seeing how you feel.

• Be Mindful Of Ultra Processed Foods: Ultra-processed foods (junk food, most big chain fast foods, and many packaged foods) are often high in unhealthy fats, sugars, and sodium, which can contribute to weight gain and other health issues. They also contain very little nutrition. Treats are fine once in a while as part of a balanced diet, but they should be an occasional food, not an everyday one!

• Focus On When You Eat: Many of us eat from when we get up to when we go to bed, yet this can lead to eating more calories than we actually need. It can also result in our blood sugar levels going up and down all day, as we are less sensitive to insulin during and after menopause. Circadian eating involves trying to eat with our body clock, aiming to eat all our meals within a 10-12 hour window, and having a smaller meal in the evening when our metabolism is slower and we're less active. Many studies show it can be a simple but surprisingly effective habit to maintain and can improve blood sugar and insulin levels, and cholesterol, and help counteract belly fat.

• Prioritise Protein At Breakfast: Western breakfasts are often highly processed and full of sugar - even supposedly ' healthy' mueslis. Many people get a nasty surprise when they start reading the nutrition labels on breakfast cereals - as they can pack in a huge punch of sugar first thing! Eating a breakfast low in fibre and high in sugar can result in a blood sugar and insulin spike first thing in the morning, which can set us on a blood sugar roller coaster for the rest of the day (cue snacking and sugar cravings). In contrast, if we eat a breakfast that's lower in sugar and higher in protein it can help maintain blood sugar levels in a healthy range, keep us full and reduce the need to snack. Some of our top tips include trying to have wholegrain rather than refined carbs; checking the sugar content on packaged foods (aiming for less than 5g per serving); and boosting the protein and healthy fat content of your breakfast with nuts, seeds, steel-cut oats, yoghurt, and low-sugar fruits such as berries. Avocados, whole grain bread, and eggs (if you eat eggs) are all also great to include.

We cover all of these topics in depth (and much more), along with over 60 delicious whole food dietician approved plant based recipes in our Reboot and Nutrition courses.

If you need more help getting started with your nutrition, and would like to learn how to eat in a way that optimises your hormones, weight, and health, they’ll teach you all you need to know (plus lots of practical tips and tricks to help you on your way!)

Regular Exercise

Exercise is absolutely vital to maintain muscle mass, help improve metabolic health and fitness, improve mood, and help promote insulin sensitivity - all of which help with mitigating weight gain. It’s often what is missing in women who are struggling with their weight, as in western societies, we simply do not move enough in general!

Many of us also spend our days sitting - at work, during our commute, and in our leisure time - which contributes to further muscle loss, slowed metabolism, inflammation, and weight gain. So getting moving is incredibly helpful for not just our weight, but our overall health too.

Ideally incorporate a combination of cardiovascular exercises, strength training, and flexibility exercises into your routine - aiming for at least 150 min (ideally 300 minutes or more) of moderate-intensity cardio; and 2-3 days per week of strength training:

• Cardiovascular Exercise: Engage in activities like brisk walking, jogging, cycling, swimming, or dancing to get your heart rate up and burn calories. Short higher intensity bursts of exercise can be highly effective, and great if you're time-poor. In particular HIIT training is gaining a lot of attention during menopause, for it’s ability to get our metabolic rate up, and keep it up, often for many hours after we stop exercising. It is also great for heart health and bone density - but in reality ANY cardio you can do that you enjoy and can stick to is good - so try out a few different things and see what takes your fancy!

• Strength Training: Incorporate resistance exercises, such as weight lifting or bodyweight exercises, to build muscle, which can counteract the natural decline in muscle mass during menopause. Strength training becomes extra important in perimenopause and menopause in order to reduce sarcopenia, improve insulin sensitivity, and protect our bones. Muscle is also highly metabolically active (ie burns more calories than fat, even at rest), plus it’s the major store for glucose, and plays a key role in regulating blood sugar and insulin levels. This means that building muscle can be highly effective in helping with weight and overall metabolic health. You don’t need to bulk up to get the benefits - just aim to build strength and endurance, and do it regularly.

• Flexibility and Balance: Yoga and stretching exercises can improve flexibility, and balance, and reduce the risk of injuries, which becomes more important as we age. Tai chi also has many benefits. Again the key is finding an exercise you enjoy, and trying to do it daily if possible - balance and flexibility exercises are one’s that many of us overlook, but are just as important as cardio!

• Consistency is Key: Aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week, along with strength training exercises twice a week. More cardio has extra benefits, so if you can manage 300 min/ week of moderate exercise or 150 min/ week of vigorous exercise, this is even better!

• Break Up The Sitting: Any talk of exercise also needs to include a mention of the ‘sitting disease’, aka the fact that many of us spend most of our day sitting. Sitting for more than 6 hours per day increases the risk of heart disease, diabetes, and many other health issues, and also contributes to back issues and weight gain. If you have a job that involves sitting, try break it up with a few minutes of movement every 20-30min, and get out for a walk during your lunch (even 10 minutes helps). Try find ways to move more during the day as well, such as taking the stairs rather than the lift; parking further away from work and walking there; walking further to buy your lunch or coffee; and walking over to talk to colleagues rather than sending an email. If you’re able to, using a standing desk is extremely helpful, as this gets rid of the health effects of sitting, plus also burns more calories throughout the day.

For more info on exercise in menopause check out our podcast episode here. We also take a deep dive into exercise, how it impacts on health, what exercises we should be doing, and loads of practical tips to get moving (plus online workouts to get you going) in our Reboot and Exercise courses.

Restorative Sleep

Quality sleep is often overlooked but plays a vital role in weight management and overall health, as sleep deprivation plays havoc with our hunger hormones, metabolism, food cravings and blood sugar levels.

When we don't get enough zzz's, it alters our hunger hormones (making us more likely to overeat by up to 30%), messes with our brain's reward centres (making us more susceptible to food cravings), affects our ability to make rational food choices, and makes us more prone to comfort eating.

Sleep deprivation also mucks up our metabolism, increasing our cortisol (stress) hormone, which increases blood sugar and promotes weight gain. Prioritise quality sleep by:

• Creating a Sleep-Friendly Environment: Make your bedroom comfortable, cool, and dark to promote better sleep. Use ear plugs or an eye mask if needed. Keep your bedroom for sleep and sex only, and leave screens out! You want your brain to associate your bedroom with rest and relaxation, not stress and work!

• Establishing a Regular Sleep Pattern: Our circadian clock plays a big role in healthy sleep, to help regulate it’s function try go to bed and wake up at the same time each day, even on weekends. Irregular sleep habits can play havoc with our sleep quality, as well as our metabolism, food cravings, appetite and weight.

• Creating a Relaxing Evening Routine: Running on 110% all day, and then hitting the pillow expecting to just drop off doesn't work, especially in menopause! Instead try create a calming routine in the evening for the hour before bed, where you put work away, switch off screens, turn lights down, and do something that helps you wind down and prepare for sleep. Sipping a herbal tea, reading a book, gentle stretching or yin yoga, listening to music, or meditation are all great for improving sleep quality and signalling to your brain and body that it’s time to get out of work mode and go into sleep mode. Having the same routine each night also signals our brain to start producing melatonin (sleep hormone) and switch off cortisol (stress hormone) levels, which improves our sleep, and helps avoid that 3am waking…

• Limiting Stimulants: Reduce caffeine, ideally avoiding within 8-10 hours of bed, and avoid heavy meals close to bedtime. If you can finish eating at least 3-4 hours before bed, and avoid sugary salty foods in the evening this also helps. Caffeine, a full stomach, salt, and sugar can all play havoc with our sleep patterns!

• Managing Stress: Stress can interfere with sleep, so implementing stress management techniques will benefit both aspects (see next section).

For more tips on sleep check out our blog post here. We also teach you all you need to know about sleep, how to fix common sleep issues, how sleep impacts on health and wellbeing, and ways to get a better nights sleep in our Reboot and Sleep courses - so please check them out if you’d like to know more!

Manage Your Stress

Stress during menopause is a super common issue, but many of us don’t realise just how much it can exacerbate weight gain! Chronic stress can result in excess release of cortisol, a hormone that promotes fat storage and increases blood sugar levels.

And stress can be a tricky issue in menopause and perimenopause, as changing oestrogen and progesterone levels impact mood and stress hormones, making us more prone to the effects of stress.

Serotonin (happy hormone) levels can also change leaving us feeling irritable or down and impacting on sleep.

PLUS if we're feeling stressed or down, we can be more likely to reach for those sugary treats as a way to feel better!

This means managing stress effectively is essential for holistic weight management and overall well-being.

Some of our top tips are:

• Identify Triggers and Situations Causing Stress and minimise these where possible. This may mean saying 'no' more often, cutting back on workload, sharing responsibilities at home, and getting rid of unnecessary commitments. Menopause can be challenging, but also a great opportunity to reassess what is really important to you, and where you want to focus your time and energy moving forward. Often we do a lot of things we feel we ‘should’ do, rather than actually want to do or enjoy! Try become more mindful of where you spend your time and energy, and try align this more with your goals and what truly matters to you. Being 'less busy' is hard when we’ve been conditioned to be on the go all the time, but can make a huge difference ❤️

• Eat to Keep Blood Sugar and Energy Stable aiming for wholegrain carbs/lower sugar meals, adequate-protein, and LOTS of fibre. These help optimise gut health (affects mood and sleep), and reduce the effects of stress on the body and mind - as blood sugar ‘spikes and crashes’ can cause food cravings and fatigue. Ironically our bodies often crave sugar/carbs as a quick energy boost when we're tired and stressed, yet these can actually worsen symptoms, leading to a cycle of food cravings and comfort eating😬

• Prioritise Sleep and Exercise as they help boost stress resilience (how well we are able to cope with the day to day stresses that occur). Research shows they can significantly lower our stress hormones, as well as changing the part of our brain that helps us process and manage stress.

• Try Stress Resilience Practices such as slow breathing, mindfulness, meditation, yoga, and time in nature, as these all help 'turn down' the stress response. You don’t have to do all of them, but experiment to find things that you enjoy, that help you feel well, and that you can do on a regular basis. Even 5-10min a day can make a difference!

• Be Kind to Yourself and try to take at least 30 minutes each day to do something you enjoy, that's just for you. Prioritize activities that bring joy and fulfilment to your life. This also means being kind to your body and mind - being aware of that little voice in your head that might be telling you you’re lazy, fat, unmotivated, or hopeless, and turning this around to focus on what’s good about yourself. Self criticism is very real, and can be a challenge when you’re struggling with your weight. Start to be nice to yourself - writing down or thinking of three things you like about yourself and are grateful for with your body or health each day is a good start!

• Seek Support and share your feelings and experiences with friends, family, or a support group. Often others are going through the same issues, and talking about it can make a big difference and help us feel less isolated

We take a deep dive into stress, how to recognise it, common symptoms of stress, how it impacts on our body and mind, and most importantly what you can do about it, in our Reboot and Stress courses. Please check them out if you’d like to know more!

Social Support

And lastly, maintaining a strong social network is vital for emotional well-being during menopause. Social support is one of THE most vital areas for health and longevity, as it helps reduce stress and creates a positive environment for adopting healthier habits. Research shows when we are well supported, we have lower rates of many diseases; live longer happier healthier lives; and means we are more likely to look after ourselves. Some tips include:

• Join Supportive Communities: Look for menopause support groups or online forums where you can connect with others going through similar experiences.

• Exercise with Others: Consider joining group fitness classes or activities to combine socializing with physical activity.

• Talk Openly: Communicate with your loved ones about your needs and feelings during this transition.

• Prioritise Meaningful Connections: Social connections can often fall by the wayside when life is busy, yet prioritising these into our week is just as important as going to the gym, or making healthy meals! Try create regular times where you meet and talk with people you feel close to, and feel inspired and uplifted by.

Wrapping it up

Menopause is a time of huge transformation in a woman's life, that can come with its own set of challenges - including weight management.

But by taking a whole person lifestyle medicine approach, we can navigate this transition with greater ease maintain a healthy weight, as well as overall well-being.

As with everything in life, it’s all about balance - remembering keep in mind all the pillars of health, such as balanced nutrition, regular physical activity, quality sleep, stress management, and social support.

And with a sustainable holistic well-being plan, menopause can also be an opportunity for growth, empowerment, and a vibrant life ahead.

The Japanese word for menopause is ‘Konenki’ - which translates roughly to regeneration, years, and season or energy. It refers to a time of renewal during mid-life years, bringing a sense of new purpose and growth.

It is not seen as a time to mourn what has occurred in the past, but a time to embrace the future possibilities.

Menopause doesn’t have to be a negative thing - instead can be a perfect time to reassess your priorities and goals, focus on your own health again, and start to live for your future health and the life you want!

And if you feel like you need some extra support, knowledge or guidance with this, we can help you ❤️

We offer wraparound support with our 10 week signature Reboot Transformation health course, where you’ll learn how to take a holistic evidence based approach to well-being, and receive personalised support and coaching to help you turn your health around.

We also do in depth lifestyle medicine consults New Zealand wide, for people who need more in depth advice and input with their health.

Whatever your needs, we’d love to help you - so flick us an email if you have any questions - it’s our passion to help people on their journey to better well-being!

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