How to Prevent Menopause Weight Gain

While hormonal changes are often blamed for menopause weight gain, they are not the main reason why it happens, according to Dr. Loeb-Zeitlin. “It’s more of an aging process that causes this weight gain,” she says, which can include decreased physical activity, loss of muscle mass, and a slower metabolism. All these factors together lead to more fat buildup over time.

What menopause does impact is where fat is distributed in the body. Estrogen plays a key role in how the body stores fat. As estrogen levels drop, the body stores fat differently, shifting from the hips and thighs to the abdomen and midsection. This is why many women experience more belly fat during menopause, even if they haven’t changed their eating habits or activity levels. “Lack of estrogen changes a woman’s body shape,” Dr. Loeb-Zeitlin says. “Even thin women will notice more fat in their midriff.”

The symptoms of menopause can also indirectly contribute to weight gain. Hot flashes and night sweats can make it difficult to get restful sleep, which is important for maintaining a healthy weight. “If you’re not sleeping well, you’re going to feel like eating more, snacking, and indulging in higher-calorie foods,” she says. “But more importantly, if you’re not sleeping well, you don’t feel like being active. So much of the weight that we see with aging comes from decreased physical activity.”

Mood changes experienced during menopause — or because of other life stressors — can also interfere with living a healthy lifestyle because stress releases the hormone cortisol, which impacts the metabolism, says Dr. Loeb-Zeitlin. You may also be more inclined to turn to comfort foods when feeling emotional or stressed.

There are reasons to be diligent about maintaining a healthy weight during menopause. “Carrying extra weight, particularly around the abdomen, is linked to an increased risk of several health conditions, including heart disease, type 2 diabetes, obesity, sleep apnea, and certain cancers,” says Dr. Loeb-Zeitlin.

But while weight gain during menopause is common, “it’s not inevitable,” Dr. Loeb-Zeitlin says. “And it’s also not impossible for a menopausal woman to lose weight, but it requires work.” She recommends implementing these lifestyle changes to help maintain a healthy weight:

Stay active and add strength training to your exercise routine. Regular physical activity is one of the most effective ways to manage weight during menopause, as aging leads to loss of muscle mass. “Our job is to fight the body from storing more fat and to build that muscle back, so core strength and resistance training are super important,” Dr. Loeb-Zeitlin says. She recommends combining aerobic exercise, like brisk walking or cycling, with strength training a few times a week. You don’t need to lift heavy weights, either — body-weight exercises like planks and push-ups can help build muscle.

Eat a plant-focused diet. Dr. Loeb-Zeitlin recommends aiming for a Mediterranean diet that centers around plenty of vegetables and lean protein. “Plant-focused diets have been shown to decrease cardiovascular disease and cancer risk and are great overall for weight management.”

Watch your calories. “People tell me all the time, ‘I’m eating the way I always ate.’ Well, maybe you can’t anymore,” Dr. Loeb-Zeitlin says. Metabolism slows naturally with age, so some caloric restriction is needed. “This doesn’t mean starving ourselves, but it’s also not indulging all the time.”

Treat your menopause symptoms. Some people find that taking antidepressants to help with mood changes that may occur during the menopause transition can be beneficial. “It may cause modest weight gain,” says Dr. Loeb-Zeitlin. “The benefits may very well outweigh the risk of weight gain.”

In addition, hormone replacement therapy may be an option for managing bothersome symptoms like hot flashes and night sweats. “If you’re sleeping better and having fewer hot flashes, it’s easier to exercise and make lifestyle changes,” she says. Hormone therapy may also help redistribute fat that deposits in the midsection, but should not cause weight gain or weight loss.

Remember that ultimately, making healthy lifestyle choices is more important than numbers on a scale. “Don’t be too hard on yourself,” Dr. Loeb-Zeitlin says. “If you’re eating a healthy, balanced diet and exercising regularly and you do gain a few pounds, that’s okay.”