Menopause and Weight Gain: Causes and Tips to Control

Last updated 12.14.2023 | by Dr. Karen Pike | 11 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.

The average woman gains 5 pounds during menopause, and those who are already overweight are likely to gain more.

This added weight is a result of hormonal changes, and it usually creeps on slowly. Sometimes, so slowly that we might not even realize until we try on an old pair of jeans, or weigh ourselves for the first time in a while. 

But carrying excess weight can be detrimental to our health. Research shows that women with a high body mass index (BMI) suffer from more intense and frequent menopause symptoms than those in a healthy weight range. Not to mention that being overweight or obese raises the risk of developing serious chronic illnesses such as diabetes and heart disease. So, it’s essential to understand the potential causes of weight gain during menopause, and learn how to control it. 

Like many women, I began to notice I was gaining weight during perimenopause (the build up to menopause.) I’d always been relatively slim and tried to keep a healthy diet. Yet while I hadn’t changed my eating habits or activity levels, the number on the scale was beginning to creep up. 

So, determined not to let my health suffer, I decided to take action, shed the pounds, and keep them off. And I’m so glad I did. Although I didn’t have a lot of weight to lose, stopping weight gain in its tracks and becoming leaner has improved my overall health significantly. I have much more energy, I feel more motivated, and I’m a happier and more confident version of myself. Plus, other symptoms of menopause, such as hot flashes and night sweats, have become less frequent and severe. 

So, are you concerned about weight gain during menopause? Have you noticed your clothes don’t fit like they used to, and your health is beginning to suffer? Rest assured, you’re not alone. But menopause-related weight gain doesn’t have to be an inevitable part of aging. With the right strategies, you can beat the battle of the bulge and remain fit and healthy before, during, and after menopause. 

In this post, I’ll explain the causes of weight gain during this transitional time, and share some tried and tested tips to help you control it.

What Causes Menopausal Weight Gain?

As we age, our metabolism slows down. Even in our late 20s and early 30s, many women begin noticing that the diet and exercise regime that once kept them slim no longer works like it used to. 

Yet during perimenopause, menopause, and post-menopause, maintaining a healthy weight can become more of a challenge than ever before. Suddenly, we’re piling on the pounds and no longer able to fit into our jeans.

Several factors contribute to weight gain during menopause.

Part of the problem is age related muscle mass, known as sarcopenia.

The process of sarcopenia begins as early as our 30s, but this muscle loss accelerates after menopause, around the age of 60 and above.

Hormones are another major contributing factor to weight gain in women during menopause. Estrogen has been shown to inhibit food intake. It works by blocking the body’s hunger signals. But during perimenopause and menopause, our estrogen levels start to plummet, and this appetite-suppressing effect disappears.

A lack of estrogen also alters the way we gain weight in menopause. Younger women tend to gain weight in their hips and thighs. However, once estrogen begins to decline, any new weight gain tends to settle around our middle.

Alongside muscle loss and hormonal changes, many women become increasingly sedentary as they age. They might stop playing sports or going to the gym and spend more time sitting still. This lack of activity, combined with slowing metabolism and shifting hormones, makes weight gain tricky to avoid.

What Are the Potential Risks of Weight Gain During Menopause?

Control Weight Gain During Menopause

Menopausal weight gain tends to settle around our midsection. But this type of visceral belly fat comes with some serious health consequences. Having a waist circumference of more than 35 inches raises the risk of developing heart disease.

Heart disease is particularly concerning for menopausal women. That’s because estrogen, which has heart-protecting properties, declines dramatically during menopause. This leaves us more vulnerable to developing cardiovascular complications.

But a high BMI doesn’t just spell bad news for your heart. As the number on the scale creeps up, so does the risk of developing type 2 diabetes. Belly fat causes insulin resistance, a condition that makes it harder for your body to respond to insulin. If left unchecked, insulin resistance can lead to prediabetes and diabetes.

Alongside the serious health complications above, being overweight or obese can make your menopausal journey more difficult. The more excess weight you carry, the more difficult the symptoms of menopause are likely to be.

Obese women tend to suffer more from hot flashes, night sweats, mood swings, and insomnia. But the good news is that losing weight during menopause reverses the pattern. Women who drop pounds also see a drop in the severity of their symptoms.

How to Control Weight Gain During Menopause

It becomes much easier to gain weight during menopause. But there are several ways to minimize the damage.

Follow these tips and enter perimenopause and postmenopause as the healthiest version of yourself.

Eat smart

Diet is the single biggest contributing factor to weight gain. If you’re eating too much of the wrong type of foods, you are fighting a losing battle, no matter how much you move.

As we age, our calorie requirement goes down. In fact, menopausal women need 45% fewer calories than women in their 20s.

As an emergency room doctor, I spend a lot of time rushing around on my feet. Yet despite my fairly active lifestyle, when I entered perimenopause, my calorie requirements reduced, and I noticed I was gaining weight. So, I had to adjust my food intake accordingly. For me, sticking to around 1800 calories per day was ideal. That being said, if you’re fairly sedentary, aim for around 1600 calories per day to maintain a healthy weight. If you’re trying to lose weight, it takes a 500-calorie-a-day deficit to lose 1 pound per week.

However, it’s important to remember it’s not all about calorie counting. Eating the right types of food, and avoiding the wrong ones, is the true key to success. That’s why these days, I focus more on what I eat, rather than the calorific content, and this seems to work well for me.

So, what does a healthy menopause diet look like?

  • Low sugar

Sugar is the driving force behind weight gain and obesity. It’s also the leading cause of many chronic conditions, such as heart disease and diabetes.

So, if you’re trying to lose weight or avoid gaining excess fat during menopause, reducing your sugar intake should be your number one priority.

But what do you do if, like me, you have a sweet tooth? Thankfully, there are still ways to enjoy delicious desserts and satisfy your cravings, without the added sugar. I’ve started baking with natural sweeteners such as erythritol and stevia. These are healthier alternatives to sugar, and still taste delicious in many different recipes.

  • Real food

Avoid pre-packaged and processed foods as much as possible. Instead, opt for real, nutrient-rich, wholesome, home-cooked foods.

  • Healthy fats

Research shows that eating a diet laden with trans and saturated fats accounts for almost a pound of additional weight each year.

But fat itself isn’t the enemy. Consuming the same amount of monounsaturated and polyunsaturated fats, aka ‘healthy fats, ’ isn’t associated with a rise in weight. In fact, these types of fats help control cholesterol and protect the health of your heart.

Foods rich in monounsaturated and polyunsaturated fats include olive oil, peanut butter, avocados, nuts, seeds, and oily fish.

  • The Mediterranean diet

There are countless diets out there, and many of them can be effective in helping you to lose unwanted weight. But one of the most popular and well-researched diets for weight loss and health is the Mediterranean diet.

This way of eating avoids processed foods. Instead, the focus is on a rich variety of phytonutrient-rich fruits and vegetables, seafood, chicken, eggs, and whole grains.

  • Plenty of protein

Lean muscle mass naturally decreases during menopause. But the more lean muscle you have, the faster your metabolism works. So, eating a diet rich in muscle-building protein can help you stay slim.

Research suggests that women should eat between 0.8 and 1.2 grams of protein per kg of body weight every day.

  • Less alcohol

Drinking more than one 4-ounce glass of wine per day can see your waistline expand. Alcoholic drinks are packed with empty calories and sugar, making them a fast track to weight gain.

  • Stay hydrated

Remember to drink plenty of water, around 11.5 cups (2.7 liters) per day. Replacing sugar-laden drinks with water can help to stave off hunger and reduce cravings. Some research even suggests that drinking water helps you to burn more calories.

I like to carry a reusable 1- gallon water bottle with me wherever I go. This means I always have water on hand, and it helps me track my intake and reach my daily hydration goals. 

Move more

Getting plenty of exercise is crucial during menopause. Not only does it help you lose weight by burning calories and building lean muscle, it also keeps your heart healthy and boosts your mood.

The Department of Health and Human Services recommends a minimum of 150 minutes of moderate exercise per week for women during menopause. This includes activities like brisk walking, swimming, and cycling. If you prefer more vigorous workouts, such as running or going to an aerobic exercise class, aim to fit in at least 75 minutes per week.

I find that the best way to stay motivated to exercise is to engage in activities I enjoy. This way, I’m much more likely to make it part of my daily routine. 

So, I’ve started playing tennis with a friend and hitting the local cycling trails on the weekends. Then, when I have time during the working week, I take a yoga class, or practice yoga at home.

Finding sports and activities that I enjoy has made it much easier to incorporate into my day to day life, and it keeps me coming back for more.

Get your family and friends on board

Make sure your family and friends know that you’re trying to make a positive change to lose weight and become healthier. Ask them to help you by encouraging you to stay active and eat well. And if you have a partner or friend who also wants to lose a few pounds, why not buddy up and embrace a new healthier lifestyle together?


Does everyone gain weight during menopause?

Not everyone, no. But it’s certainly a common phenomenon. Research shows that the average woman gains around 5 pounds weight during menopause.

At what stage of menopause does weight gain begin?

Women who gain weight during menopause typically start to notice the scale creeping up a few years before their periods stop during perimenopause. This is when hormonal fluctuations begin, and keeping a healthy weight becomes more of a challenge.

Can HRT help me lose weight during menopause?

Hormone replacement therapy (HRT) is sometimes prescribed to help alleviate the bothersome symptoms of menopause, including hot flashes and night sweats.
But it can also help with weight loss, too. One study showed that women who take HRT carried 3 less pounds of fat than those who didn’t. They also scored lower on the BMI scale.
However, HRT isn’t for everyone. It comes with an increased risk of side effects, including stroke, blood clots, and breast cancer. So, it should only be used as a last resort.


If you’ve gained weight during menopause, remember that you’re not alone. Many women, myself included, find that the number on the scale creeps up as they go through this transitional time.

Menopausal weight gain is common, but it doesn’t have to be inevitable or permanent. If you stick to a healthy and nutritious diet and keep your body moving, you can shave off the extra pounds and go through menopause as the happiest and healthiest version of yourself.



  • Dr. Karen Pike

    Dr. Pike is a senior physician administrator and board-certified emergency room doctor actively working in northern California. She received her undergraduate degree at Dartmouth College, where she graduated Phi Beta Kappa and played collegiate soccer. She attended Georgetown University for medical school and performed her residency in emergency medicine at Stanford University. She was part of the first-ever, women-majority emergency medicine program in United States. Dr. Pike is also the primary medical consultant for “Grey’s Anatomy,” a role she has held since the pilot episode when she partnered with Shonda Rhimes as the show’s original medical consultant. At her hospital, she was the second woman Chief of Staff. Today serves as the Director of the Emergency Department. Whether in leadership or direct patient care, her dedication to excellence in communication, quality, and collaboration is unwavering.