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- Weight gain is a common experience during menopause.
- Research indicates that midlife weight gain may actually begin earlier than previously thought.
- Experts suggest some diet and lifestyle tips to help prevent age-related weight gain.
Menopause describes a life transition when menstrual periods have stopped for 12 consecutive months, and pregnancy is no longer possible. It is a natural part of the aging process.
The average age of menopause onset in the United States is 52, but this can vary widely.
The time leading up to menopause is called perimenopause or the menopause transition, which typically occurs during your mid- to late-40s.
Along with symptoms like hot flashes, night sweats, joint and muscle discomfort, and mood changes, menopause-related shifts may change how the body uses energy. The distribution of fat throughout the body can also shift, potentially leading to weight gain.
Many people experience weight gain during menopause; however, new research suggests that weight gain could begin earlier than previously thought.
A review of studies suggests that the menopause-related metabolic shift, which contributes to weight gain, may begin during perimenopause, or sooner. The findings were recently published in the Journal of Mid-Life Health.
“Weight changes are not only characteristic of midlife or menopause. Data have shown that weight gain starts early in adulthood,” Daniela Hurtado Andrade, MD, PhD, an endocrinologist and obesity expert at Mayo Clinic in Jacksonville, FL, explained in a news release. Andrade wasn’t involved in the study.
“Around age 30, your muscle mass starts decreasing gradually as part of the natural aging process, and this is exacerbated in midlife due to menopause,” Andrade continued.
Here’s what you need to know about age-related weight gain before menopause, and what you can do to help prevent it.
Hormonal, physiological shifts before menopause
On average, individuals experience perimenopause for four years before their period stops completely, but this phase can last anywhere from two to eight years.
During perimenopause, estrogen and progesterone begin to fluctuate unpredictably. These hormone shifts can affect nearly every metabolic system in the body. The metabolic system is the network of chemical reactions that convert food into energy.
The new review notes that estrogen plays a role in controlling fat distribution, muscle repair, and insulin sensitivity.
When these levels fluctuate significantly, the body changes how it stores fat, redistributing it from the hips and thighs to the abdomen.
“It is well known that metabolism starts to slow down as we age. The frustrating effects on the body include weight gain, along with a loss of muscle and energy,” said Sherry Ross, MD, board certified OB-GYN and Women’s Health Expert at Providence Saint John’s Health Center in Santa Monica, CA, who wasn’t involved in the research.
“These untimely and normal aging effects accelerate as estrogen levels fluctuate in perimenopause,” Ross told Healthline. “Estrogen has a significant influence on metabolism, affecting the body’s ability to properly regulate insulin production, glucose metabolism, and fat distribution.”
Muscle protein synthesis can also slow down during perimenopause. This is the body’s natural metabolic process that builds and repairs muscle tissue by incorporating amino acids into muscle proteins.
This can result in increased insulin resistance and gradual muscle loss even if you haven’t changed your eating or exercise habits. These hormone changes can also:
All of these can influence changes in your weight.
However, these changes may not only reflect weight gain.
Even if your weight remains the same, it is not uncommon to lose muscle and gain belly fat, which may increase visceral fat. This deeper fat surrounds your vital organs and has been linked to inflammation. It can increase your risk of
Fat increases during menopause transition
The Study of Women’s Health Across the Nation (SWAN) has been tracking females of various backgrounds across several areas of the United States since 1994.
The researchers have been investigating the physiological changes that occur in the female body during midlife years.
One of the key findings of the study was that during perimenopause, long before the period stops, lean muscle mass declines and fat mass begins to increase.
Once this accelerated redistribution of fat plateaus during menopause, it is much more difficult to reverse.
This is why it may be important for people to view perimenopause as a window of opportunity. The new review notes that, during this time, the body is still much more adaptable. With the right strategies at this time, females can help offset the hormonal effects and help set themselves up for a healthier transition through menopause and beyond.
“You are never too young to discuss making healthy lifestyle choices to help control unwanted weight gain. Dietary changes are important to reduce the chance of disruptive … weight gain,” Ross said.
“Adjusting dietary behaviors should begin in their 30s to control weight gain and medical complications, including high blood pressure, heart disease, and cancer associated with obesity and aging,” she continued.
Ross suggested adopting a well-balanced, plant-based diet that limits consumption of red meat and excessive dairy products. She cited the Mediterranean diet as an example.
“Limiting ultra-processed packaged foods, fatty meats, sugary foods, refined oils and fried foods, carbonated beverages with sugar, and alcohol consumption during the sensitive hormonal transition of menopause should be a priority for weight control and long-term wellness,” Ross said.
Talk with your doctor about age-related weight gain
The standard concept of “eat less and move more” may not be sufficient for all females in their 40s. This advice generally ignores hormonal contexts and oversimplifies biology.
You may wish to speak with your doctor for advice on how to mitigate the weight gain that may come as you near perimenopause and menopause.
“The cultural stigma to aging that is attached to perimenopause is a hard topic to accept or share with a healthcare provider. But the time is now to have these courageous conversations with your provider,” Ross said.
“Empowering yourself to talk openly about your health concerns must be your top priority. There are practical lifestyle choices and treatment options that will help ease this normal hormonal transition and avoid perimenopausal weight gain,” she added.
You may wish to discuss hormone therapy as well. It is a common potential treatment for perimenopause and menopause symptoms. However, not everyone may be considered a potential candidate.
On the other side, Ross also noted that conversations about female midlife weight gain should be individualized. She added that there are several considerations that healthcare professionals should discuss with each person:
- medical history
- dietary habits
- physical activity
- sleep issues
- stress management
- genetic history
- other disruptive symptoms of perimenopause or menopause
Ross suggested working with a psychologist and a dietitian may also help with age-related weight gain.
Sarah Gray, MD, general practitioner and women’s health specialist at St. Erme Medical, agreed, noting that “a good dietitian may be better” than just discussing these issues with your healthcare professional. Gray wasn’t involved in the review.
Preventing weight gain during perimenopause
Ross told Healthline that a healthy lifestyle can go a long way when a person enters perimenopause and menopause.
She noted that certain harmful lifestyle habits can contribute to making the symptoms of perimenopause and menopause worse and weight gain more challenging, including:
- excessive alcohol consumption
- getting poor quality of sleep
- smoking
- eating an unhealthy diet
- having obesity
- living a sedentary lifestyle
“Combining a well-balanced plant-based diet, limiting red meat and high fat dairy intake, and consuming ‘good’ fats- monounsaturated and polyunsaturated fats reduces weight gain and other medical complications,” Ross said.
“Simple lifestyle adjustments will not only make hormonal symptoms less disruptive but will also have a positive impact on weight control,” she added.
These lifestyle modifications include:
- eating a balanced diet
- getting regular exercise
- limiting alcohol consumption
- getting at least 7 hours of sleep
- managing stress
