Effective Strategies for Managing Menopause Weight Gain

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Reviewed by Helen Kollias, PhD and Brian St. Pierre, MS, RD

At some point in my mid-40s, the scale started climbing.

A pound or two turned into five, then 10, then 20.

It seemed as if I was doing all the right things: Eating less, moving more, rinse, repeat. Yet, the harder I worked, the less the scale seemed to respond.

Had perimenopause destroyed my metabolism?

It sure felt like it.

However, after asking my doctor to run a series of tests, I learned that my metabolism was, in fact, fine. Instead, like the vast majority of midlife women, the true causes of my weight gain stemmed from several subtle issues that I would have sworn, at the time, didn’t apply to me.

If, like me, you or your client are currently stuck in what feels like an eat less, gain more cycle, this article is here to help.

In this story, you’ll discover:

First, what is menopause?

Many women refer to midlife hot flashes and inconsistent menstruation as “being in menopause” or “menopausal.”

However, menopause isn’t a phase as much as a transitional moment that separates menstruation from non-menstruation.

Once you’ve gone 12 consecutive months without a period, you’ve reached menopause. For most people, that moment arrives somewhere between ages 46 and 56.

The hot-and-dewy months and years leading up to that 12th missed period are technically known as “perimenopause.”

Perimenopause means “around menopause.”

Some people refer to this time as the menopause transition. This is when estrogen levels fluctuate. Menstrual cycles lengthen and shorten and, at times, disappear, only to return a few months later. For many people, this marks the beginning of symptoms like hot flashes, sleep issues, vaginal dryness, mood changes, and, yes, creeping weight gain.

(For a thorough overview of the many changes that can happen during this time, read: ‘What’s happening to my body!?’ 6 lifestyle strategies to try after menopause)

How much weight do women gain during menopause?

Many women think of menopause and weight gain the same way many young parents think of two-year-olds and tantrums: Inevitable.

However, not all women gain weight during the menopause transition, explains Helen Kollias, PhD, who is an expert on physiology and molecular biology, and a science advisor at Precision Nutrition and Girls Gone Strong.

On average, in the West, women gain four to six pounds during the three-and-a-half years of perimenopause, or about one to two pounds a year. That’s double the rate of weight gain in pre-menopausal women, though it’s roughly the same amount men gain at midlife, notes Dr. Kollias.

In other words, the menopause transition may not be solely to blame for those extra pounds on the scale. Aging may play a significant role, as we explore below.

The real reasons the scale climbs

Several factors conspire to add pounds to your frame during the menopause transition.

✅ You’re not sleeping as well.

Maybe this sounds familiar: You wake repeatedly with sweat pooling under your breasts and sheets that are uncomfortably damp (or soaked).

Even if you don’t have night sweats, plenty of other issues might keep you awake.

First, there’s worry—over aging parents, teenagers with car keys, money needed to replace that leaking roof, some strange bodily sensation you’re worried might be cancer, the colonoscopy or mammogram you don’t want to schedule but also don’t not want to schedule, the sex you’re not having, and so many others.

Plus, if you’re like me and you have osteoarthritis in multiple joints, your body hurts. Or your skin might itch. Or your legs are restless. Or you’re bloated.

My point: Problems that make sleep uncomfortable can multiply with age.

Because of this, I’ll sometimes wake four or more times a night, as the red sections of this readout from my smartwatch show.

These bad nights often set up a vicious cycle:

The following day, I feel as if I’m two inhales away from death. So, I keep myself going with caffeine, which makes the next night just as bad or worse.

Lack of sleep indirectly adds pounds to your frame in several ways:

When you’re sleep-deprived, it’s harder to cope with negative emotions, which may mean you turn to food for solace.
In addition, your decision-making gets compromised, so it’s harder to choose an apple when a chocolate chip cookie is also available.
Plus, sleep deprivation intensify both appetite and cravings (which we’ll discuss more in the next section)

(Want to get a handle on some of the sleep challenges unique to this transition? Check out: How menopause affects sleep, and what you can do about it)

✅ You’re hungry, and not for celery.

True story: When I was in my early 30s, someone once told me about her intense cravings, and I thought, “Cravings? What are those exactly?”

(Don’t hate me.)

Those days now feel foreign to me. Post-menopause, I spend most of my morning wondering how soon I can eat lunch, what I might have for lunch, whether it’s okay to have a snack now, and, if so, what it should be.

After lunch, I go on to spend the afternoon thinking about dinner.

It’s as if my appetite never flips off.

For the longest time, I thought something was wrong with my brain or metabolism.

It didn’t occur to me that the increased hunger, appetite, and cravings likely stemmed from my repeated awakenings each night.

Until I checked out the research.

In one study, people who were sleep-deprived reported higher levels of hunger and a stronger desire to eat. When provided access to snacks, they consumed twice as much fat compared to days when they weren’t sleep-deprived.

In another study, when healthy, young study participants slept four hours a night, they consumed 350 more calories the following day.

The annoying cycle of weight and food preoccupation

Hormonal transitions (puberty, pregnancy, menopause) often cause changes to women’s body shape and size.

Sometimes that’s welcome (“Ooh, a butt!”) and sometimes it’s not (“Darn, a butt!”).

Some women—like me—don’t worry too much about their weight or body shape. Then, we gain unexpected (and unwanted) pounds, and with that, a new (also unwanted) preoccupation with the scale.

Many women also find that as they try to get a handle on the scale, their preoccupation with food may (frustratingly and paradoxically!) shoot upwards—especially if they turn to restrictive diets or food rules for a solution.

Interestingly, this preoccupation with food can occur whether or not someone is actually reducing their calorie intake. In other words, this phenomenon can happen when someone just thinks about reducing their food intake.

The phenomenon has a name: It’s called cognitive dietary restraint (CDR), and it can create a frustrating cycle of body image dissatisfaction, food preoccupation, and stress.

In one study, people who used a low-carb, intermittent fasting protocol to lose weight reported more frequent episodes of binge eating and more intense food cravings.

In another study, postmenopausal women who scored high in CDR excreted more of the stress hormone cortisol than women who scored lower in this measure. Higher levels of CDR in pre- and postmenopausal women were even associated with shorter telomeres, a sign of accelerated aging.

All this to say, leaning too hard into self-criticism and extreme dieting can backfire. Which is why the strategies we suggest later in this article focus more on adding more nutritious, appetite-regulating foods, and prioritizing things like mindfulness and movement.

With these approaches, you’ll be less likely to feel deprived, and more likely to feel satisfied—and hopefully, empowered.

✅ You’re moving less.

As humans age, we develop chronic low-grade inflammation and weakened immune function. When combined with the crummy sleep we mentioned earlier, along with other biological changes, this can interfere with the body’s ability to recover from intense exercise.

The result: If you do too many vigorous workouts too close together, you’ll start to feel run down, sore, and unmotivated.

Other issues that crop up around midlife can also interfere with movement, like chronic injuries or joint pain.

(A personal example: Due to osteoarthritis in my feet and spine, I switched from running to walking. This is easier on my body, but isn’t as efficient at burning calories.)

Finally, due to those pesky time-sucks known as full-time jobs and caregiving responsibilities, you might not be as active in your 40s and 50s as you were during your 20s. Plus, over the past few decades, multiple inventions (hello, binge-watching) have conspired to keep people on the couch and off our feet.

So, can you blame your hormones for anything?

Other than messing with your sleep which, in turn, messes with your appetite and energy levels, fluctuating estrogen and progesterone likely aren’t behind your extra pounds—at least, not directly.

If they were, menopause hormone therapy would help people stop or reverse weight gain. (It doesn’t.)

However, shifting hormonal levels are responsible for where those extra pounds appear on your body. As estrogen levels drop, body fat tends to migrate away from the thighs and hips and toward the abdomen, even if you don’t gain weight

Old tactics may stop working after menopause

The “Rocky” weight loss method was my go-to when I was younger.

Whenever I wanted to drop a few pounds, I imagined I was a character in one of those “couch potato gets super fit” movies.

In addition to walking and running, I embraced the sweat-til-you-vomit workout du jour. (Remember Tae Bo?) I also cut out foods, food groups, or entire macronutrients. A couple of times a week, I skipped lunch or dinner.

It worked.

Until, of course, it didn’t.

Now, whenever I push too hard in the gym, I either get injured or feel so unbelievably tired that I must take four days off from all forms of movement. If I try to do anything extreme with my diet, I eventually eat every crunchy or sweet thing I can find, including stale crackers.

For these reasons, after midlife and beyond, the countermeasures for weight gain aren’t strict diets (looking at you, intermittent fasting) or barfy workouts.

Instead, to limit weight gain after menopause, you need to get wise about finding ways to tip calorie balance in your favor without triggering overpowering hunger, cravings, and fatigue.

Regardless of age or stage, fundamental nutrition and fitness strategies still apply—and work.

What changes after menopause is how you tackle these fundamentals.

Experiment your way to better results

The best menopause plan will look different for each person.

That’s why experiments are so important.

Precision Nutrition coaches often use experiments to help clients discover essential clues about what they need (and don’t need) to reach their goals. Based on the results you get from each experiment, you can make tiny tweaks, test them, and decide whether they work for you—until you find something that does work for you.

How to run an experiment

Health experiments are no different from the scientific method you learned about in middle school.

Choose a question to answer, such as, “Would I feel less munchy at night if I ate a protein-rich snack every afternoon?”
Run an experiment to test your question. In the above example, you’d track your hunger and cravings before adding the snack—to get a baseline—and then continue to track them for a couple weeks after adding the snack.
Assess what you learned. Did your ratings of hunger and cravings drop? Remain the same? Go up? What about your actual nighttime food consumption? This information can help you determine your next steps.

Below are 11 experiments worth trying during and after menopause. We’ve separated them into three categories: sleep, hunger, and energy.

(And if those 11 options aren’t enough, we’ve got more ideas here: Three diet experiments that can change your eating habits)

Experiments for improved sleep

Below, you’ll find a mere smidge of the many sleep tweaks you can try and test. For more ideas on potential sleep experiments, check out our 14-day-sleep plan and story about cognitive behavior therapy for insomnia.

Experiment #1: Reset your body’s circadian clock

As you age, your body starts to behave like an old clock that continually runs slow.

Even if you used to be a morning person, you might wake groggy, as if your body doesn’t know it’s morning. Or, your body might tell you “time for bed” at weird times, like the middle of the afternoon. Then, after spending several hours fighting the urge to nod off during work meetings, you find that, when it actually is bedtime, you’re staring at the ceiling in the dark.

This is why it’s helpful to experiment with zeitgebers, which are environmental and behavioral time cues that help to set your body’s internal circadian clock.

These experiments might include the following:

Get up at the same time every day, regardless of how you slept the night before.
Spend 10-20 minutes in the sunlight as soon as possible after you wake.
Take a cold shower at the same time each morning or a hot shower or bath at the same time each evening.
Get outside frequently during the day, especially whenever you feel sleepy.
Exercise at the same time daily. Try first thing in the morning or 4 to 6 hours before bed. Bonus points if you do it outdoors.
Eat meals, especially breakfast, at the same time every day.