Why Does Menopause Make Losing Weight Harder?

Key TakeawaysMenopause often leads to weight gain and a shift in body fat distribution due to hormonal changes and a slower metabolism.Lower estrogen levels during menopause can increase hunger and reduce lean muscle mass, making weight management more challenging.Hormone replacement therapy and weight management strategies like strength training, quality sleep, and adjusting calorie intake can help mitigate menopausal weight gain.

Key Takeaways

Menopause often leads to weight gain and a shift in body fat distribution due to hormonal changes and a slower metabolism.Lower estrogen levels during menopause can increase hunger and reduce lean muscle mass, making weight management more challenging.Hormone replacement therapy and weight management strategies like strength training, quality sleep, and adjusting calorie intake can help mitigate menopausal weight gain.

This article is part of Verywell Health’s 2024 survey on obesity care. Read the full analysis of the key findingshere.

Many people entering menopause experience a similar struggle: They can’t seem to lose weight even if they keep hitting the gym.

“Post-menopausal women gain an average of 1.5 pounds per year and may experience a shift in body shape, with more fat accumulating around the midsection,” saidKathleen Jordan, MD, chief medical officer at Midi Health, a virtual care clinic focusing on perimenopause and menopause.

“Some of the weight and body composition changes occurring at midlife can be chalked up to aging and a naturally slowing metabolism," Jordan added. “But declining estrogen levels due to menopause, as well as menopause symptoms that interfere with sleep and mental health, also play a role.”

I’m doing the same stuff at the gym, but it’s not helping after menopause.

Before menopause, higher estrogen levels can support better muscle mass, bodily strength, fat and glucose metabolism, according to Jordan. Fat tends to store around the breasts, buttocks, and thighs. However, during menopause, declining estrogen levels result in more fat accumulation around the belly and decreased lean muscle mass.

Jordan said that in addition to these bodily changes, declining estrogen levels can increase hunger, as estrogen normally helps control appetite. Lower estrogen can further contribute to some common menopausal symptoms, including hot flashes, poor sleep quality, and diminished mental health.

“It might make you feel like you want to eat less healthy food [and] don’t want to exercise,” saidPichamol (Sigh) Jirapinyo, MD, MPH, director of bariatric endoscopy fellowship and associate director of bariatric endoscopy at Brigham and Women’s Hospital in Boston, and assistant professor of medicine at Harvard Medical School.

Jirapinyo added that changes in both personal and professional life during menopause sometimes lead to less physical activity. For instance, a mother of young children may move a lot because of parenting demands. As her children grow older and require less attention, her daily activity level may naturally decrease.

What Is the Average Age for Menopause to Start?

These physiological changes and shifts in life circumstances can make weight management during menopause more challenging. However, there are ways to minimize weight gain or even lose weight if necessary.

Hormone replacement therapyis a viable treatment option for many people who are peri- or postmenopausal. A 2018 study published in theJournal of Clinical Endocrinology and Metabolismconcluded that menopause hormone therapy is associated with a reduction or redistribution of belly fat, also known as visceral fat.This visceral fat collects between abdominal organs such as the spleen, stomach, and liver, and can predispose you to insulin resistance and type 2 diabetes.

For individuals with obesity, additional options may exist depending on their overall health. These include medications like Wegovy and Zepbound, two of theeight drugs approved for weight loss.

Another option is endoscopic sleeve gastroplasty, a minimally invasive procedure that uses a flexible tube inserted through the mouth to surgically reduce stomach size. Jirapinyo said roughly 90% of her patients who receive bariatric endoscopy are women, and they’re typically around the age of menopause.

Jirapinyo emphasizes that maintaining a healthy weight can reduce the risk of developing high blood pressure, heart disease, type 2 diabetes, and breathing problems such as sleep apnea. Some of the weight management strategies include:

What’s the Best Way to Treat Menopause?

What This Means For YouHormonal changes and a slower metabolism contribute weight gain during menopause. Discuss potential treatments like hormone replacement therapy with your healthcare provider, and consider incorporating strength training, improving sleep quality, and adjusting your diet to better manage your weight.

What This Means For You

Hormonal changes and a slower metabolism contribute weight gain during menopause. Discuss potential treatments like hormone replacement therapy with your healthcare provider, and consider incorporating strength training, improving sleep quality, and adjusting your diet to better manage your weight.

2 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Papadakis GE, Hans D, Gonzalez Rodriguez E, et al.Menopause hormone therapy is associated with reduced total and visceral adiposity: the OsteoLaus cohort.J Clin Endocrinol Metab. 2018;103(5):1948-1957. doi:10.1210/jc.2017-02449Chopra S, Sharma KA, Ranjan P, Malhotra A, Vikram NK, Kumari A.Weight management module for perimenopausal women: a practical guide for gynecologists.J Midlife Health. 2019 Oct-Dec;10(4):165-172. doi:10.4103/jmh.JMH_155_19

2 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Papadakis GE, Hans D, Gonzalez Rodriguez E, et al.Menopause hormone therapy is associated with reduced total and visceral adiposity: the OsteoLaus cohort.J Clin Endocrinol Metab. 2018;103(5):1948-1957. doi:10.1210/jc.2017-02449Chopra S, Sharma KA, Ranjan P, Malhotra A, Vikram NK, Kumari A.Weight management module for perimenopausal women: a practical guide for gynecologists.J Midlife Health. 2019 Oct-Dec;10(4):165-172. doi:10.4103/jmh.JMH_155_19

Papadakis GE, Hans D, Gonzalez Rodriguez E, et al.Menopause hormone therapy is associated with reduced total and visceral adiposity: the OsteoLaus cohort.J Clin Endocrinol Metab. 2018;103(5):1948-1957. doi:10.1210/jc.2017-02449Chopra S, Sharma KA, Ranjan P, Malhotra A, Vikram NK, Kumari A.Weight management module for perimenopausal women: a practical guide for gynecologists.J Midlife Health. 2019 Oct-Dec;10(4):165-172. doi:10.4103/jmh.JMH_155_19

Chopra S, Sharma KA, Ranjan P, Malhotra A, Vikram NK, Kumari A.Weight management module for perimenopausal women: a practical guide for gynecologists.J Midlife Health. 2019 Oct-Dec;10(4):165-172. doi:10.4103/jmh.JMH_155_19

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Key Takeaways#

What This Means For You#

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What This Means For You