Weight Gain in Pre- and Perimenopause: What You Need to Know & How to Take Control

The Connection Between Menopause and Weight Gain

If you've ever been told that weight gain during menopause is unrelated to hormonal changes, it’s time to take a closer look at the science. A 2019 study titled Changes in Body Composition and Weight During the Menopause Transition (PubMed) followed over 1,200 women across the premenopause, perimenopause, and menopause stages. The findings revealed a clear link between menopause and changes in body composition.

Using advanced DEXA scanning technology, researchers measured fat mass, muscle mass, weight, and BMI over several years. Their findings were striking: fat mass dramatically increased in the years leading up to menopause, while muscle mass declined. These changes were not simply due to aging but were directly related to the menopausal transition.

Why Does Menopause Lead to Weight Gain?

Several biological and lifestyle factors contribute to weight gain during pre- and perimenopause, including:

1. Hormonal Shifts

Estrogen levels drop during menopause, which leads to increased fat storage, particularly in the abdominal area. This redistribution of fat can contribute to metabolic changes and increased risk of conditions like insulin resistance.

2. Slower Metabolism

With age, metabolism naturally slows down, but the hormonal changes during menopause accelerate this process, making it easier to gain weight and harder to lose it.

3. Loss of Muscle Mass

The study found that muscle mass decreases over the menopause transition, and since muscle burns more calories than fat, this loss leads to a lower resting metabolic rate.

4. Increased Appetite & Cravings

Hormonal changes can also influence hunger hormones, leading to increased cravings, emotional eating, and a preference for calorie-dense foods.

5. Poor Sleep & Stress

Many women experience disrupted sleep due to night sweats, hot flashes, and anxiety, all of which can impact cortisol levels and contribute to weight gain.

What Can Women Do to Manage Weight Gain During Menopause?

While menopause-related weight gain is common, it is not inevitable. Here’s what you can do to maintain a healthy weight and body composition during this transition:

1. Prioritize Strength Training

Since muscle mass declines during menopause, incorporating resistance training at least 2-3 times per week helps preserve muscle, boost metabolism, and prevent fat accumulation.

2. Focus on Protein-Rich Foods

Protein supports muscle retention and satiety. Aim for lean proteins like chicken, fish, eggs, tofu, legumes, and Greek yogurt in your diet.

3. Adopt a Balanced, Whole-Food Diet

Limit processed foods, refined carbs, and excess sugar, which can contribute to insulin resistance. Instead, opt for fiber-rich foods, healthy fats, and nutrient-dense vegetables.

4. Incorporate Cardiovascular Exercise

While strength training is crucial, adding aerobic exercises like brisk walking, swimming, or cycling can support heart health and calorie expenditure.

5. Manage Stress & Improve Sleep

Chronic stress and poor sleep disrupt hormones that regulate appetite and fat storage. Practice mindfulness, meditation, or deep breathing, and establish a bedtime routine to improve sleep quality.

6. Stay Hydrated & Limit Alcohol Intake

Drinking enough water supports metabolism, digestion, and overall health. Cutting back on alcohol can also help regulate hormones and reduce calorie intake.

7. Monitor Portion Sizes & Mindful Eating

Since metabolism slows down, it’s essential to be mindful of portion sizes. Eating slowly, reducing emotional eating, and listening to hunger cues can make a difference.

8. Consider Professional Guidance

A dietitian, personal trainer, or hormone specialist can help create a personalized plan to support your health goals during this transition.

The Bottom Line

Weight gain in pre- and perimenopause is backed by science, but it doesn’t have to be an unavoidable reality. By understanding the changes happening in your body and taking proactive steps, you can maintain a healthy weight, preserve muscle mass, and improve overall well-being.

For a deeper dive into the research, you can explore the full study here.