How to Lose Weight During Menopause

Menopause comes with dozens of symptoms, from the common—hot flashes, sleep troubles, mood changes, vaginal dryness—to the surprising (hello, hair loss). But the one that may upset and frustrate women the most is menopausal weight gain. 

Weight gain during menopause and perimenopause is completely normal. In fact, 87% of Midi patients complain of weight gain and body changes. “You are not alone if you’re having issues with weight at midlife,” says Kathleen Jordan, MD, Chief Medical Officer at Midi Health. “Hormonal changes contribute to a lot of what you’re going through. But relief is possible. You don’t need to sit at home and suffer through.” 

She’s absolutely right: Just because menopausal weight gain is common doesn’t mean it’s something you have to live with. You may simply need to take a different approach to weight loss than you’ve tried before, and working with a healthcare provider can help. Midi clinicians are trained menopause specialists who can help you understand the “why” behind your menopausal body changes, and they can offer a range of solutions for midlife weight gain, including prescription medications and lifestyle coaching. 

Read on to learn more about why weight gain can happen during menopause and how you can reverse it.

Understanding Menopause and Weight Gain 

If you’ve gained weight at other points in your life, it was probably easy to pinpoint why. Excess calories, stress, or inactivity are common culprits and ones you probably know how to address. But weight gain during menopause works a little differently. Your body is adjusting to a new hormonal normal, and weight gain is one external sign of that. Here’s why your weight can shift dramatically during menopause.  

The Science Behind Menopause-Related Weight Gain

During perimenopause and menopause, your estrogen levels drop significantly as your reproductive system gradually shuts down, with periods becoming irregular and eventually stopping. Estrogen, however, plays a vital role in more than just your menstrual cycles; it can also affect your heat regulation, bone density, and, most importantly for weight, your metabolism. 

As estrogen declines, it affects weight in two ways: Not only does estrogen depletion contribute to a loss of lean muscle and an increase in fat (with more of it around the belly), it also leaves you hungrier, so you may struggle to rein in your appetite and maintain your weight. A recent study of 667 postmenopausal women also found that higher levels of FSH (which goes up during menopause in response to lower estrogen) were associated with increases in body fat.

To be clear, estrogen isn’t the only reason your weight may start to creep up at this time. Some weight gain can be a natural part of aging. As you get older, you’re more likely to experience anabolic resistance, which just means it’s harder for you to build muscle. Women lose 1-2 percent of their muscle mass per year starting at around 35, and that rate speeds up over time. 

Unfortunately, that muscle loss usually gets replaced with fat. And because it takes more calories to build and maintain muscle than it does to fuel fat, losing muscle is one reason women’s metabolism tends to slow down five to ten percent every ten years. Couple that with what’s going on hormonally, and you can see why maintaining a healthy weight can seem like an uphill battle for women at midlife. 

Common Misconceptions About Menopause and Weight

Despite how common midlife weight gain is for women, there are persistent myths about its connection to menopause. Considering that only 20% of OB/GYNs receive formal menopause training, it’s no wonder there’s a knowledge gap. Here are some of the most stubborn misconceptions about menopausal weight gain, paired with truths based in science and clinical practice. 

• Myth: Weight gain during menopause is inevitable. 
  The truth: Not all women gain weight during menopause, and those who do gain it in different ways. While hormonal changes can influence weight, you can take a proactive approach to lifestyle and care can help mitigate impact.
• Myth: Menopause alone causes weight gain.
  The truth: While hormonal changes play a role, lifestyle factors including diet and physical activity also contribute to how much you gain and where pounds accumulate.
• Myth: Menopausal weight gain is permanent.
  The truth: With a well-informed approach to nutrition and exercise overseen by a healthcare professional, you can effectively manage and reduce weight gained during perimenopause and menopause.
• Myth: Hormones are the only way to reverse weight gain.
  The truth: Hormone replacement therapy (HRT) is just one potential approach to reaching a healthy weight in midlife. Sustained weight loss and good health may require a more holistic approach. Lifestyle modifications, such as maintaining a balanced diet and staying physically active, are crucial strategies for weight management, and weight loss medications may be appropriate as well.

Of course, everyone’s menopause journey is unique. To get personalized recommendations based on your symptoms and health history, you can book a virtual visit with a menopause specialist through a platform like Midi.

Menopausal Weight Gain: The Midi Mindset

At Midi, we understand that weight is a common challenge for women going through the menopause transition. “Many of the hormone changes you experience as part of menopause are actually significant contributors to weight struggles,” says Dr. Jordan.
That’s why working with a healthcare provider to understand your hormone needs is important. Hormone replacement therapy, if it’s the right course of treatment for you, has the potential to set you up for success by improving symptoms that make it easier to gain weight and harder to lose it. Remember: Any approach to sustained weight loss should be multifaceted, encompassing various elements that contribute to your overall well-being. So while diet and exercise are important, so is addressing hormones, reducing stress, and prioritizing sleep.

“I want my patients in a great mood and sleeping better, so they're teed up to engage in an exercise and nutrition plan that’s going to be very successful for weight management,” says Dr. Jordan. In other words, once your hormones are no longer working against you, you may have more energy to focus on other lifestyle changes that can help reverse weight gain.

Dietary Changes for Weight Loss During Menopause

To effectively manage your weight during menopause, you’ll need a diet that serves your body’s new normal. By making informed dietary decisions, you can look and feel your best. Before starting any new diet, always check with your doctor. 

Nutritional Needs for Menopausal Women

Focusing on nutrition becomes crucial during menopause to align with your body's changing energy needs, especially on a weight loss journey. “If you’re losing weight, you’re losing muscle mass,” says Dr. Jordan. “As you eat less, what you eat matters even more because you still need to feed your entire body—from your bones to your skin—with healthy nutrients.”

Focus on nutrient-dense foods that offer the most bang for their buck, and avoid empty calories from processed snacks and added sugars. If you haven’t already, learn about macronutrients and their role in nutrition, because while most of us turn to calorie counting as the go-to method for tracking intake, focusing on your macros is often more effective. Carbohydrates from whole grains, proteins from lean sources, and healthy fats from foods like avocados and nuts can help you sustain your energy levels and maintain muscle mass. 

A diet rich in vitamin D and calcium is also important during this time to help preserve bone health. Osteoporosis is common among postmenopausal women and can lead to fractures and breaks, if not addressed.

Foods to Include and Avoid

A plant-centric diet rich in fruits, vegetables, and whole grains provides vital nutrients and fiber. These foods help support digestive health, regulate blood sugar levels, and contribute to a feeling of fullness, making them valuable tools for maintaining a healthy weight. Lean proteins, such as poultry, fish, tofu, and legumes, are excellent choices to  preserve muscle mass and stabilize your iron levels. 

Processed foods and added sugars, on the other hand, can contribute to weight gain. That doesn’t have to mean constantly depriving yourself (sometimes a scoop of ice cream can be exactly what you need after a hot flash). Just be conscious about the meals you choose and stock up on healthier snacks, like carrot sticks, hummus, guacamole, and whole fruit, so you’ve always got a feel-good option to grab when you’re hungry. 

The Role of Portion Control and Mindful Eating

Another vital facet of nutrition during menopause is being more mindful of when and how much you eat. Many of us eat out of boredom or to self-comfort—and while this can feel good in the moment, it can also compound hormonal weight gain. Planning your portions and eating mindfully can nurture a more well-rounded relationship with food and your body. 

Mindful eating involves being fully present during meals, savoring each bite, and paying attention to hunger and fullness cues. This practice also helps you to eat slower, enjoy your food more, and prevent overeating by giving your body more time to signal to you that you’re full. 

If you’re prone to emotional eating, learning to differentiate between actual hunger cues and emotional triggers will be important. Your body may react to stressful situations with a phantom appetite, even if you don’t need any nutrients at that time. Talk to your doctor, a nutritionist, or a Midi clinician about recognizing and overcoming these triggers and what to do when the emotional urge to eat strikes. 

Exercise and Physical Activity

Staying active is important when you’re going through menopause. And it’s about more than just weight loss. By staying active and exercising regularly, you’re investing in your future mobility. Even if you haven’t been much of a gym-goer before now, this is the perfect time to explore new fitness routines. 

Best Exercises for Menopausal Women

Aerobic exercise and strength training are important throughout life and especially during menopause, thanks to their cardiovascular benefits. From brisk walking to running to cycling, any activity that gets your heart rate up counts. And regularly engaging in exercises with weights or resistance bands helps keep your muscles strong and limber. Building and maintaining muscle supports metabolism and contributes to your overall strength and energy.

Incorporate some flexibility exercises into your routine, too. Stretching helps stabilize your joints and prevent aches and pains as you age. Yoga and Pilates, for instance, not only improve flexibility, but they also enhance balance, stability, and overall joint health. 

Overcoming Exercise Barriers in Menopause

Creating a regular exercise routine during menopause is easier said than done—especially if you experience joint pain, feel chronically tired, or have other barriers to traditional exercise. Your doctor may recommend physical therapy before starting a new fitness routine, especially if you have prior injuries or conditions that could make working out unsafe. 

Joint pain is common during menopause, but you can mitigate some discomfort by easing into high-impact exercises, such as weight lifting, running, or HIIT, once your body is strong enough. If you’re experiencing aches and soreness, make sure you’re stretching consistently and safely. Even if you just do some yoga on your living room floor, stretching and expanding the muscles around your joints helps alleviate soreness and improves mobility. 

Hormone replacement therapy (HRT)  may also bring relief from joint pain. That’s because estrogen plays a key role in overall joint health, so when levels drop during midlife, you might notice that once-supple spots feel tight and sore. If you’re a good candidate for HRT, it can often improve that stiffness and discomfort, making it easier to exercise.

And let’s face it: Another common hurdle to building a menopausal fitness routine is not physical, but mental. It’s not always easy to feel motivated to exercise. Don’t beat yourself up. Instead, focus on creating a routine you actually look forward to. Maybe that means inviting a friend to meet you for a workout class or scheduling a weekend walk with a neighbor. Buddy up and you’ll start looking forward to fitness dates (and stop canceling on yourself).

Lifestyle Modifications for Weight Loss During Menopause

Just like everything in life, there’s no single easy solution to menopausal weight gain. Effectively managing your weight through menopause and beyond requires a comprehensive and holistic approach. Exercise and diet are two important components, but they aren’t the only ones.

Quality sleep is integral to overall health, and its impact on weight during menopause is significant. Since menopause symptoms can often lead to poor or interrupted sleep, you may notice that you wake up feeling less rested. What’s more, disrupted sleep patterns can influence hormones, potentially leading to increased cravings and weight gain. 

Prioritizing good sleep hygiene, which includes maintaining a consistent sleep schedule and creating a peaceful sleep environment, can help ensure quality sleep and, as a result, better weight management. If your menopause symptoms are causing regular insomnia, ask your doctor or a Midi clinician for guidance. 

Medical and Professional Support

Many women simply accept their menopause symptoms, including weight gain, as one more non-negotiable part of aging. In fact, according to some studies, less than 30% of women seek help for their symptoms at all. At Midi, we encourage the opposite: consulting actively with healthcare providers while going through menopause..

When to Seek Medical Advice

It’s important to recognize if weight gain becomes a health concern during menopause. Putting on pounds can lead to other health issues and shouldn’t be ignored. Talk to your doctor if you gain significant weight, especially if it happens within just a few months. 

Even if your weight gain is more gradual and not an immediate medical concern, it’s still a good idea to loop your doctor in. Tracking and identifying your symptoms throughout menopause empowers your provider to give you the most personalized and practical recommendations and treatments. They may refer you to a nutritionist or physical therapist or recommend a fitness regimen tailored to your needs. 

Midlife is a time to thrive, not struggle, and by working with a menopause specialist, you can make sure symptoms don’t hold you back.

Medications That Can Help With Menopausal Weight Gain

Sometimes diet and lifestyle modifications simply aren’t enough to counteract menopausal weight gain. Your doctor may use other treatments and methods to address your weight and wellness, including prescription medications. In conjunction with lifestyle changes, these methods may transform your menopause experience. 

Hormone Replacement Therapy (HRT)

If weight gain is just one of many symptoms that you’ve experienced, your doctor may suggest hormone replacement therapy, or HRT. The name is a bit misleading—you’re not replacing any hormones in your body as much as you’re supplementing them. Your doctor will prescribe supplemental estrogen and, for all women with a uterus, progesterone, to help ease the symptoms caused by hormonal fluctuations. HRT takes many forms, including a patch, pill, cream or gel, and should be personalized to your health history and symptoms. 

HRT is not a weight loss method in and of itself. Going on HRT will not lead to immediate weight loss. What HRT does is help you achieve better hormonal balance and ease your symptoms, which may make exercising and eating well easier to commit to.

Natural Supplements and Alternatives

Menopausal weight gain requires a holistic approach—and that includes healing methods often thought of as “alternative.” At Midi, we champion a multifaceted approach to wellness that considers supplements and botanicals, as well as wellness therapies.

Several supplements have been studied for their effects on menopause symptoms, and the research is promising. Black cohosh, for example, may help decrease hot flashes; red clover has been found to positively impact your bone and cardiovascular health. For mood swings and anxiety, ashwagandha is a potential remedy both before and after menopause. 

It’s also worth considering other alternative methods to wellness. One study examining the impact of traditional Chinese medicine on menopausal women showed that acupuncture could help bring relief to many physical symptoms. Meditation and mindfulness practices may also contribute to the easing of insomnia and anxiety. 

Should You Turn To Weight Loss Drugs for Menopausal Weight Gain? 

You’ve probably heard about the weight loss “wonder drugs” that everyone seems to be taking these days. Weight-loss medications like Ozempic and Wegovy are trendy, but are they right for you? 

The short answer: It depends. GLP-1 meds have been shown to help people lose a significant percentage of body weight when paired with a healthy diet and regular exercise. Examples of GLP-1 meds that are FDA-approved for weight loss include Zepbound (tirzepatide) and Wegovy (semaglutide). Other medications, such as Ozempic (semaglutide) and Mounjaro (tirzepatide), are approved for diabetes but used off-label to help patients lose weight.

However, these drugs aren’t for everyone. They’re typically appropriate for people with obesity (a BMI greater than 30) as well as those with a BMI greater than 27 and one or more weight-related conditions such as high blood pressure, type 2 diabetes, or high cholesterol. It’s also important to consider possible downsides, such as cost and potential side effects (like nausea, bloating, and indigestion).

All medications carry risks, and these are no exception. If you are a candidate for any weight loss medication, a Midi weight specialist can review all the benefits, potential risks, possible side effects, and ways to mitigate them, so you have all the facts you need to decide on a care plan.

Real-life Examples of Weight Loss During Menopause

At Midi, we’re successfully helping women reverse menopausal weight gain. Take S.K., a Midi patient from Alabama, for example. When she came to Midi, she told us her first noticeable symptom of perimenopause was weight gain. “After a lifetime of being lean, the extra pounds caused me to lose my waist,” she said. Once she started working with a Midi clinician, she had a lightbulb moment: “It wasn’t me, it was my hormones!” S.K. started on HRT and noticed many of her other symptoms, including brain fog and fatigue, started to dissipate. Over the next few months, she also lost 15 pounds: “I can see my waist again!” 

C. Griffin., a Midi patient in California, was frustrated by midlife weight gain—but even more so by the lack of help she got from doctors. “I talked to my general practitioner and gynecologist, but my concerns were shoved aside. Their only suggestion: ‘Eat less, exercise more.’ I’d already tried that—didn’t work!” When she started working with a clinician at Midi, things started to shift. Not only did she finally feel heard, but she also started to get results: “After listening to my concerns and diving into my health history, my Midi clinician prescribed a Care Plan that includes weight-loss medication. It was refreshing to have my unique needs considered rather than having a standard plan thrown at me. After just three and a half months, I’m down 12 pounds.”

For Jenn W., a Midi patient in California, getting back to her pre-baby weight was important. “When I hit my mid-40s, I started gaining weight around my middle, which was so frustrating,” she told us. After beginning HRT under the recommendation of her Midi clinician, the scale started to move. “The first thing I noticed was my energy came back at full force within just a couple of weeks,” she said. “I jumped on the scale and realized my weight was coming off for the first time in years. With my clinician’s coaching and guidance and with the help of hormone replacement therapy that I desperately needed, I was able to lose 10 pounds.” From there, Jenn worked with her Midi clinician to add weight loss medication to her Care Plan, and is now back down to her pre-baby weight. “I never thought in a million years that I could have done this and now I'm 100% confident that I'm not going to yoyo with my weight because I’m on a maintenance dose.”

Staying Motivated and Setting Realistic Goals

Maintaining a healthy lifestyle through midlife and beyond is a marathon, not a sprint. While it may be tempting to set big, lose-the-weight-fast goals, focus on what’s realistic for you right now. If you’re a lifelong night owl, planning to run a sunrise mile daily may feel punishing, not promising. Meet yourself where you are and craft goals that fit into your current life. 

It can help to start by establishing short-term routines or habits, like stretching 10 minutes after waking up or turning off your phone 30 minutes before bedtime. Then, build upon these habits until 10 minutes of stretching becomes 30 minutes of yoga or a walk around the block to wake up your metabolism while your coffee brews. By letting yourself build towards bigger goals, you’re more likely to stay motivated and work towards a happier and healthier you. 

FAQs About How to Lose Weight During Menopause

What is the fastest way to lose weight during menopause?

The fastest way to lose weight during menopause involves a balanced diet, regular exercise, and lifestyle adjustments. A diet rich in fruits, vegetables, lean proteins, whole grains, and consistent physical activity, including cardio and strength training, can accelerate weight loss. Managing stress and getting adequate sleep are also crucial, as they can significantly impact metabolism.

Why is it so hard to lose weight during menopause?

Losing weight during menopause is challenging due to hormonal changes that affect metabolism and body composition. Decreased estrogen levels lead to a slower metabolism and changes in fat storage. Aging often coincides with decreased muscle mass, further slowing the metabolism and making weight loss more difficult.

How do you get rid of menopause weight gain?

To combat menopause weight gain, focus on creating a calorie deficit through a healthy diet and regular exercise. Emphasizing portion control, eating nutrient-dense foods, and engaging in cardio and strength training are all effective strategies. Addressing other menopause-related issues like sleep disturbances and stress can also help in managing weight.

Can hormone replacement therapy (HRT) help with weight loss during menopause?

HRT can alleviate menopausal symptoms, but its not a weight loss solution on its own. HRT might help manage weight by alleviating symptoms like sleep disturbances and mood problems, which in turn may make it easier to be active and make healthier food choices.

Are there specific diets recommended for menopausal women trying to lose weight?

There's no one-size-fits-all diet for menopausal weight loss, but a diet low in processed foods and high in fruits, vegetables, lean proteins, and whole grains is recommended. Focusing on foods rich in calcium and vitamin D benefits bone health.

How does exercise influence weight loss during menopause?

Exercise helps burn calories, increases muscle mass (boosting metabolism), and improves overall health, all of which can support weight management. A mix of cardio, strength training, and flexibility exercises is most beneficial.

What role does stress management play in weight loss during menopause?

Stress management is significant for menopausal weight loss, as high stress can lead to abdominal weight gain. Techniques like meditation, yoga, or deep breathing can help manage stress.

How important is sleep in the context of menopausal weight loss?

Quality sleep is vital for weight loss during menopause. Poor sleep can disrupt appetite-regulating hormones, leading to increased hunger and potential weight gain. Without adequate rest, mood and energy suffer, which makes it more challenging to choose healthy foods and be active.

Can dietary supplements aid in losing weight during menopause?

Some dietary supplements might help manage menopausal symptoms but they aren’t primary solutions for significant weight loss. Consultation with a healthcare provider is essential before starting any supplements.

What lifestyle changes are recommended for losing weight during menopause besides diet and exercise?

Besides diet and exercise, getting quality sleep, quitting smoking, reducing alcohol intake, staying hydrated, and managing stress can contribute to a healthier lifestyle and aid in weight loss during menopause.