This Is the Secret Menopause Weight Gain Culprit No One's Talking About, According to OB/GYNs

If you are struggling with weight gain during menopause, you are not alone. Between 60% and 70% of women gain weight during menopause. While you may think that hormonal changes are the sole reason for weight gain during menopause and there’s nothing you can do about it, that’s not entirely true.

As OB/GYNs explain here, fluctuating hormones do contribute to weight gain, but it’s not the only reason. Here’s what’s really encouraging: Gaining weight during menopause isn’t inevitable.

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The Unexpected Reason for Weight Gain During Menopause

Dr. Priyanka Venugopal, DO, an OB/GYN and weight loss coach at Burn Stress Lose Weight, says that something many people don’t realize about midlife weight gain is that it actually starts to happen before menopause—specifically, in perimenopause. “Menopause is hard to define. It’s 12 months consecutively without a period, but 10 years leading up to menopause people can start to notice the changes of perimenopause, which is also going to impact how people are losing weight and their ability to lose weight because they are having hormonal changes,” she explained.

One reason for weight gain during this time, Dr. Venogopal says, is a decline in estrogen levels. This is the reason many people expect and it’s absolutely spot-on, as scientific research does show a connection between declining estrogen levels and weight gain.

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Dr. Dympna Weil, MD, a board-certified OB/GYN and speaker at Prescribing Possibility, says this hormonal fluctuation has more to do with where fat gets stored on the body than the number on the scale. “The Study of Women’s Health Across the Nation from 2022 demonstrates that numbers on the scale often stay relatively stable, but waist circumference increases and body shape shifts during the menopausal transition.”

Dr. Venugopal adds, “Estrogen plays a key role in how fat is distributed and metabolized. With lower estrogen levels, we will start to see more belly fat.”

That said, a change in estrogen levels is not the only reason many women experience an increase in belly fat. Dr. Venugopal says that this is also due to a decline in muscle mass. This, both doctors point out, is connected to aging in general, not specifically menopause. Muscle mass declines about 1% a year between the ages of 30 and 50. After age 70, it declines about 3% per year. This change in body composition can lead to more belly fat.

Here’s the real surprising culprit for weight gain during menopause (or more specifically perimenopause), according to Dr. Venugopal: Stress. “After the age of 40, decades of living a high-stress life starts catching up to women,” Dr. Venugopal says. “By the late thirties to early forties, that constant secretion of cortisol really starts to impact the body.”

Additionally, Dr. Venugopal says that not exercising regularly and eating unhealthy foods can also contribute to weight gain during menopause, just as they do during other life stages.

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How to Maintain a Healthy Weight During Menopause

As you can see, there are several factors that together can cause weight gain during menopause. So what can you do about it, especially the high cortisol levels caused by decades of stress?

Dr. Weil’s biggest advice is to get back to the basics: Eating a well-balanced diet, exercising regularly, getting enough sleep and finding healthy ways to manage stress. She says it can be especially helpful to make sure you’re getting enough protein, since that’s important for maintaining muscle mass. (Remember: Losing muscle as we age is one reason for weight gain!)

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“There are so many controllable factors like lifestyle changes, the quality of nutrition we’re eating, how much we’re sleeping and how much we’re moving that can really move the needle for people to make weight loss so much simpler,” Dr. Venugopal noted.

Dr. Venugopal says to pay attention to the quality of food you’re eating: Are you often reaching for ultra-processed foods, especially when you’re stressed? If so, it can help to plan ahead by stocking your pantry and fridge with easy-to-grab nutrient-rich foods, like fruit, nuts and air-popped popcorn. “When we eat highly processed foods for years, our body starts to develop insulin resistance and when that happens, insulin levels go up and insulin is a fat storage hormone,” Dr. Venugopal says on how eating ultra-processed foods can contribute to weight gain.

If you’re really struggling with weight gain during menopause and changing your diet and lifestyle habits isn’t working, Dr. Weil suggests talking to your primary care doctor, an endocrinologist and/or an OB/GYN. There may be an underlying reason for your weight gain or they could suggest solutions you haven’t heard before.

Even though gaining weight during menopause is normal, it isn’t inevitable. Do what you can to maintain healthy habits and talk to your doctor if they don’t seem to be working. After all, part of their job is helping make menopause easier to navigate! 

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Sources

• Dr. Priyanka Venugopal, DO, an OB/GYN and weight loss coach at Burn Stress Lose Weight
• Dr. Dympna Weil, MD, a board-certified OB/GYN and speaker at Prescribing Possibility