If you’ve noticed the scale creeping up or your clothes fitting differently in your 40s or 50s, you’re not imagining it, and you’re far from alone. More than half of all women struggle with weight management during the menopause transition. According to the Mayo Clinic, women gain roughly one and a half pounds per year during perimenopause, the years leading up to the end of menstrual periods.
During perimenopause and menopause, levels of the hormones estrogen and progesterone begin to decline. This hormonal shift triggers changes in your metabolism including a gradual loss of muscle mass. Because muscle burns more calories than fat, having less of it means your body uses fewer calories throughout the day. Over time, those unburned calories are stored as fat.Â
But it’s not just about the number on the scale. Where that weight lands matters, too. During menopause, fat tends to migrate from the hips and thighs toward the belly, and that shift raises the risk of heart disease, type 2 diabetes, and other serious health conditions. The good news? Weight gain during menopause is common, but it’s not inevitable, and understanding what’s driving it is the first step toward addressing it.
We reached out to Dr. Cee Nicole, OHOW advisory board, and an expert in weight management, obesity, and lifestyle changes for better health and well-being, to answer a few questions about menopause-related weight gain and what you can do to protect yourself from chronic disease.
Here are some insights from her:
OHOW: How does menopause-related weight gain affect long-term risk for chronic disease?
Dr. Cee Nicole: During menopause, hormonal shifts—particularly declining estrogen—can change how the body stores fat. Many women notice increased abdominal or belly fat, which creates a higher risk of insulin resistance, type 2 diabetes, cardiovascular disease, and fatty liver disease.
The key message is that these risks are modifiable, and midlife is a critical window for prevention.
OHOW: What lifestyle practices are most beneficial to maintaining a healthy weight during this time?
Dr. Cee Nicole: During menopause, protecting muscle mass and metabolic health becomes especially important.
Strength training is one of the most valuable habits because it helps preserve lean muscle mass, which naturally declines with age and contributes to a slower metabolism. Pairing strength training with regular aerobic activity—such as brisk walking—supports both metabolic health and cardiovascular fitness.
Nutrition also plays a key role. Adequate protein intake, fiber-rich foods, and minimally processed carbohydrates help support blood sugar stability and satiety.
Equally important are sleep and stress management, both of which influence hormones involved in appetite, fat storage, and insulin sensitivity.
OHOW: What advice would you give women entering perimenopause who want to stay proactive about their health?
Dr. Cee Nicole: My advice is to view perimenopause as a time to become more intentional about health and prioritize consistency with habits.
Start by scheduling your physician to check your blood pressure, cholesterol, blood sugar, and waist circumference—and monitor them regularly. Many of the conditions that become more common after menopause develop gradually and can be prevented or treated early.
I also encourage women to prioritize strength, nutrition, sleep, and mental well-being. These foundational habits help stabilize metabolism during a time of hormonal transition.
Finally, advocate for yourself. Women’s health concerns during midlife are sometimes minimized or attributed solely to aging. If your body feels different or something seems off, it’s reasonable to ask questions and seek care that listens and explains.
Resources:
Mayo Clinic- The reality of menopause weight gain