During perimenopause, your sensitivity to leptin may decrease as estrogen levels rise and fall, causing out of control hunger hormones. All of these things, of course, contribute to pesky unexplained weight loss or gain during perimenopause. Combat unexpected weight gain during perimenopause caused by high cortisol levels by hitting the gym to blow off steam – and get that endorphin rush! The objective of this contemporary review is to review the body of evidence on factors influencing weight gain during the transition through menopause and resultant CVD risk factors in midlife women. In an analysis of the National Health and Nutrition Examination Survey (NHANES) dataset, a nationally represented survey of adults in the United States, the prevalence of obesity in women (40.4%) is significantly higher than in men (35%) when adjusted for age-related factors.9 The effects of weight gain on CVD risk have been well studied; however, the causes of such weight gain during the menopausal transition are less understood. In this contemporary review, we examined recent evidence for adverse changes in body composition at midlife during the menopausal transition and the link to increased CVD risk and described factors that may contribute to these changes, including normal chronological aging, hormonal factors (decreased estrogen, etc.), behavioral factors (changes in diet, physical activity), or other emerging factors (e.g., sleep). Changes in muscle mass in strength after menopause.Now, this doesn’t mean that weight-loss centers and some physicians are not prescribing it for this off-label reason, but be aware that this is not an FDA-approved use.To further examine weight gain following menopause another study followed-up on postmenopausal women that underwent a weight loss program.The objective of this study was to determine the effectiveness of exercise and/or nutrition interventions on changes in body weight, body composition, and body fat distribution in women specifically during the menopause transition stage.If you’re a vegetarian, cottage cheese is a great source of protein and probiotics; whey and pea protein powder are typically good bets in a pinch for supplementation (find our favorite in the Self-Care O-wards).Maybe you’ve gained or lost some weight.In this guide, we’ll explore the ideal perimenopause diet, what foods to embrace or avoid, and the key lifestyle and supplement choices to support your health during this time. Menopause is the time in a woman's life when, as a consequence of hormonal changes occurring in the body, the risk of overweight and obesity increases significantly and, therefore, so does the risk of metabolic and cardiovascular diseases. Research indicates that the decline in estrogen influences how your body stores fat, builds muscle, and metabolizes carbohydrates. In perimenopause, weight gain (especially around the middle) becomes more common and frustrating. Rather, studies show that a diet that includes the items listed below helps to improve various perimenopause symptoms. In addition, with so many different diets popping up everyday, research dollars have not allocated to studying how each of them affects health during perimenopause. Whether it’s unexplained weight loss during perimenopause or unwanted weight gain, knowing what each hormone is supposed to do can help keep all weight swings at bay. If you’re experiencing unexplained weight loss or weight gain during perimenopause, you may want to take a look at your insulin levels. These obesity-related cardiometabolic risk factors and menopausal symptoms can be effectively managed by achieving clinically significant weight loss through lifestyle modification. Even if you don't put on weight during the menopause transition, you may see a change in your body composition in the form of an increased ratio of fat to muscle. How to support sustainable weight loss during menopause – what to eat, what to limit, the best forms of exercise and tips for better sleep. Due to poor awareness they think they should be losing weight when really they are simply not being consistent enough with their food choices day to day and not creating an energy deficit. Many people who want to lose weight have healthy intentions. Reduced estrogen levels also led to a reduction in incidental movement in animal studies, so there may be hormonal triggers contributing to reduced activity levels. For example, it’s harder to exercise and make good food choices when you’re exhausted from lack of sleep caused by hot flushes. In addition to weight gain, hot flashes, muscle loss, and decreased bone mass, some of the most reported symptoms of menopause include mood and sleep changes. M. Friedrich, “Effects of diet modification and the resultant body weight loss on body composition in obese menopausal women,” Polish Journal of Food and Nutrition Sciences, vol. Easter et al., in “Effects of dietary protein on the composition of weight loss in post-menopausal women,” Journal of Nutrition, Health and Aging, vol. Best Fitness and Nutrition Strategies During Perimenopause and Menopause With hormones at a lower baseline and a slower metabolism, it might take a few extra tweaks to see results. To lose weight, you need to maintain a calorie deficit. You might look and feel different, but with a few modifications to how you eat, move, sleep, and manage stress, you can get back on track. Weight loss medication, including GLP-1s like Ozempic®, Wegovy®, and Zepbound®, can also be an option for some. As increased hunger persists for a long time, obesity must be considered a chronic disease, which means that as with other chronic illnesses, medication must be lifelong. Leptin is released from fat cells as an appetite suppressant. These two lesser-known hormones are major players in appetite control! When this happens, you may feel tired, and lethargic, and your body temperature will cool. It also is a key player in nutrition, balancing energy by synthesizing the proper macronutrients our bodies need to function. This well-known hormone actually helps our bodies maintain their chief functioning processes. Of all components of lifestyle, nutrition exerts some of the most significant impacts on postmenopausal women's quality of life and morbidity. Against those risks, diet is particularly relevant given its impact on quality of life and longevity and its modifiability . The age at which menopause occurs, generally between 45 and 55 years old, is primarily determined by genetics but also susceptible to the influence of environmental factors such as obesity, multiparity, physical activity, tobacco use, and alcoholism . These risks are usually higher for women who start HRT later in life or use it for extended periods, which is why the timing and duration of HRT are critical. During the diet, it is recommended to drink 2 litres of still water. Carbohydrates supplement the diet, yet their amount should not be less than 130 γ a day . The remaining amount of consumed fat should include monounsaturated fats (n-9). Very low calorie diets (VLCD) – less than 800 kcal daily – may be followed provided such a diet is ordered by a physician and is implemented under medical supervision 22, 23. An adequately prepared diet should meet all nutritional requirements in a suitable amount and proportion. Estrogen has a direct influence on metabolism by enhancing insulin sensitivity and promoting fat utilization for energy. Many women also experience an increase in belly fat storage, which further adds to their frustration. Women in midlife can expect to gain about a pound and a half per year, and since hormonal shifts during perimenopause can last upwards of 10 years, that adds up fast. For some women, this weight accumulation can occur despite maintaining the same diet and exercise routines that previously kept their weight stable. You may get added weight management benefits if you’re on hormones for other reasons, but it’s not recommended to take HRT for weight loss. Hormone replacement therapy (HRT) will help to control the deposition of fat to your midsection, Faubion says, but it’s not a weight loss drug. HORMONAL FACTORS INTERACT WITH MACRONUTRIENT METABOLISM AND BODY COMPOSITION IN THE MENOPAUSE Reducing energy by 500–700 kcal per day can be achieved primarily by omitting snacks between meals, incorporating small meals but reducing portion sizes, and avoiding sugar-containing liquids and alcoholic beverages 10,45,49,50. In other respects, the diet should follow the guidelines of a balanced mixed diet. This means a 15–30% or 500–1000 kcal lower energy intake than the current energy requirement. When you bounce from detox to challenge to 30 day shred, you’re not just confusing your body, you’re burning out your metabolism, your hormones, and your mindset. This one’s a tough truth, but it has to be said quick fixes don’t work, especially in perimenopause. They’re fuel for your brain, hormones and muscle. You may think that having a cup of tea or coffee first thing in the morning is a great way to kickstart your system but actually caffeine can lead to weight gain because of the way it affects our blood sugar balance. It may sound counter-intuitive but eating fat is an important way to lose weight – but you have to make sure it’s the right fat. Weight gain during the perimenopause can be down to a few reasons. Dr Gemma Dovey is a GP with a passion for women's health with experience of these issues herself as a patient. The key is having a diet which you enjoy and is beneficial to your overall health. Many people notice the changes in their bodies but don’t have severe symptoms. But you don’t always need to see a healthcare provider for an official diagnosis. Until you haven’t menstruated for 12 consecutive months, you should assume your body is still ovulating. It’s always a good idea to inform your doctor about any health changes, including menopause-related weight gain. Gaining weight after menopause can make your body less sensitive to insulin, which works to balance your blood glucose levels. Lack of estrogen may also cause the body to use starches and blood sugar less effectively, which would increase fat storage and make it harder to lose weight. The same thing may happen with women when estrogen levels drop after menopause. Ovarian hormones and obesity.Understanding what’s happening with your body is a key first step.Compared to baseline, participants exposed to moderate endurance exercise over 12 weeks saw reductions in BMI, total body fat, and waist circumference (P ≤ 0.05) .Protein is also critical for building lean muscle mass, stabilizing blood sugar, and providing energy, which are extra important during menopause because muscle mass decreases.During individualization of energy and nutrient intake in menopause, it must be taken into account that with the onset of menopause and due to the lack of the effect of sex steroids, the basal metabolism decreases.In their recent menopause paper, Raubenheimer and Simpson highlight the elegant solution to reverse this all-too-common trend of menopausal weight gain.“Lack of estrogen changes a woman’s body shape,” Dr. Loeb-Zeitlin says.In the period from 1980 to 2008 the number of obese people (body mass index, BMI ≥ 30 kg/m2) increased two-fold globally .It emphasizes lean protein, fiber, healthy fats, and low-GI carbs to support hormonal balance and stable blood sugar. The longer and more aggressively you diet, the more your body adapts by lowering its metabolic rate. And when that happens, your body responds by trying to conserve energy, not burn it. You need enough calories, especially from protein and carbs to support muscle growth, recovery, and hormonal balance. You’ve been taught that eating less is the answer, but in perimenopause, that approach can completely blackfire. It’s the background hum of constant responsibility that wears down your nervous system and disregulates hormones like cortisol, which directly impacts your ability to lose fat. If you’ve made healthy lifestyle changes and the scale isn’t budging, there may be other factors at play. A general rule of thumb is to aim for 150 minutes of exercise each week. Managing your weight is a matter of balancing what you eat with plenty of physical activity. If you’re a caffeine lover, try gradually transitioning to decaf coffee or herbal teas to see if this helps with your symptoms. Calories are not your enemy; you need them for energy in the lead up to menopause, just like in all other stages of life. Hormonal changes during perimenopause can also be a factor in this. Find the Perfect Women's Health Training Program for You These obesity-related cardiometabolic risk factors and menopausal symptoms can be effectively managed by achieving clinically significant weight loss through lifestyle modification.This means gradually increasing weight reps or time under tension.But in perimenopause, that mindset can backfire.However, none of these studies have tracked women with irregular menstrual cycles before the onset of the menopausal transition.Behavioral factors such as poor diet, decreased physical activity, may also influence weight status in women undergoing menopause.Some women may also note that the variation in their menstrual cycle length exceeds 7 days.However, most struggle with perimenopause weight gain belly issues, requiring targeted solutions. While the fact that menopause bumps up the possibility of weight gain isn’t new news, the link between perimenopause and changes in weight is less well known – until now. If you’ve tried adjusting your nutrition and fitness habits and aren’t noticing any weight loss, then it might be time to see a doctor who can tailor a health plan to your needs. “During menopause, your body may become less sensitive to insulin, which leads to higher blood sugar levels and increased fat storage,” says Dr. Saunders. Hormone imbalances combined with insulin resistance create a perfect storm for weight gain during perimenopause. The other hormone that plays a big role in perimenopause symptoms? The query question was (“intervention” or “food and nutrition education” or “trial” or “pilot study” or “program”) AND (“mediterranean diet”) AND (“menopause” or “menopausal”). Therefore, the MD, currently recognized as one of the healthiest dietary models worldwide , may offer many benefits to women in the climacteric phase of life. Because menopause is also viewed as a time in women's lives when they are more susceptible to changing habits and acquiring healthier behaviors , it presents an excellent opportunity for health interventions as well. Those results seem to be relevant for public health interventions aimed at improving menopausal women's quality of life. Estrogen deficiency and rising follicular-stimulating hormone are known to cause altered body composition with increasing brown adipose tissue along the waistline and viscera after menopause.1,2 Unsupervised IF may result in nutritional deficiencies, also fasting episodes can have an effect on reproductive hormones – estrogen, progesterone, and testosterone which affect physical and psychological well-being in women. Strategies aimed at reducing weight gain and improving physical activity have huge impact on physical and psychological health by reducing metabolic syndrome and cardiovascular morbidity. Reduced physical activity during menopause exacerbates weight gain. How to Jump-Start Your Metabolism While in Menopause Better insulin sensitivity is gonna give you more stable energy, fewer crashes, fewer cravings, and better fat loss. And this is a hallmark of perimenopause related fat gain. The phases of sleep where recovery, hormone repair and fat regulation happen. In fact, sleep disturbances affect an estimated 39–47% of women at this time in their lives. It can also help manage weight and provide mental health benefits. Read more about how to eat during perimenopause here. Focus on mental health Eating cruciferous vegetables (like broccoli, kale and Brussels sprouts) is especially beneficial during perimenopause because they help balance estrogen levels. A hormone-friendly perimenopause diet includes a variety of whole, nutrient-dense foods. This dietary pattern not only supports hormonal balance, but also aids in maintaining a healthy weight and reducing the risk of chronic diseases. While Dr. Ali says that weight management is largely about diet, he also stresses the importance of being physically active. (Most women need to have at about 25 grams a day.) Just ramp up your fiber intake slowly—otherwise, you run the risk of dealing with uncomfortable bloating and gas. It also lowers the odds you’ll lose muscle mass, which can help to support bone health as you get older, Dr. Ali says. That's because protein helps support muscle mass, which can rev up your metabolism, Dr. Shepherd says. “Factors like stress, sleep disturbances, and changes in activity levels can also contribute.” Let’s work together to keep you feeling empowered, healthy, and confident at any stage of life. Health care for women international, 41(11-12), 1255–1272. Check out The Perimenopause and Menopause Certificate Program here. And, this load has continued to increase since 2020 especially for professional women during the COVID-19 pandemic and beyond (Sharma, & Vaish, 2020). Chronic stress and abdominal fat can encourage insulin resistance, in which cells aren’t able to work with the hormone to use glucose for energy.The "sleepy" hormone is actually present in cherries, grapes, strawberries, salmon, eggs, legumes, pistachios, peppers, and mushrooms, so Ward says you can increase your supply by incorporating these foods into your diet.Chronic calorie restriction raises cortisol levels.Midlife hormone shifts often bring weight gain during perimenopause and menopause.One is that it can help you to wake up feeling refreshed, providing plenty of energy to do things like maintain your activity level and workout routine.Mood changes experienced during menopause — or because of other life stressors — can also interfere with living a healthy lifestyle because stress releases the hormone cortisol, which impacts the metabolism, says Dr. Loeb-Zeitlin.However, as they get older, their post-meal blood sugar levels increase. I tried for five years unsuccessfully to lose weight, but once I figured out what I needed to do to control the number on the scale, it took me anywhere from eight to twelve months. My heaviest weight as an adult was 192, and my current weight is 130 pounds. My motivation was just being myself, getting into my old body, wanting to run around with my kids, and be proud to be in photos with them. A simple 5-day menopause diet plan can kickstart your weight loss.Oestradiol started to decline three years before menopause and dropped more significantly when amenorrhoea occurred.That said, a sedentary lifestyle, poor diet, and unmanaged stress are more likely to cause menopause weight gain than hormone shifts.But with more isolated movements, I’ll lift lighter weights but do more reps, around 12 to 20.Chronic stress raises cortisol, which promotes fat storage, especially around the belly.The best time to start HRT is usually in perimenopause or right after menopause.The red bullseye provides an estimate of the shift required during the menopausal transition to a higher protein (91 g) target at the same total energy requirement of 2122 kcal (8.9 MJ). When hormones in our bloodstream reach the liver, they get metabolized. The gut microbiome also plays an important role in regulating hormones. It recommends women aged 51 to 70 get 1,200 mg per day, and no more than the maximum of 2,000 mg. This leads to an increase in blood sugar spikes and fat storage. Estrogen plays a role in the way your cells switch from fat burning between meals and carb use after meals. But despite this fact, some general nutrition ideas remain true for almost everybody. ‘So many women blame lack of willpower for weight gain, but it’s not your fault,' a doctor says Menopause often causes poor sleep quality, which can worsen weight gain. Burning more calories than you take in is what causes weight loss. Don’t overcomplicate weight loss. Apart from their bother, hot flashes may have implications for a woman's health. About 20% of women in their late 50s, 10% of women in their 60s, and 5% of women in their 70s experience persistent hot flashes.32 Thus, although they thankfully diminish in prevalence over time for most women, a minority remains highly symptomatic and requires lifelong treatment to maintain quality of life. African-American and Native American women appear to have the highest reporting of hot flashes.24 In the SWAN Study, Chinese and Japanese women had lower rates of hot flash reporting and a shorter overall duration of hot flashes.13 Body size also affects the severity and frequency of hot flash reporting in a complex way. It has allowed investigators to link key symptoms that were previously believed to occur randomly to the reproductive aging milestones as defined by STRAW. This is because most of our definitions of menopausal milestones are still menstrual based. Excessive cardio, particularly long-duration steady-state exercise, can lead to muscle breakdown if not supported by adequate nutrition and recovery. Resistance training helps preserve and rebuild muscle mass, which in turn supports a healthy metabolism. Estrogen plays a role in how your body stores fat and utilizes carbohydrates. Ideally, studies should be sensitive to the potential relationships between cultural norms, socioeconomic status, and body weight changes during the menopause transition stage. Of the three included studies, only one study suggested the potential impact of periodic clinical measurements as an intervention to attenuate weight gain during the menopause transition stage. Despite using a less rigorous study design and having a shorter follow-up period, another study concluded that a Nordic walking program might reduce weight gain during the menopause transition stage . The other studies measured overall gains and/or losses in body weight reported as BMI with percentage body fat or total kilograms of fat . The search strategy was developed collaboratively with an academic reference librarian (LAU) and researchers investigating the effect of menopause transition on body weight regulation (Table 1). If your knees and other joints tend to hurt during exercise, try swimming and water aerobics. Sunshine’s added Vitamin D boost helps your body maintain hormonal balance. In fact, working out at too high an intensity can stress the body and trigger added cortisol production. Whatever it takes, really try to make sure you get enough sleep at night. ZOE’s scientists are currently exploring how diet affects the symptoms of perimenopause, including weight gain. In recent years, research has shown that sleep patterns, including short sleep duration and poor sleep quality also contribute to weight gain and these factors play roles in weight gain as women transverse menopausal transition in midlife. Overall, studies show that body weight gain often occurs during the menopausal transition in women ages 40–50 years, yet there are mixed results on whether these adverse weight changes occur primarily due to hormonal changes, aging, and/or behavioral/lifestyle factors. The role that changes in hormonal levels play influencing adverse body composition changes during menopausal transition in women was investigated in the SWAN, which documented patterns of hormone change for E2 and FSH. During the early stages of menopausal transition, women experience estrogen deficiency.30 The reduction in estrogen leads to a decrease in lean body mass and an increase in fat mass.28 The Melbourne Women's Midlife Health Project is a 9-year-long prospective observational study with 438 native Australian women 45–55 years of age at the start of the study. In just a year, she lost 60 pounds and regained her energy and confidence. The answer is not to exercise more and eat less. For some women, it’s 200 pounds, and for others, it’s 125. I believe every woman has a weight that makes her feel confident and amazing. Focus on Blood Sugar Balance First We have to approach weight loss differently at midlife. If this wasn’t enough, research into the hunger hormone ghrelin has shown that it can be hyper-stimulated at perimenopause, meaning we’re more hungry and susceptible to cravings. Plus our stress levels are often super high as we’re spinning many plates, which leads to the worry waist – regardless of perimenopause! Weight gain during menopause is more than a cosmetic concern; it carries several potential health risks that can impact overall well-being. While menopause-related weight gain is typical, it is not inevitable. Increasing your protein intake is vital for maintaining muscle mass and promoting satiety. The main risk factor is reaching the age of menopause. See your healthcare professional as soon as you can if you bleed from your vagina after menopause. Keep seeing your healthcare professional for wellness visits and medical concerns before, during and after menopause. Period cycles tend to get shorter in early perimenopause, so periods are closer together. But in perimenopause, that mindset can backfire. Hormonal shifts in your 40s and 50s can completely change how your body responds to food, exercise, and stress. The use of various smartwatches and smart devices can also help to recognize and monitor sleep disorders, as well as to assess the effectiveness of the applied diet therapy and medical treatment 132,133. This is consistent with the observation that self-reported sleep problems seem to become much more prevalent in women than in men as they age beyond 45 years—just about the timing of the onset of the menopausal transition.39 A recent report by the Penn Ovarian Aging Study, which includes 16 years of follow-up, did not find an increasing incidence of self-reported poor sleep with progress through the menopausal transition.35 The latter cohort included 255 women and did not examine sleep architecture in detail, however. Hot flashes, or vasomotor symptoms, are a cardinal feature of menopause that is almost universally experienced by women.13 Recent epidemiological evidence indicates that hot flashes are experienced by 30%–70% of premenopausal women,24 but they are likely to be mild in nature at these earlier stages of a woman's reproductive life. It is important to note that the loss of ovarian reserve that accompanies the menopausal transition occurs before there is follicle failure, that is, an inability for granulosa cells to respond to a follicle-stimulating hormone (FSH) signal with estradiol production. This is one of the most overlooked but effective diet strategies during perimenopause and menopause. If fat loss is a goal, start by nailing your protein. As hormones shift, your ability to build and repair muscle declines, so protein becomes even more critical. As estrogen and testosterone decline, your body naturally loses lean muscle—and that muscle is your metabolic engine. Treatment of overweight/obesity is of particular importance in prediabetes and diabetes. Lifestyle intervention, including diet and exercise, is the cornerstone of diabetes prevention and management . The risk of developing a carbohydrate metabolism disorder was the lowest with menopause occurring between the ages of 45 and 49. A large Chinese study revealed a clear correlation between the date of menopause and the risk of diabetes. Similar principles are implemented in the menopause diet recommendations of the British Dietetic Association. P. J. Teixeira, S. B. Going, L. B. Houtkooper, et al., “Resistance training in postmenopausal women with and without hormone therapy,” Medicine and Science in Sports and Exercise, vol. M. Roussel, S. Garnier, S. Lemoine, et al., “Influence of a walking program on the metabolic risk profile of obese postmenopausal women,” Menopause, vol. A. E. Ready, B. Naimark, J. Ducas, et al., “Influence of walking volume on health benefits in women post-menopause,” Medicine and Science in Sports and Exercise, vol. About 30% of women aged are not just overweight — they have obesity. It can worsen anxiety, hot flashes, and sleep disturbances—all things you don’t need more of during perimenopause (32). While the myth that soy can mess with men’s testosterone levels (it doesn’t) has long persisted, studies suggest that soy and other foods packed with phytoestrogen may help women in this phase. Magnesium can help knock out a surprising number of unwanted menopause symptoms, including risk of osteoporosis, insomnia, and anxiety. Changes during perimenopause can cause the body to secrete proinflammatory molecules. Here, we explain what causes this and how to get rid of menopause belly fat naturally. Despite its benefits, IF may not be suitable for all menopausal women. This anti-inflammatory effect is pivotal for improving overall health during menopause. IF enhances the production of brain-derived neurotrophic factor, a protein that supports neuronal health and cognitive resilience. The little blue pill might help with physical arousal, but there are better treatments for low libido in women Missed periods, heavy periods, painful sex and frequent hot flashes are just a few symptoms worth discussing with your provider “Weight gain after menopause can feel inevitable, but it doesn’t have to be.” By identifying the hurdles to a healthier lifestyle, you and your healthcare team can find ways to sidestep them. Maybe recurring knee pain is interfering with your exercise plans. Perimenopause is the 4–10 year lead-up to menopause, and it’s when your hormone levels—especially estrogen and progesterone—start fluctuating significantly. The best diet during perimenopause supports hormonal balance, metabolism and overall health. Limiting certain foods can reduce inflammation, stabilize mood and help manage weight on a perimenopause diet. Staying well-hydrated also supports temperature regulation, potentially easing hot flashes, and aids in digestion, joint health and overall energy levels during this transitional time. Their natural antioxidants may also ease symptoms like fatigue and mood swings, while fiber aids in digestive health and estrogen regulation, key during hormonal fluctuations in this phase. For most of my mother's life, she was able to keep to a healthy weight with little effort, but perimenopause changed that. To learn more about weight loss, read about the best ways to lose weight without dieting. With these four steps to lose weight, you'll be able to keep off the extra pounds as your body transitions during menopause. Understanding the hormonal changes that occur during this period and knowing which lifestyle changes can support healthy weight loss is essential. In their midlife, women undergo the biologic transition into menopause. The majority of middle-aged women do not regularly participate in exercise and/or fail to report healthy nutrition practices such as consuming five or more vegetables and fruits per day 4, 5. The data on alcohol’s benefits and risks are mixed, but research is clear that alcohol can disrupt sleep (a risk factor for belly fat) and add excess calories. Further, studies addressing belly fat found that a low carbohydrate, higher protein dietary combination may yield the most effective results. Dietary therapy is more cost-effective, successful, and essential for prediabetes and obesity, and in preventing the progression of type 2 diabetes . According to the American Academy of Nutrition and Dietetics, for adults with prediabetes or type 2 diabetes, dietary therapy administered by a registered dietitian improves the effectiveness of medical treatment and longevity. In addition, there is an impairment of insulin secretion and insulin sensitivity, as well as an increase in the risk of T2DM . The main elements of these lifestyle changes are weight control, reducing alcohol and salt consumption, and increasing calcium, potassium, and magnesium intake . If you don’t want to expand your family, use birth control until your healthcare provider tells you it’s safe to stop. You may find that certain activities or specific foods make your symptoms worse. Still, other people find that taking medication relieves their symptoms and improves their quality of life. Many people don’t need medication and find that their symptoms are mild enough that lifestyle changes alone make a big difference. As we go through perimenopause, bones can become weaker as hormone changes mean we lose some of the minerals that keep them their strong. The best exercise for perimenopause is something that you enjoy and can stick to doing on a regular basis. Here are some ideas of how you can manage your weight in perimenopause, including how to lose weight without Mounjaro, Ozempic or Wegovy in perimenopause. Unfortunately there is no ‘one size fits all’ answer to “how can I lose weight in perimenopause? There are different strategies that you can use to help combat the natural changes that occur during the perimenopause period, and keep yourself healthy and active in the long term. You don’t need to lift heavy weights, either — body-weight exercises like planks and push-ups can help build muscle. The symptoms of menopause can also indirectly contribute to weight gain. This is why many women experience more belly fat during menopause, even if they haven’t changed their eating habits or activity levels. As estrogen levels drop, the body stores fat differently, shifting from the hips and thighs to the abdomen and midsection. “It’s more of an aging process that causes this weight gain,” she says, which can include decreased physical activity, loss of muscle mass, and a slower metabolism. Remember that ultimately, making healthy lifestyle choices is more important than numbers on a scale. Stay active and add strength training to your exercise routine. So much of the weight that we see with aging comes from decreased physical activity.” “But more importantly, if you’re not sleeping well, you don’t feel like being active. “If you’re not sleeping well, you’re going to feel like eating more, snacking, and indulging in higher-calorie foods,” she says. Chronic calorie restriction raises cortisol levels. The mistake here is that believing, eating less is going to give you better results because that’s what you learn from diet culture, your mom or every magazine you’ve ever read. What your body actually needs in this season is fuel not restriction. When you chronically undereat, especially during an already stressful and hormonally volatile time, your body reads that as a threat. They’ve been through the crash diets, the detoxes, the meal plans, and now they want sustainability. Losing muscle mass makes your metabolism slower, and a slower metabolism makes it easier to gain weight and harder to lose it.11, no. 4, pp. 305–308, 2010, recruited participants, women “postmenopausal” (with absence of menses for at least one year and FSH levels), 45–68 years of age.Stress management during perimenopause can include practices like yoga, meditation, deep breathing, and mindfulness techniques.Perimenopause weight loss is achievable with the right diet, supplements, and lifestyle changes.Lifestyle strategies are the cornerstones of perimenopause weight management.In these circumstances, achieving a higher protein target without exceeding energy needs requires a change in macronutrient balance towards a higher percent protein diet.31, 32Nutrition, exercise, sleep, and mental health practices help to maintain a healthy and balanced weight.Hence, strength and resistance training (i.e., weight training) is often best, especially when combined with lower-intensity activities. Weight loss during perimenopause is a holistic journey that includes mental, emotional, and physical well-being. Rather than focusing solely on the scale, track other progress indicators such as energy levels, mood, waist circumference, sleep quality, and strength gains. According to a study published in Obesity (2017), strength training 2–3 times a week can reduce abdominal fat and improve metabolic markers in postmenopausal women (Beavers et al., 2017). It emphasizes lean protein, fiber, healthy fats, and low-GI carbs to support hormonal balance and stable blood sugar. For a deeper dive into the connection between hormones and midlife weight gain, The North American Menopause Society offers valuable, research-backed insights. What you really want is body recomposition, more lean mass and less fat, not just a lower number on the scale. One pound of muscle takes up less space than one pound of fat. You could be losing fat and gaining muscle, which is the goal, and still see the scale stay the same or even go up a little bit. Weight doesn’t differentiate between fat, muscle, water, or inflammation. Hot flashes, sleep apnea, and insomnia may affect sleep during menopause. “We don’t control how fast our estrogen levels change — or many of the stressors that can influence our personal lifestyle habits,” Klingberg said. But weight isn’t always the best predictor of health. Many people find that losing weight happens more slowly during and after menopause. Recommendations generally range from 0.8g – 1.0g to 1.2g for every kilogram of body weight. More studies are needed to determine how the gut microbiome specifically impacts menopause-related disease risks. During this phase, your body produces less testosterone, estrogen, and progesterone. “They’ll get some of the health benefits of intermittent fasting without the hassle or excessive hunger.” “Try to really focus on fruits, vegetables and lean proteins,” Faubion says. However, it can help you avoid additional gain and maintain your weight. Strength train and lift weights to burn more at rest. Self-compassion is a vital ingredient in supporting your health when life is in flux. Going through big life changes is healthier when you have a supportive social network. If you’re feeling sad or overwhelmed, talk with your healthcare team about therapies that can help. And many life changes tend to happen at the same time as menopause. Black beans and kale support iron and magnesium intake—important minerals during perimenopause. Avocado and olive oil help absorb fat-soluble vitamins and support hormone production. One of the most frustrating challenges during this time is weight gain, particularly around the abdomen. This abdominal fat surrounding the organs is known as visceral fat. Of course, that’s just an average, with some women gaining less and some women gaining more. (Hot flashes? Missed periods? Trouble sleeping? Sound familiar?) What is the average weight gain during menopause? The risk of central obesity in menopausal women is five times higher than before menopause . During perimenopause and menopause, the risk of cardiovascular diseases (CVD) increases with the decrease in estrogen levels . There is no difference in the number of kilos lost between low-carbohydrate diets (120 g CH/day during weight loss, 150 g/day during weight maintenance) and low-fat diets, but their cardiometabolic effects are different. Diets with a high protein content (at least 20% of energy) only result in weight loss if the energy content is low. Many women also try to deal with extra pounds by going to extremes with dieting or exercise. That just feeds the insulin resistance that causes perimenopausal weight gain. Favorite weight loss strategies can do more harm than good. These changes create an even greater imbalance between the sex hormones (especially estrogen and testosterone) and lead to more fat deposition. Since body fat can actually produce estrogen, your system will start to rely on it to produce the estrogen you need, as a way to make up for what can no longer be produced by your ovaries. 104, no. 7, pp. 1080–1090, 2010, recruited participants, women “postmenopausal” (with absence of menses for at least one year and FSH levels), 45–68 years of age. Weineck, in “Effects of single- versus multiple-set resistance training on maximum strength and body composition in trained postmenopausal women,” Journal of Strength and Conditioning Research, vol. A. Holcomb, in “Calcium-fortified beverage supplementation on body composition in postmenopausal women,” Nutrition Journal, vol. Hedayati, in “Effects of conjugated linoleic acid supplementation on body composition and leptin concentration in post-menopausal women,” Iranian Journal of Endocrinology and Metabolism, vol. “Cravings and food noise are gone, I finally feel confident in the healthy habits I’ve built to last with Noom.” “My doctor recommended Noom after I was frustrated trying to lose weight. “All of the Noom providers that I’ve met with have been exceptional and prescribed medications that are appropriate for my situation and health.” ‘’Noom has changed my life and I’m so thankful, I feel great, have more energy and am no longer prediabetic.” “Noom has taught me that every day is a new chance to make better, healthier choices. It’s true that menopause weight tends to settle around your midsection. It only makes sense that it’s now that much harder to exercise and make healthy food choices. And if you have health limitations that make exercise more difficult, that’s just one more obstacle to overcome. “Menopause weight gain is a normal and expected result of the aging process,” Dr. Batur explains. This inflammation makes it harder for your body to use insulin properly, which in turn leads to even more fat and inflammation, creating a difficult cycle to break. Your body redistributes fat from subcutaneous areas to visceral deposits around your abdomen. What sustained your weight at 35 may lead to weight gain at 45. Since muscle tissue burns more calories at rest than fat, losing muscle slows your metabolic rate by 2-4% per decade after age 40. This metabolic shift happens even if your diet and exercise haven’t changed. Changes to your mood, sleep, energy levels and physical body. By addressing weight management, hormonal regulation, and age-related risks, IF can significantly enhance the quality of life for menopausal women. While IF offers several benefits, its application in menopausal women must consider overall individual health conditions, dietary preferences, and lifestyle. The drop in estrogen levels during menopause can affect brain function, increasing the risk of neurodegenerative conditions. Try a strength-training exercise like Pilates or hit the gym for a more traditional workout with weights. Engage in exercises that focus on the major muscle groups — your arms, legs and core. Practicing yoga helps to calm your mind and reduce cortisol, helping to prevent this major stress hormone from “feeding” more belly fat. Women who present with any of the four symptoms above have a strong evidence base supporting the likelihood that their symptom(s) are related to their menopausal transition, and hormonal therapy is therefore likely to be of benefit. Therefore, the key principle in clinical management of women suffering from menopausal symptoms is to distinguish what is typical from what is not and address each woman's individual symptom experience with an eye toward providing maximal relief. While it is easy to understand the relationship between low estrogen and GSM in postmenopause, the relationship between GSM and early and late perimenopause, when estrogen is not consistently low, is harder to explain. The constellation of symptoms of vaginal dryness, irritation, and dysuria has been named genitourinary syndrome of menopause (GSM).45 The latter may be a truer reflection of the collective morbidity to the female genital tract caused by a lack of estrogen. So, does that mean you need to spend at least 10 years of your life feeling low, anxious, overweight, and struggling with insomnia just because that’s expected during perimenopause? The best fitness and diet strategies during perimenopause and menopause aren’t extreme—they’re sustainable, science-based, and tailored to your changing physiology. Manage Stress Like It’s Your JobCortisol becomes a bigger player during midlife, especially if you’re not sleeping well or pushing too hard with exercise or dieting. Poor sleep raises cortisol, decreases insulin sensitivity, impairs recovery, and makes fat loss more difficult. With the right tools and support, you can navigate perimenopause and maintain a healthy weight. Other symptoms can range from mood swings and hot flashes to sleep disturbances and higher stress levels, which can all affect weight and wellness. On average, weight gain during perimenopause is around five pounds, although it can be more for some. Behavioral lifestyle intervention uses behavioral techniques for counseling corrective dietary and physical activity practices in achieving sustainable weight loss outcomes. Reducing stress can help you regain control over your body and support your efforts to lose weight during perimenopause. As women transition into perimenopause, many experience lifestyle changes that lead to increased sedentary behavior. Lifting weights or using resistance bands can help maintain and build muscle mass, ultimately making it easier to lose weight during perimenopause. Proper hydration is essential for overall health and can aid in weight loss. How fat affects osteoarthritis. But prioritizing your health goes a long way. But the faster changes around the time of menopause last for about 4 years — 2 years before and 2 years after the last menstrual period. They can also make sure you’re getting the right screening for any weight or age-related conditions. And those changes are often more noticeable around the time of menopause. What those extra pounds really mean to our health and longevity — and how to deal with them effectively Hallie Levine is a contributing writer and an award-winning medical and health reporter. Taking estrogen will not lead to a change on the scale either up or down. This is sometimes called ‘andropause’, as androgenic hormones like testosterone decrease with age. Additionally, activity levels often also decrease, meaning we require less food. Together, the two drive your metabolism, fuel your sex drive, build bones, and keep you burning fat efficiently. With lower body, I’ll usually do two glutes and hamstrings days, plus a glutes, quads, and calves day. For upper body, I do a shoulders day, a chest and triceps day, and a back and biceps day. I remember bundling my daughter up in a jogging stroller before I went for a run once and thinking, This is my natural Prozac; this is what I need for my mental health. Through adolescence and early adulthood, I stayed active, running four or five days a week, mostly because it was beneficial for my mental health. Watching my father compete was especially inspirational for me. During menopause, an increase in body weight, including visceral fat weight, is characteristic, which not only increases the risk of CVD but also the risk of IR and, through this, the development of tumors . In addition to improving glycemic control, continuous and non-forced weight loss can contribute to regulating blood pressure and blood fat levels. Lifestyle interventions, including dietary changes and regular exercise, aimed at moderate weight loss (5%) are the mainstay of treatment . You may be able to manage perimenopause symptoms at home without needing medication from your provider. Certain medications and health conditions interfere with hormone levels and will affect the results of any hormone tests. But FSH tests can be misleading because during perimenopause, your hormones rise and fall erratically. For example, testing your FSH (follicle-stimulating hormone) level is one to see if perimenopause is beginning. But certain hormone tests can tell your provider you’re in perimenopause. They can confirm that the symptoms are due to perimenopause and not another health condition. Once your estrogen levels begin to decline, your body must adjust to the changes in hormones. It’s common for hormone levels to fluctuate during perimenopause — to go up and down like a rollercoaster.