Along with hot flashes, weight gain is a common concern among women who have reached or are approaching menopause. And research does show that, on average, women gain an average of 1.5 pounds per year in their 50s and 60s.
There are many reasons for this, including hormones, genetics, and lifestyle habits, and not every person in menopause gains weight. Whether you’re perimenopausal, menopausal, or postpenopausal, you may be thinking about what you can do to manage a healthy weight as you get older.
In this article, we’ll break down what causes menopausal weight gain and tips for weight management during this time.
What Causes Menopause Weight Gain?
Menopause marks the end of a person’s menstrual cycle, beginning 12 months after their last period. Most people experience menopause in their 50s or 60s, though some can go into menopause earlier.
Menopause is not a medical condition, disease, or disorder. Instead, it’s a natural biological process that may bring on moderate to severe symptoms.
Common menopausal symptoms include hot flashes, chills, mood changes, insomnia, and weight gain. Most people assume that hormonal changes are the key reason for menopause weight gain.
While this is a potential cause, it’s not the only one. Other things—like aging, genetics, medications, and lifestyle habits—could be the primary cause for a person’s weight gain. Or menopausal weight gain may be brought on by a combination of these factors.
Since menopause occurs later in life—typically in a person’s 50s or 60s—the natural effects of aging may contribute to weight gain during menopause. For one, people typically lose 3-8% of muscle mass every decade after the age of 30, and the rate of decline accelerates after the age of 60.
Decreased muscle mass can lead to a number of changes, such as weakness and loss of endurance and mobility. Research also suggests that a decrease in muscle mass is usually accompanied by a progressive increase in fat mass.
Additionally, even when you adjust for lost muscle mass, metabolism decreases with age. And since the body is naturally using up less energy (i.e. burning fewer calories) at rest, even with no changes to diet and physical activity, most people will gain weight.
Estrogen levels naturally decline as a woman ages, often starting several years leading up to menopause. And research has found that as estrogen levels decrease, levels of visceral fat (fat that wraps around abdominal organs) tend to increase.
Since declining levels of estrogen are natural, there’s usually no need for hormone replacement therapy. However, a physician may recommend hormone therapy in cases where symptoms like insomnia or hot flashes seriously affect a person’s quality of life.
According to research, genetics can influence the amount of fat a person accumulates during menopause and where the body stores that excess fat. Genetic factors also contribute to changes in body composition after menopause.
For example, if a person’s parents tend to carry excess weight around their abdomen, their body may be predisposed to distributing weight the same way.
Certain medications can contribute to postmenopausal weight gain. One study found that taking antidepressants, beta-blockers, or insulin increased the likelihood of gaining weight after menopause.
If you suspect that weight gain is a side effect of a prescribed medication, talk to your healthcare provider. Do not quit the medication without having a discussion about it first.
It’s common to lack energy during menopause. With aging, some people may also experience additional obstacles, such as joint inflammation, that make it difficult to stay active.
These changes may also make it harder to cook and eat healthy foods. All of this can contribute to weight gain.
Complications of Menopause Weight Gain
Whether the weight gain occurs during menopause or another time of life, excess body fat is a risk factor for health issues such as high blood pressure, heart disease, insulin resistance, and diabetes. Obesity can also increase the risk of certain cancers, including breast and endometrial cancer.
Tips for Preventing Weight Gain During Menopause
Although the hormonal changes of menopause and the natural effects of aging are out of your control, you can take action to try to prevent weight gain. Below are some lifestyle changes that may help.
The key to physical activity for weight management (or any health goal) is consistency. And the key to consistency is to pick activities that you enjoy, whether that’s dance classes, lifting weights, walking, hiking, or anything else that gets you moving.
According to the Physical Activity Guidelines issued by the U.S. Department of Health and Human Services, older adults should aim for at least 150-300 minutes of moderate exercise or 75-150 minutes of vigorous exercise per week.
Moderate exercise includes:
- Brisk walking
- Doubles tennis
- Biking slower than 10 miles per hour
Vigorous exercise includes:
- Strenuous fitness classes
- Singles tennis
- Swimming laps
The guidelines also recommend that older adults do muscle-strengthening activities.
Some examples of strength-training activities are:
- Bodyweight exercises (push-ups, planks, squats, etc.)
- Exercises with weights or resistance bands
- Using resistance machines at the gym
Since metabolism decreases with age, many people find that reducing their caloric intake helps them maintain a healthy weight. However, this doesn’t mean crash dieting. Instead, eating balanced meals with protein, healthy fats, and carbohydrates will help you stay fuller longer.
And eating a variety of vegetables and fruit will help you consume plenty of micronutrients to support overall health. If you’re unsure about where to start, consult your primary physician or a registered dietitian to put together the right plan for you.
Proper sleep habits
Sleep issues like insomnia are a common symptom of menopause, and lack of sleep appears to be linked to weight gain. Good sleep hygiene may help you get the sleep you need.
Try the following:
- Avoid caffeine late in the day
- Avoid naps in the late afternoon or evening
- Avoid looking at blue light-emitting devices before bed
- Use low lighting in the evenings to signal to your body that it’s time to wind down
- Follow a regular sleep and wake schedule, even on weekends
Stress is part of everyday life. However, high levels of stress is also associated with weight gain.
If you find that you’re more stressed than usual, consider the following stress-management strategies:
- See a licensed therapist
- Turn to family and friends for social support
- Try walks in nature, meditation, or journaling
- Practice deep breathing, even for a few seconds
- Be physically active
When to Talk to Your Doctor
Some people transition into menopause with minimal challenges. Others experience more severe symptoms, including weight gain.
If your menopause symptoms are negatively impacting your quality of life or you’ve gained more than 2-5 pounds in a year, see a healthcare provider.
How K Health Can Help
Did you know you can have a primary care doctor online?
Check your symptoms, explore conditions and treatments, and if needed, text with a healthcare provider in minutes through K Health.
K Health’s AI-powered app is HIPAA compliant and is based on 20 years of clinical data.
Frequently Asked Questions
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
The Association Between Weight-Promoting Medication Use and Weight Gain in Postmenopausal Women: Findings From the Women's Health Initiative. (2020).
Central Effects of Estradiol in the Regulation of Adiposity. (2009).
Does Body Weight Affect Cancer Risk? (2020).
A Good Night's Sleep. (2020).
Independent Genetic Factors Determine the Amount and Distribution of Fat in Women After the Menopause. (1997).
Menopause, Energy Expenditure, and Body Composition. (2002).
Muscle Tissue Changes With Aging. (2010.)
Obesity in Menopause – Our Negligence or an Unfortunate Inevitability? (2017).
Obesity in the Elderly: Is Faulty Metabolism to Blame? (2010).
Physical Activity Guidelines for Americans. (2018).
Psychosocial Stress Is Positively Associated With Body Mass Index Gain Over 5 Years: Evidence From the Longitudinal AusDiab Study. (2014).
Sleep Deprivation and Obesity in Adults: A Brief Narrative Review. (2018).
Weight Gain in Women at Midlife: A Concise Review of the Pathophysiology and Strategies for Management. (2017).