Key Takeaways:

• The contributing factors to menopause weight gain include hormonal changes, body composition changes, lifestyle choices, genetics, and carbohydrate and fat metabolism dysregulation.

• Menopause-related weight gain could increase your risk of physical and emotional health problems, including cardiovascular disease, type 2 diabetes, and depression.

• Weight loss during and after menopause is possible through a healthy lifestyle (e.g., nutritionally wise food choices and regular physical activity).

You’re officially at the age where there are at least four big candles on your birthday cake.

And despite the increasingly popular cultural view that “40 is the new 20”, biology disagrees. It’s incredibly rare for a woman in her 20s to experience menopause. In the 40s, though? When the number of eggs has dwindled to ≤ 1,000? It’s almost expected.

Menopause brings plenty of party-popper-worthy things — e.g., bye-bye, worries about unplanned pregnancies, or stocking up on pads/tampons.

But, of course, with that comes the … not so pleasant. Hot flashes. Night sweats.

Plus, arguably the most dreaded of all: weight gain. If you've been losing sleep over menopause weight gain, this is the article for you. Learn the causes of menopause weight gain and, more importantly, how to counter it below.

What causes menopause weight gain?

There are several contributing factors to menopause weight gain:

• Hormonal changes: Men tend to store excess fat in the abdominal region and women in the thighs and butt. Have you ever wondered why? Women can thank estrogen for their "pear-shaped-like" fat distribution. Well, until menopause, that is. That's because, around menopause, your estrogen levels fall — which changes how you store fat on your body, often translating to a marked expansion in your midsection. That said, it’s worth remembering that regardless of hormonal changes, your body cannot gain weight unless you’re in a calorie surplus (i.e., eating more calories than you burn). And that’s where the following factors come into play.

• Age-related body composition changes: The amount of muscle mass you carry naturally decreases with age, around 3% to 8% per decade after age 30. Since muscle mass is more metabolically active (i.e., burns more calories) than fat mass, this lowers your basal metabolic rate (BMR), increasing the likelihood of ending up in a weight-gain-enabling calorie surplus.

• Lifestyle choices: Weight gain isn’t just specific to menopause and women per se, but also an overall trend observed in aging adults who increasingly consume ultra-processed, calorie-dense foods and live a sedentary lifestyle with little time dedicated to physical activity — planned (i.e., exercise) or otherwise (i.e., non-exercise activity thermogenesis). Naturally, this adversely tips the calorie balance scale, resulting in weight gain.

•  Dysregulation of fat and carbohydrate metabolism: Interestingly, research shows an association between menopause and dysregulation in lipid and glucose metabolism that could explain (at least, in part) menopausal women’s predisposition to weight gain.

• Genetic factors: Some women are more prone to gaining weight than others. Why? It could all come down to genetics. Some studies show that genes are responsible for 80% of body weight. So, your mom or aunt gaining extra weight after menopause makes it that much likelier that you would, too.

Risks of menopause-related weight gain

Menopause itself increases your risk for serious health conditions, including cardiovascular disease, osteoporosis, and diabetes.

Add menopause-related weight gain (especially when it’s stored as visceral fat that sits deep inside your abdomen and surrounds your organs) into the picture, and those risks are amplified.

More specifically, a large body of evidence shows that visceral adipose tissue is associated with increased metabolic risk — from cardiovascular disease to type 2 diabetes to hypertension — and overall mortality.

And menopause weight gain doesn’t just hurt your physical health, either.

It could also mess up your emotional health. The bodily changes you see in the mirror could be awfully distressing, feeding gnawing insecurities and anxieties about your appearance.

Making this particularly concerning is a 2023 systematic review published in Australas Psychiatry; after analyzing 22 studies, the researchers concluded that menopause increases your vulnerability to depression and anxiety.

Weight loss is possible

Thankfully, you can lose weight. One study that underscores this is a 2012 study published in Menopause. The researchers randomly assigned 17,473 post-menopausal women who were not using hormone therapy to two groups:

1. Control group

2. Experiment group: The women were put on a diet with an increased intake of healthful foods like fruits, vegetables, and whole grains 

Guess what the researchers found after a year? 

Women in the experiment group were three times more likely to lose weight (≥2.27 kg or 5 lbs.) than those in the control group, while those in the control group were over two times more likely to gain weight (≥2.27 kg or 5 lbs.) than those in the experiment group.

Of course, beyond general healthy eating principles, other things you could try to nudge your calorie balance in the right direction also include:

• Getting at least seven to nine hours of quality sleep nightly

• Staying physically active (an appropriate mix of cardio for heart health and resistance training to mitigate age-related muscle mass loss)

•  Maintaining “healthy” blood sugar levels as much as possible (note: you could do so by being mindful of your carbohydrate intake throughout the day; psst, if you need help with this, the NOVI Optimum Glucose Program may be a good fit for you)

Still feel like it’s impossible?

Yes, weight loss during and after menopause is possible. But that doesn’t mean it’s easy. Especially when your biology — everything from your hormones to your brain’s reward circuitries’ preference for palatable foods to genetics — works against you.

Despite your best efforts, everything you do can feel futile, like swimming against the currents in a choppy sea.

But what if there was something that could transform the turbulent sea into a calm swimming pool? That’s exactly what weight loss medications could do for you (if suitable). Interested in learning more? Check out our medical weight loss program, NOVI Optimum Plus, here.