Many women notice that, upon reaching menopause, they start gaining weight or that fat accumulates especially around the abdomen. Although diet and physical activity remain important, the hormonal changes typical of this stage also affect metabolism.
The good news is that there are effective strategies to protect health and improve body composition during menopause.
Why does weight increase during menopause?
As estrogen levels decline, changes occur in the way the body uses energy.
It is common to observe:
- • Increased abdominal fat accumulation;
- • Decreased muscle mass;
- • Reduced energy expenditure;
- • Greater insulin resistance;
- • Changes in appetite and satiety.
All this makes maintaining weight harder than in previous years, even without changing one's diet. It's not a lack of willpower, but biological changes typical of this stage.
Is weight gain inevitable?
No.
Although menopause favors these changes, weight gain is not an obligatory consequence.
Women who maintain healthy habits, exercise regularly, and receive appropriate treatment have much better chances of preserving good metabolic health and preventing complications.
Which strategies work best?
The recommendations with the strongest scientific backing include:
- • Prioritizing a diet rich in vegetables, fruits, legumes and good-quality protein;
- • Doing strength exercises at least twice a week to preserve muscle mass;
- • Incorporating regular aerobic physical activity;
- • Getting enough sleep;
- • Managing stress;
- • Avoiding smoking and limiting alcohol consumption.
These habits not only help control weight but also reduce the risk of osteoporosis, cardiovascular disease and type 2 diabetes.
When habits are not enough
In some women, lifestyle changes may not be enough.
In these cases it is important to carry out a comprehensive medical evaluation to assess:
- • Body composition;
- • Cardiovascular risk;
- • Insulin resistance;
- • Metabolic syndrome;
- • Need for pharmacological treatment for obesity when indicated;
- • Whether or not menopausal hormone therapy is indicated, according to each case.
Treatment must be individualized and take into account the medical history, symptoms and goals of each woman.
A message to take away
Menopause represents a new stage of life, not the end of caring for your health.
If you have noticed changes in your weight, in the distribution of body fat, or in your energy, don't resign yourself to thinking "it's just age."
With appropriate medical care it is possible to improve metabolic health, preserve muscle mass, and feel better.
Bibliographic references
- • The North American Menopause Society (NAMS). The 2022 Hormone Therapy Position Statement of The North American Menopause Society.
- • European Menopause and Andropause Society (EMAS). EMAS Clinical Guide: Menopause and Obesity.
- • Davis SR, Lambrinoudaki I, Lumsden M, et al. Menopause. Nature Reviews Disease Primers. 2015.
- • Elmaleh-Sachs A, Schwartz JL, Bramante CT, et al. Obesity Management in Adults: A Review. JAMA. 2023.
- • American Diabetes Association. Standards of Care in Diabetes. 2026.