Why Women Gain Weight During Menopause: What Science Reveals

Menopause weight gain is a common concern for women in their 40s and 50s. If you’re noticing belly fat during menopause, you’re not alone. The latest research shows that menopause triggers hormonal changes, affecting metabolism, body composition, and overall health.

1. Hormonal Changes Shift Fat Distribution

During menopause, declining oestrogen levels cause fat to move from the hips and thighs to the abdomen. This leads to increased visceral fat and a higher waist circumference. These hormonal changes in menopause—not lifestyle choices—are the main reason for changes in body shape.

2. Slower Metabolism

Menopause and metabolism are closely linked. As muscle mass decreases, the body burns fewer calories at rest. This slower metabolic rate means women may gain weight even if their diet and exercise routines remain unchanged.

3. Increased Insulin Resistance

Menopause and insulin resistance go hand in hand. Lower oestrogen makes it harder to regulate blood sugar, increasing the risk of abdominal fat and cravings for sugar and carbohydrates.

4. Elevated Stress Hormones

Menopause and stress are connected. Higher cortisol levels during menopause promote belly fat and make weight loss more difficult. Life changes and responsibilities at midlife can further increase stress.

5. Sleep Disruption

Menopause and sleep problems—such as hot flushes and night sweats—can disrupt rest. Poor sleep affects appetite hormones, increasing hunger and reducing satiety, which contributes to menopause weight gain.

6. Declining Testosterone

Testosterone supports muscle strength and fat metabolism. Its decline during menopause accelerates muscle loss and reduces calorie burning, making menopause and muscle loss a key factor in weight changes.

7. Body Composition Changes

Research shows women typically gain 1–1.5 kg per year during perimenopause, with more of this as visceral fat. These changes happen even without eating more or exercising less.

How to Manage Weight During Menopause

·       Supporting hormonal balance

·       Prioritising menopause nutrition and muscle-strengthening exercise

·       Improving sleep quality and managing stress

·       Addressing insulin resistance with healthy lifestyle choices

·       Seeking menopause support and creating sustainable, individualised plans

Menopausal weight gain is common, but with the right approach, it is manageable. Your body is adapting—not failing—and with support, you can maintain health and confidence through this transition.

References

Palacios S. (2024). Obesity and Menopause. Climacteric.

Hurtado MD et al. (2024). Weight loss response to semaglutide in postmenopausal women. Menopause Journal.

Castaneda et al. (2025). Tirzepatide + menopausal hormone therapy. Endocrine Society Annual Meeting.

British Menopause Society (2023). Nutrition and Weight Gain in Menopause.

Leitão et al. (2024). Behavioural strategies for weight control. Appetite.

Gonçalves et al. (2024). Mediterranean dietary patterns. Nutrients.

Simpson et al. (2022–2023). Protein leverage and body composition. American Journal of Clinical Nutrition.