What's the Deal With Menopause Weight Gain?

If you're a woman over, say 40 or 45, maybe you've wondered, "What's the deal with menopause weight gain?"

Maybe you've never had an issue with weight before and 5, 10, even 20 pounds seems to come out of nowhere, basically overnight. What is going on?

By the end of this post, after watching the video, you should feel a whole lot better about your menopause weight gain because you'll understand the why behind it and, more importantly, you'll have a 3 step plan to start losing that weight and feeling like yourself again.

Calories In/Calories Out

"You just need to burn off all the calories you eat. Then you'll lose weight! It's that simple."

As a woman in perimenopause or menopause, have you ever heard something like that? Maybe a doctor has even said something along those lines to you.

Conventional wisdom completely buys the concept of calories in, calories out, when it comes to weight loss. We've been taught this since we were kids that it's a simple equation. Burn more than you eat and lose weight.

If that advice has not worked for you . . .

"You must not be doing it right."

"Are you cheating or not really exercising, or sneaking some candy or cake or cookies on the sly?"

"You simply don't have the willpower to lose weight."

How many people, especially women, do you know who have tried this method of weight loss? How many of them have been successful at it?

Sure, you can eat like a bird and exercise like an Olympic athlete 2 hours a day, 6 days a week. You can literally starve yourself and eat nothing but lettuce and celery with water. Stay away from sugar and starch and bread and pasta. You might lose a few pounds. Some people can make a sustainable habit of that kind of life and get to their target weight. But not very many of us can succeed. The weight goes off, then comes right back in a few weeks . . .

Voices in your head - parents, spouse, friends, maybe even your doctor - tell you that you have to burn more calories than you eat. But your experience tells you that just doesn't work.

"Out of nowhere . . ."

Here are a few quotes from my surveys of women in menopause. Many of them say they've gained 5, 10, even 20 pounds or more from "out of nowhere."

I'm in menopause, but only symptom I seem to have with that is unexplained weight gain. I've spent months researching, changing up my diet, changing how I eat and when I eat, and nothing seems to help. I'm a firm believer that it's my hormonal imbalance but not sure how to fix it.
I am a 53 year old Fitness Trainer & nutritionist. I prepare my meals in advance with controlled calories, controlled carbohydrates and containing no sugar. I eat protein, fibrous carbs & healthy fat. I also exercise and am active with my clients on a daily basis. I have never had a weight problem, actually have been under weight a majority of my life. In spite of all of my healthy living, I continue to gain weight and am tired. I have gained 20 pounds.
I have gained a great deal of weight and I am not sure what all this is from.
I never had a weight problem until the hysterectomy.
I have put on weight especially my mid section where I have usually never carried weight before.
Since starting menopause 3 yrs ago, I've gained 50+lbs. Nothing seems to help, diet or exercise.
The [worst issue is] weight gain and the boating or feeling of water weight. I have gained 20 pounds and I eat a clean diet and all the information out there says to eat a clean diet and exercise, yet I continue to gain and the bloating is the worst, especially at night.
Weight gain and how to get rid of the extra pounds gained.  I have no appitite and when I do eat it is junk food, My weight gain is around my middle aka belly fat, HELP!!'
Gaining weight 30lbs this year cannot lose weight.
Unstoppable weight gain. 58 years old 50 lbs in less than a year. Tried WW, Atkins, nutritionist, personal trainer, boot camp, Nutrisystem, all organic clean, paleo nothing works.

Weight Gain: It's Not Just You!

If you're near menopause, maybe you recognize yourself in some of these stories?

It doesn't take a randomized clinical trial to recognize that weight gain around menopause is very real. In addition to being painful, it's frustratingly difficult to do anything that makes a difference.

Calories in/calories out is simply not the whole story. Menopause weight gain is about hormonal control of your metabolism and your weight.

For a more in-depth discussion about the "hormone theory of obesity," I'd strongly recommend a book by Dr. Jason Fung called The Obesity Code [affiliate link]. I also reviewed the book on my YouTube channel.

Perimenopause Patterns

Most commonly, women gain weight between age 40 and 50. What that looks like is usually increased belly fat or a larger waistline. As I've alluded to, it often comes on suddenly, within a year or so. It also just doesn't want to leave. No matter what you try with diet and exercise, nothing seems to make a difference. For many women, making diet and exercise adjustments have been the key to losing weight in the past. Only now it's not working.

3 Hormones and Menopause Weight Gain

Three specific hormones are involved in menopause weight gain, whether that starts before or after menopause. All three of these hormones make dramatic shifts, 1 gets high and 2 go too low, in your mid-to-late 40s. After that, these same 3 hormones continue to affect your weight through menopause.

  • Low Thyroid - Thyroid influences every system in your body. This is especially true when it comes to your metabolism and weight gain. Low thyroid levels mean you'll burn less energy, no matter how much you try to exercise.
  • High Insulin - Insulin is a crucial hormone that moves glucose (sugar) from your blood into your cells. But over time, your body can start ignoring the message that insulin is trying to tell it. That leads to something called "insulin resistance." Insulin resistance can lead to weight gain and type 2 diabetes. The loss of estradiol at menopause makes you more likely to develop insulin resistance.
  • Low Estradiol - During perimenopause, estradiol can be unpredictable. That means it jumps all over the place, very high one day and very low the next. After menopause though, your estradiol levels drop to almost zero. That very low level of estradiol is one of the major reasons for post-menopausal weight gain.

There Is Hope for Menopause Weight Gain

Even though it may seem like a lost cause, there are some steps you can take that will make a difference in perimenopause or menopause weight gain. As you may have guessed, those steps are all about getting your hormones optimized. By that I mean getting your thyroid, insulin, and estradiol to levels that aren't too high or too low but they're just right.

Optimal hormone levels are not the same as "normal" hormone levels. Normal levels are usually age-adjusted. They're the same as the levels of every other woman in menopause who is also feeling frustrated by weight gain, overwhelmed by hot flashes, and is snapping at her husband and kids. Optimal hormone levels are the ones that eliminate all your menopause symptoms and reduce your long-term health risks at the same time.

Step 1

The first step in getting your hormones optimized and working toward losing that menopause weight is to request a referral to a hormone optimization specialist. I know lots of physicians, nurse practitioners, and physicians' assistants, all over the US who know how to help you get optimal hormone levels. Click this link to go to my patient referral page and I'll check for a provider near you. I can't guarantee anything, but I'll give it a go.

Step 2

The second step is to actually get your thyroid, insulin, and estradiol optimized.

That looks like your provider checking your thyroid levels and getting them up to where they need to be. Thyroid comes in 2 forms, T3 and T4. Some doctors don't pay attention to both and that's a mistake. Make sure your provider checks and adjusts both.

You'll want your provider to look at your insulin and something called HOMA-IR. That's a score that shows how insulin sensitive or resistant you are. In addition, your fasting blood glucose and something called Hemoglobin A1C are both important for your provider to look at. Both of these numbers contribute to insulin resistance. The ultimate goal is that you become more sensitive to insulin. Insulin sensitivity helps with weight gain.

In the video, I focus on some specific steps that help you optimize your insulin. These include:

  • Reduce carbohydrates - especially sugar
  • Get more and better sleep
  • Stop snacking - fast between dinner and breakfast

If you're still in perimenopause, some providers won't want to mess with your estradiol, because it's too unpredictable. After menopause though, they will probably want to prescribe estradiol. Estradiol is the single most effective hormone treatment for hot flashes, mood swings, and . . . weight gain.

Step 3

The last step is to do what you can with diet and exercise and see if optimal hormones make a difference. I can honestly say that I've talked with hundreds of women who have had their hormones optimized. I can't think of a single one who hasn't seen a dramatic difference, specifically with weight gain, after getting her hormones right.

What's Your Menopause Weight Gain Story?

Drop a comment below if you've struggled with menopausal weight gain. I'd love to hear how you do, both before and after getting your hormones optimized. Thanks for watching!

Steve Goldring
Author: Steve Goldring

I'm here to help with easy-to-understand patient education resources for both patients and healthcare practitioners. I save providers time in getting patients up to speed. I also love matching patients who need help with experienced hormone optimization practitioners.

About the Author

I'm here to help with easy-to-understand patient education resources for both patients and healthcare practitioners. I save providers time in getting patients up to speed. I also love matching patients who need help with experienced hormone optimization practitioners.

  • Hello- I understand that thyroid, insulin and estrodial all can be involved with weight gain during peri menopause and menopause. I have read that fat cells can produce a type of estrogen as the body struggles to achieve homeostasis during the loss of its estrogen. This is also a reason for the weight gain. Is this a fact or is it wrong.

    • Thanks for asking Susanne! You’ve got it right that there are (at least) 3 hormones involved in perimenopause and menopause weight gain. It’s also true that fat cells CAN produce some estrogen, although not nearly as much as the ovaries, which are either sputtering during perimenopause or completely shut down in menopause. I would say the estrogen produced in fat cells is probably a very minor factor in weight gain. It’s unlikely to have much effect either way. The biggest factor is the loss of estrogen that happens around menopause. Losing estrogen usually leads to at least some weight gain. The loss of estradiol increases insulin resistance, which will raise insulin and cause weight gain. Thyroid issues are a problem around the same time, although it’s not clear that they’re caused by loss of estradiol.

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    Patients: Find help with your hormones

    I have relationships with hundreds of hormone optimization specialists, all over the US and some in other countries. I can't guarantee that I know providers in your area, but I'll give it my best shot . . .