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Perimenopause Weight Gain

Updated: May 5

Perimenopause is a phase marked by hormonal fluctuations leading up to menopause. As we transition through this phase many of us may experience changes in our body composition. Indeed, studies show that perimenopause is associated with an increase in fat mass and waist circumference and a decrease in muscle mass.While these changes are common, understanding the underlying contributory factors and adopting strategies to address these factors can help us to achieve our weight goals.

Caroline Farrell Menopause Nutritionist

Factors that Contribute to Perimenopausal and Menopausal Weight Gain

Hormonal Fluctuations

One of the key factors that contribute to weight gain in perimenopause and menopause are the hormonal shifts occurring within the body. Oestrogen and progesterone levels begin to decline. Oestrogen influences where fat is stored in the body. Higher oestrogen levels tend to promote fat storage in the hips and thighs, while lower oestrogen levels may shift fat accumulation towards the abdomen. This redistribution of fat can result in an increase in visceral fat, the type of fat stored around the organs in the abdominal cavity, contributing to a larger waist circumference.

Oestrogen also plays a role in appetite regulation and satiety signals. Lower oestrogen levels may disrupt these signals, leading to increased hunger and cravings, especially for high-calorie, carbohydrate-rich foods.

In additional, oestrogen helps regulate insulin sensitivity, the body's ability to respond to insulin and control blood sugar levels. Declining oestrogen levels may lead to reduced insulin sensitivity, increasing the risk of insulin resistance. Insulin resistance can promote fat storage, especially in the abdominal area.

Declining Metabolic Rate

Metabolic rate naturally declines with age, a process further accelerated by the hormonal changes of perimenopause. This decrease in metabolic rate makes it easier to gain weight and harder to lose it.

Declining Muscle Mass

With age and hormonal changes, there is often a decline in muscle mass and strength. This loss of muscle mass is called sarcopenia. Muscle mass is metabolically active tissue, meaning it burns more calories at rest compared to fat tissue. As muscle mass decreases, metabolic rate can decline, making it harder to maintain or lose weight.

Lifestyle Factors

While hormones play a significant role, lifestyle factors also influence weight changes during perimenopause and menopause. As stress levels mount and responsibilities increase, we often find ourselves reaching for comfort foods. Poor sleep is also common and can disrupt the balance of hunger hormones, leading to an increase in ghrelin (which stimulates appetite) and a decrease in leptin (which signals satiety). This imbalance can result in increased hunger, cravings for high-calorie foods, and overeating, ultimately contributing to weight gain.

Factors that May Reduce Perimenopausal Weight Gain

Eat more Plants

Eating more plant-based can support weight loss in perimenopause and menopause. Examples of plant-based foods are fruits, vegetables, whole grains, nuts, seeds, beans, and other pulses. These foods are high in fibre which can keep you fuller for longer. Fibre is also a food sources for healthy bacteria in the gut.These bacteria play a key role in osteogen balance in the body.

Also, many plant foods also contain compounds known as “phytoestrogens”. Phytoestrogens are very similar to human oestrogen. If eaten regularly, and in sufficient quantities, they can start to have mild oestrogen-like effects.  Some particularly rich sources of phytoestrogens include soya-based foods such as tofu, tempeh, miso, edamame beans and soya yogurt (opt for unsweetened ones) and ground flaxseeds.

Increase Protein

Including an adequate amount of protein in your diet can help preserve muscle mass, which is important for maintaining metabolic rate and promoting fat loss. Additionally, preserving muscle mass can help prevent age-related muscle loss. Protein also keeps you feeling full and satisfied after meals. Including protein-rich foods in your diet can help control appetite, reduce cravings, and prevent overeating. Aim to include protein with every meal and snack. Good options include chicken, fish, shellfish, eggs, Greek yoghurt, soya yoghurt, cottage cheese, tofu, tempeh, pulses, nuts and seeds (and their butters).


Drinking water may reduce bloating, a side effect of hormone fluctuations. Also, drinking water before a meal can help you feel full quicker and may increase your metabolism.


Practice Portion Control

Pay attention to portion sizes to avoid overeating. Also, try to practice mindful eating by savouring each bite and listening to your body's hunger and fullness cues.

Manage Stress

Incorporate stress-reducing practices such as mindfulness, meditation, deep breathing exercises, or yoga into your daily routine to help manage stress levels and reduce the likelihood of emotional eating.

Stay Active

Engage in regular physical activity, including aerobic exercise, strength training, and flexibility exercises. Exercise not only helps burn calories but also supports metabolism, muscle maintenance, and overall well-being.

Prioritise Sleep

Aim for adequate and quality sleep each night, as poor sleep can disrupt hunger hormones and metabolism, leading to weight gain. Establish a regular sleep schedule and create a relaxing bedtime routine.

The Bottom Line

In summary, perimenopause can affect weight through multiple physiological and lifestyle factors, including hormonal changes, metabolic rate, muscle mass, physical activity, insulin sensitivity, and psychological factors. However, adopting a holistic approach to addressing these factors through diet and lifestyle can play a key role in support weight loss in perimenopause.

Feel free to get in touch if you would like a bespoke plan to support your weight goals in perimenopause and menopause.




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