Menopausal Weight Gain (And How to Lose It)
As you get older and move through menopause, you may notice that staying at your usual weight is harder. Even if you’re eating the same foods and exercising the same amount as you usually do, your clothes may start feeling tighter and the number on the scale may start creeping up.
It’s fairly common for people to gain weight as menopause starts. According to the Mayo Clinic, many women gain around a pound or so a year as they move through their 50s. A 2024 study reported that women ages 40 to 65 gained about 1.5 pounds per year. The same study found that women ages 40 to 75 gained more body fat than younger and older women.
Why does menopause cause weight gain?
Changes in estrogen levels are a big — but not the only — culprit. Aging, sleep, and lifestyle factors, including sitting more and being less active, also play a role. You’re also a product of your genetics. If your parents or other close relatives carry extra weight, it’s likely you will, too.
Changes in estrogen levels
Weight gain is usually highest in the years leading up to menopause, called peri-menopause. During peri-menopause, estrogen levels are dropping, but you still have a period, though it may be irregular. The changes in estrogen levels, whether caused by natural menopause or menopause caused by treatment, can cause your weight to increase rapidly. They also make it more likely for you to gain weight around the belly, rather than the hips and thighs — also known as “menopause belly.”
Aging
Many people lose muscle mass and gain fat as they age. Muscle burns more calories than fat. So when you lose muscle, your body burns calories more slowly. If you’re burning fewer calories, you’ll probably start to accumulate more fat. At the same time, most people are less active as they get older. Sitting more and moving less also burns fewer calories.
Sleep and stress
Menopause can also disrupt your sleep, especially if you’re having night sweats. And not getting enough sleep can increase your risk of gaining weight for several reasons. A 2022 study found that people who slept less than 6.5 hours per night ate more calories and gained more weight than people who slept longer. Not getting enough sleep can increase levels of the hormone ghrelin, which stimulates your appetite, and decrease levels of the hormone leptin, which makes you feel full. Changes in these hormones can make you feel hungry and eat more. The study also found that people who didn’t get enough sleep were more likely to eat foods high in carbohydrates and fats, which can lead to rapid weight gain.
Menopause can affect your mental health, too. Changes in hormone levels can cause you to feel anxious and stressed. Stress increases levels of cortisol, another hormone. High cortisol levels also can increase your appetite.
Risks associated with weight gain
Menopausal weight gain is linked to a higher risk of many health problems, including:
breast cancer and other types of cancer
lymphedema, if you’ve been diagnosed with cancer
type 2 diabetes
sleep apnea
osteoarthritis
Does menopause weight go away?
Research suggests that at some point when someone is post-menopausal, weight gain slows and stops. But the weight that was gained during menopause doesn’t magically go away. Losing it requires taking steps that may include exercising more, making changes to your diet, and possibly taking medicine.
How to lose menopausal weight
Most experts agree that basic weight loss strategies can help you lose menopausal weight.
Exercise
All types of exercise can help you lose weight. Exercise, especially resistance training with weights or bands, helps you gain muscle. Muscle burns more calories than fat, so the more muscle you have, the more calories you burn.
Exercise also can ease certain menopausal side effects, including hot flashes. And regular exercise also helps you sleep better, which may help you lose weight.
According to Monica Christmas, MD, director of the Center for Women’s Integrated Health at the University of Chicago, the best exercise for losing menopausal weight is exercise that you’ll do. If you hate running, it’s unlikely that you’ll be able to motivate yourself to go for a run three or four times a wek. Pick something you like to do and try to do it for about 30 minutes a day, five days a week. And remember, you don’t have to do all 30 minutes at once. You can do 5-to-10-minute bursts of exercise throughout the day. Any type of physical activity counts because doing something is better than doing nothing. If you have mobility issues from treatment, some options are sitting in a chair and squeezing your glutes or lifting soup cans over your head for five minutes.
For adults, experts recommend 2.5 to 5 hours of moderate-intensity activity, 75 minutes of vigorous-intensity activity, or a combination of both per week. Moderate-intensity activity includes brisk walking, yoga, dancing, playing basketball, raking leaves or gardening, or riding a bike at a medium pace. Vigorous-intensity activities include running, hiking uphill or with a heavy backpack, riding a bike at 10 mph or faster, jumping rope, playing singles tennis, or doing heavy yardwork, like digging holes or hoeing weeds.
Make changes to your diet
Even if you’ve eaten the same basic way your entire life, you may need to change your diet to lose menopausal weight. This is because menopausal weight gain is mainly fat, which burns fewer calories than muscle.
Experts at the Mayo Clinic say women might need about 200 fewer calories a day during their 50s than they did during their 30s and 40s. This is especially true if you’re less active than you were in your 30s and 40s.
Many registered dietitians recommend a nutrient-dense diet that includes a lot of vegetables and lean protein, like chicken, fish, tofu, and beans. (Soy foods are safe for people who've had breast cancer.) They also recommend limiting foods high in sugar, salt, and trans fats (hydrogenated vegetable oils). Many ultra-processed foods — foods that contain high-fructose corn syrup, artificial flavors and colors, and preservatives — are also high in sugar and trans fats and very low in nutrients.
Avoid alcohol
Alcohol increases the risk of breast cancer, is full of empty calories, and contains few nutrients. Alcohol also can increase feelings of hunger and food cravings and lower your ability to resist those food cravings. This can make you more likely to make poor food choices and eat more food when you’re drinking.
Skip sugar
You may be eating more sugar than you think. A number of processed foods have what’s called added sugar: sugars and syrups that are put into foods when they’re prepared or processed. It’s estimated that added sugars make up nearly 300 calories a day in the average American diet. Sugar-sweetened drinks, like sodas, juices, energy drinks, flavored waters, and sweetened coffee and tea make up a large portion of these empty calories.
Ask about GLP-1 medicines
GLP-1 medicines include Ozempic (semaglutide), Trulicity (dulaglutide), Victoza (liraglutide), Mounjaro (tirzepatide), Wegovy (semaglutide), and Zepbound (tirzepatide). GLP-1 stands for glucagon-like peptide-1, a hormone that’s made by the small intestine. GLP-1 does several things in the body, including triggering the pancreas to release insulin, slowing the time it takes your stomach to empty, and increasing feelings of fullness, or satiety, after you eat. GLP-1 medicines work by mimicking the GLP-1 hormone and causing more of the same effects.Because GLP-1 medicines make you feel full faster and longer, you aren’t as hungry and eat less. This combination helps many people lose weight.
Although GLP-1 medicines seem miraculous, they do have risks and cause side effects. Nausea, vomiting, diarrhea, and constipation are common side effects. The drugs also can cause dizziness, headaches, and elevated heartbeat.
Listen to the episode of The Breastcancer.org Podcast featuring Neil Iyengar, MD, explaining how GLP-1 drugs work and what people with breast cancer need to know about them.
How does HRT affect weight?
Menopausal hormone therapy, also called hormone replacement therapy or HRT, can help ease hot flashes, mood swings, sleeping problems, and vaginal dryness and other genitourinary syndrome of menopause symptoms. Managing all these symptoms can make it easier for people to make lifestyle changes, like eating more nutrient-dense food and exercising more, which can help with weight loss. But HRT by itself won’t make you lose weight.
If you have a history of breast cancer, it’s a good idea to talk with your doctor about HRT because the risks and benefits vary greatly from person to person.