Weight Management in Perimenopause & Menopause

Evidence-Based Strategies for Weight Management in Perimenopause & Menopause

Many women notice changes in their body composition during perimenopause and menopause, often experiencing weight gain, increased abdominal fat, and difficulty losing weight despite maintaining their usual habits. This isn’t just about “slower metabolism” or “eating less and moving more”—hormonal shifts, changes in insulin sensitivity, muscle loss, and inflammation all contribute to how the body regulates weight during this transition.

Understanding these biological changes can help women take an evidence-based approach to weight management that supports overall metabolic health rather than focusing on restrictive dieting.

Why Does Weight Gain Happen in Perimenopause & Menopause?

Several key factors contribute to weight gain and fat redistribution during menopause:

• Declining oestrogen levels alter fat storage, shifting fat from the hips and thighs to the abdomen

• Reduced insulin sensitivity increases the body’s tendency to store fat

• Loss of lean muscle mass slows metabolic rate and makes fat gain easier

• Changes in appetite-regulating hormones (leptin & ghrelin) can increase hunger and reduce satiety

• Increased cortisol levels due to stress can promote abdominal fat storage

• Disrupted sleep impacts metabolism and hunger regulation

With these changes in mind, an approach that supports metabolism, blood sugar balance, and muscle preservation is key to managing weight during menopause.

1. Prioritise Protein to Support Muscle & Metabolic Health

Muscle is metabolically active, meaning the more lean muscle mass you have, the more energy your body burns at rest. Since muscle loss accelerates in menopause, prioritising protein is essential for maintaining metabolic health.

• Aim for 1.2–1.5g of protein per kg of ideal body weight per day

• Include protein at every meal & snack to support muscle repair and satiety

• Best sources: eggs, fish, poultry, tofu, legumes, Greek yoghurt, nuts, and seeds

Strength training combined with adequate protein intake helps maintain muscle mass and prevent metabolic slowdown.

2. Increase Fibre Intake to 25–30g Per Day

Fibre plays a crucial role in appetite regulation, gut health, and metabolic function. It helps:

• Improve insulin sensitivity, reducing midsection fat storage

• Support gut microbiome diversity, which influences metabolism and inflammation

• Increase satiety, reducing cravings and overeating

Best sources: vegetables, legumes, chia seeds, flaxseeds, berries, and whole grains.

3. Strength Train to Preserve Muscle & Improve Insulin Sensitivity

Resistance training is one of the most effective ways to:

• Prevent muscle loss and metabolic decline

• Improve bone density to reduce osteoporosis risk

• Enhance insulin sensitivity, reducing fat storage around the abdomen

Aim for 2–3 sessions per week, incorporating weights, resistance bands, or bodyweight exercises.

4. Balance Blood Sugar to Reduce Fat Storage

Hormonal changes in menopause can make the body more prone to insulin resistance, leading to higher blood sugar levels, increased cravings, and easier fat storage.

• Pair protein, fibre, and healthy fats at meals to prevent blood sugar spikes

• Reduce refined carbohydrates and added sugars

• Focus on whole, unprocessed foods to support stable energy levels

• Make sure you are eating regular meals to keep your blood sugar stable. Restrictive diets and long periods of fasting are likely to make weight loss harder.

Balanced blood sugar levels help reduce midsection weight gain and prevent energy crashes.

5. Prioritise Sleep & Manage Stress to Regulate Cortisol

Poor sleep and high stress increase cortisol, which promotes fat storage around the midsection and disrupts hunger hormones.

• Aim for 7–9 hours of quality sleep

• Reduce late-night screen time and caffeine after 12pm, which interfere with sleep quality

• Use breathwork, meditation, or gentle movement to manage stress

Better sleep and stress management help regulate metabolism and appetite hormones.

6. Support Gut Health for Hormonal & Metabolic Balance

The gut microbiome plays a key role in oestrogen metabolism, inflammation, and weight regulation.

• Include prebiotic & probiotic foods to support microbial diversity

• Eat a variety of plant foods to improve gut health and digestion

• Reduce highly processed foods, which can negatively impact gut bacteria

A well-balanced gut microbiome supports hormone balance, metabolism, and overall wellbeing.

7. Focus on Long-Term Metabolic Health, Not Quick Fixes

Weight management in menopause isn’t about extreme calorie restriction or quick fixes—it’s about supporting metabolism, muscle mass, and hormone balance.

• Prioritise protein and fibre for metabolic health and appetite regulation

• Strength train to preserve muscle and prevent metabolic slowdown

• Balance blood sugar to reduce cravings and abdominal fat storage

• Support gut health and stress resilience to improve long-term weight regulation

By focusing on science-backed strategies rather than restrictive dieting, women can navigate weight changes in menopause in a way that supports overall health and wellbeing.

If you need personalised support navigating menopause or the perimenopause transition please reach out or book an appointment here.