Perimenopause – the transitional period before menopause – brings with it a whirlwind of hormonal changes that affect more than just mood. Many women notice extra pounds creeping on, and it can feel frustratingly resistant to all the strategies that used to work. This unique and stubborn weight gain is common, but there are practical, sustainable steps you can take to navigate it. Spoiler: it certainly doesn’t entail tortuous calorie restriction.
In this guide, we’ll explore why weight gain happens during perimenopause and share straightforward strategies for maintaining a healthy balance.
Why Does Weight Gain Happen During Perimenopause?
Perimenopause is marked by low levels of progesterone, coupled with wildly fluctuating oestrogen levels in the early stages, followed by declining levels in the latter stages of the transition. This shift can seriously affect body composition – on top of a host of other symptoms! Women typically see an increase in fat mass, especially around the abdominal area (the so called “meno belly”) and a decrease in muscle mass. Some of the main factors contributing to weight gain in perimenopause are:
- Changes in energy metabolism: Because oestrogen is involved in energy metabolism, declining levels over the menopausal transition impact the way a woman’s body metabolises fat. The result can be an expanding waistline and newly raised “bad” cholesterol and or triglyceride levels.
- Insulin Sensitivity: Oestrogen is insulin-sensitising, so declining levels over the menopausal transition mean our bodies become more insulin resistant, less able to handle sugar in a healthy way – and more likely to store fat. Explore how insulin resistance affects weight with Harvard Health.
- Increased Hunger: Sex hormone fluctuations can impact appetite. For instance, hunger hormone ghrelin is higher in perimenopausal women, compared with pre/post menopause.
- Loss of muscle: Partly a natural consequence of ageing, partly the result of perhaps a more sedentary lifestyle and different dietary habits, sarcopenia (the medical name for loss of muscle) is a problem. Not only is muscle wasting associated with numerous chronic diseases, frailty and worse quality of life, but a reduction in basal metabolic rate (the energy we burn just existing) goes down, making weight gain more likely.
- Poor sleep: Sleep issues like frequent waking, waking at 2am unable to get back to sleep (hint: look at blood sugar balance!) and night sweats are often part and parcel of the perimenopause journey, leading to poor sleep quality. In fact, 39–47% of perimenopausal women experience poor sleep and this is one of the three most reported symptoms among my clients. Lack of sleep can elevate cortisol levels, worsen blood sugar control and lead to less than ideal food choices (relying on sugar, caffeine and other pick-me-ups to get though the day sound familar?) Read more about sleep and menopause at Mayo Clinic.
- Reduced Physical Activity: As energy levels fluctuate, it’s common to feel less motivated to exercise, which compounds the issue.
Understanding these factors sets the stage for taking control of weight management during perimenopause. It’s about aligning with the body’s changing needs rather than working against them.
1. Prioritise a Whole Food, Minimally Processed Diet
Focusing on nutrient-dense foods can help balance hormones and support overall health. Here’s how to craft a diet that complements the body’s changing chemistry:
- Embrace Protein-Rich Foods: Proteins like fish, legumes, and lean meats are essential for maintaining muscle mass, which can naturally decline during perimenopause. See how to boost protein in your diet with Menopause Matters.
- Incorporate Healthy Fats: Avocados, nuts, seeds, and olive oil are rich in omega-3 fatty acids, which support hormone balance and reduce inflammation.
- Whole Grains and Fibre: Whole grains such as quinoa, brown rice, and oats, along with fibre-rich vegetables, help stabilise blood sugar levels, managing insulin sensitivity.
By prioritising these foods, you can avoid the common pitfalls of refined carbs and sugars, which are known to contribute to weight gain.
2. Make Movement a Non-Negotiable
Exercise is not just about burning calories—it’s about building strength, improving mental health, and balancing hormones. The key is to integrate enjoyable, sustainable physical activity into your daily life.
- Strength Training: Building muscle is particularly beneficial during perimenopause. Incorporate weights or resistance bands to help maintain muscle mass, which supports metabolism. If you can’t access a gym or PT, I recommend Joe Wicks Menopause Workouts or similar on YouTube to do in the comfort of your own home.
- Low-Impact Cardio: Walking, swimming, or cycling can improve cardiovascular health without over-stressing joints. Discover the benefits of exercise during menopause at Cleveland Clinic.
- Mind-Body Exercises: Practices like yoga and pilates reduce cortisol levels, helping counteract weight gain linked to stress. If you can join an in-person group, the socialisation brings with it additional benefits!
The goal here isn’t punishing workouts; it’s finding ways to keep the body moving regularly. Consistency is more valuable than intensity.
3. Support Your Gut Health
Our gut health directly impacts weight regulation and overall wellness, especially during perimenopause when digestion can slow down. Keep your gut thriving with these tips:
- Probiotics: Foods like yoghurt, kefir, and sauerkraut are packed with probiotics, which foster a healthy microbiome.
- All the fibre: A high fibre diet, rich in a diverse range of plant foods such as leafy greens, berries, beans, nuts and whole grains is the absolute best way to support your “good” gut bugs. A diverse microbiome helps promote healthy blood sugar and lipid levels and reduces unhealthy inflammation.
- Stay Hydrated: Water is crucial to gut function and general health. Dehydration can lead to slower digestion and, by extension, weight gain.
Fostering gut health can enhance nutrient absorption and improve metabolism, both of which support weight management.
4. Address Stress with Self-Care
Chronic stress elevates cortisol levels, which encourages the body to hold onto fat. Managing stress is essential for maintaining a healthy weight and overall well-being during perimenopause.
- Mindfulness Practices: Meditation and deep-breathing exercises reduce cortisol levels and can be integrated into your day for a quick mood lift.
- Prioritise Restorative Sleep: Lack of sleep impacts cortisol and insulin levels, so consider developing a consistent, calming bedtime wind-down routine.
- Limit Stimulants: Caffeine and alcohol can disrupt sleep and exacerbate stress, so switch to decaf or herbal teas after 2pm.
By taking time for self-care, you’re not only addressing stress but also creating a foundation for sustainable weight management.
5. Consider Working with a Health Professional
Perimenopause is complex, and a health professional can provide personalised support for diet, exercise, and hormone management.
- Nutritional Guidance: A Registered Nutritional Therapist can help develop a bespoke plan tailored to your unique body’s changing needs. Book your FREE Discovery Call here.
- Hormone Therapy: In some cases, hormone replacement therapy (HRT) may be an option alongside nutrition and lifestyle changes, so chat to your GP is you feel you may benefit.
- Mental Health Support: Perimenopause can also bring mood changes, so working with a therapist can provide invaluable emotional support during this transition.
With professional guidance, you can find a comprehensive approach to wellness that fits your lifestyle.
Final Thoughts: Embrace the Changes
Navigating weight gain in perimenopause can be challenging, but it’s also an opportunity to reset and prioritise health in new, empowering ways. By understanding what the body needs and adapting to those changes, you can manage weight gain sustainably and embrace this unique phase of life with confidence.
Remember, perimenopause is a journey—not a sprint. With the right tools, you can make it a positive one.
