Menopausal Weight Gain: Why It Happens and What to Do About It

If you’re in midlife and struggling with weight gain—especially around the midsection—you are not alone. In my menopause practice, nearly every patient I see mentions this frustrating issue. One day, it’s as if a light switch has been flipped off in your metabolism. Suddenly, you wake up and realize you’ve gained five, ten, fifteen, or even twenty pounds seemingly overnight. If you haven’t experienced this, you’re the exception, not the rule—good for you!

Why Does Midlife Weight Gain Happen?

Hormonal changes, particularly declining estrogen levels, can contribute to weight gain, especially in the abdominal area. Muscle mass also naturally decreases with age, which slows down metabolism. Add to that the demands of life—stress, sleep disturbances, and changing activity levels—and it’s no wonder weight gain becomes such a common complaint.

What Can You Do About It?

When my patients ask me about weight loss, I tell them the same thing I do for myself. Weight loss medications may seem tempting, but they come with side effects and often result in weight regain once you stop taking them. Instead, I focus on practical, sustainable habits.

One tool I personally use and recommend is the Lose It! app, which helps track calories and create awareness around eating habits. While some argue that calories in, calories out is outdated, it remains a fundamental principle of weight management. In fact, this is exactly how weight loss medications help you lose weight—by reducing calorie intake.

My Approach to Sustainable Weight Loss

I set my goal to lose half a pound per week, which allows me to eat enough to avoid constant hunger while making mindful choices. For example, if I have to choose between chicken and steak, I’ll often opt for chicken because it’s lower in calories, giving me more flexibility throughout the day. Tracking my intake helps me make informed decisions, rather than eating mindlessly.

Your diet should be high in lean protein. I aim for 100g/day to help maintain muscle mass and support metabolism. Avoid processed foods and seed oils. Choose whole foods, organic, and non-GMO options whenever possible.

If you have a lot of weight to lose (more than 20 pounds), aiming for one pound per week initially may be a reasonable goal.

This is not to say that alternative diets such as intermittent fasting or the carnivore diet are not worth considering. These approaches work well for many people, and I encourage my patients to explore what best suits their bodies and lifestyles. The key is finding a sustainable way to lose weight and feel like yourself again—whatever method helps you achieve that is fine by me!

If you're curious about weight loss medications, we can discuss them during your visit. While they may be an option for some, I always emphasize lifestyle changes as the foundation of any long-term weight management strategy.

And just like most things in menopause, getting to where you feel like yourself again (your thinner self in this case) is more of a marathon rather than a sprint. Be patient and appreciate everything you are doing to improve your health and sense of well-being. Just reading this blog is a sign that you want to take great care of yourself and be as healthy as possible. As I always say, aging is a gift. Doing it well is a choice.

Ultimately, weight management during midlife isn’t about quick fixes—it’s about education, awareness, and making choices that support your long-term health. If you’re struggling with weight gain and want guidance tailored to your unique needs, I’m here to help and encourage you. We are in this together!

It is time to start living your best years now, and I would love to help you along the way.