How To Lose Weight During Menopause: Medical And Lifestyle Strategies

When you reach menopause, complex changes in your hormone levels can affect both your body shape and how your body processes and uses energy (your metabolism). [1] During this time, you may find that your body responds differently to diet and exercise. [2]

These changes may make you feel worried about weight gain, but understanding them is one of the best ways to know how to fuel and move your body during menopause, so that you can keep your weight loss journey firmly under control.

This article explains some of the things you can do to help reach your weight loss goals in menopause. We'll explore how both lifestyle changes and medical treatment options can help you navigate your journey.

Article summary:

• During menopause, complex hormonal shifts can cause changes to your metabolism and lead to weight gain.
• Making small changes to sleep, nutrition, and exercise can help support weight loss during the menopause.
• GLP-1 medications like Mounjaro and Wegovy may support your weight loss goals during menopause, if you're eligible.

How menopause affects your weight

If you’re struggling with your weight during menopause, you’re not alone. Menopause causes hormonal changes that alter how your body stores and burns energy. This shift affects more than just the numbers on the scale. It also impacts body shape (composition), blood sugar levels, and metabolism. [3] Here’s how:

Reduced oestrogen levels

As women approach menopause, oestrogen levels begin to go up and down, then reduce significantly. [4]

This is one reason why you might gain a little weight. Oestrogen plays a key role in regulating your metabolism and influencing where your body stores fat. When oestrogen levels go down, many women experience changes in fat distribution. Low oestrogen can cause a build up of visceral (stomach) fat that surrounds your internal organs. This can cause changes to your body shape, even if your overall weight doesn't change dramatically. [5]

Reduced oestrogen can also cause insulin resistance. This is a condition where your body's cells don't respond effectively to insulin any more, which makes it harder to regulate blood sugar and promotes fat storage, particularly in your abdominal area (tummy). [6] In addition to changing your body shape through fat storage, many women also experience a decrease in their overall muscle mass, with one systematic review showing women experiencing a drop of around 5.7% by the time menopause was completed, although a drop in oestrogen alone can’t be verified as the sole cause. [7]

Changes to metabolism

The decline in oestrogen has also been linked to a reduction in basal metabolic rate (BMR), which is the number of calories your body burns at rest. This means that even if you eat and move the same as before, your body may need fewer calories. This could contribute to weight gain during menopause. It’s also important to note that studies show that BMR is most influenced by what is known as your lean mass. Lean mass is what your bones, muscles, organs and body water weight, not your fat. If your lean mass decreases, the number of calories your body burns at rest will reduce anyway, regardless of changes in your hormone levels. [8]

Menopause can cause metabolic changes that can be linked to excess weight, greater sugar consumption, and worse sleep. [9] However, these may be lessened through lifestyle changes.

Lack of sleep

Poor sleep, often caused by hot flushes and hormonal changes, can further disrupt your metabolism. When you don't get enough sleep, it can affect hormone levels in your body. First, it can produce more cortisol, the stress hormone. It also increases levels of ghrelin (the hunger hormone), while reducing leptin (the fullness hormone). These fluctuations can lead to increased appetite and cravings. [10]

Increased appetite

There is evidence that women entering menopause may experience an increase in appetite. [11] This may make mindful eating [12] and portion control more difficult.

This can lead to eating more than you might intend to, and this could make it harder to maintain a healthy weight. It's important to understand this is due to body changes and not necessarily a lack of willpower. Treat yourself with kindness when managing appetite and eating habits during this period.

Lifestyle tips for menopause weight loss

Making small, sustainable lifestyle changes could help you feel more in control of your weight during menopause. These are the areas we recommend paying attention to.

A balanced, nutritious diet

A nutrient-dense diet is important for any weight loss journey, including during menopause. There's evidence that shows that following a Mediterranean diet (which is a mainly plant-based eating pattern centred on vegetables, fruit, wholegrains, beans, nuts, olive oil and fish, with moderate dairy and limited red meat and highly processed foods. [13] Focus on whole, unprocessed foods that provide sustained energy and support hormonal balance. Prioritise lean protein sources at every meal to promote fullness and maintain muscle mass.

Building strength

The NHS recommends adults aim to do at least 150 minutes of moderate-intensity exercise, spread over four to five days a week. [14]

Resistance training helps to preserve muscle mass, which is vital because muscle burns calories at rest. Greater fat-free mass is generally associated with a higher BMR, although the additional calories achieved from gaining muscle is usually modest. [15] Nevertheless, try to incorporate at least two to three resistance training sessions (you can do this exercise at home) per week to build and maintain muscle.

These activities can also help you maintain bone health, which can decline with oestrogen levels. [16]

Getting good quality sleep

Quantity and quality of sleep play an essential role in weight management during menopause. Menopausal hormonal changes can disrupt sleep patterns, leading to sleep trouble [17] and hot flushes. You can improve sleep quality by creating a comfortable sleep environment with a tidy room, deep stretching or meditation and lighting your favourite scented candles.

You could also try to:

• Use blackout curtains
• Take a warm shower or bath before bed
• Create and stick to a bedtime routine
• Reduce caffeine intake
• Limit screen time or late-night emails

Reducing stress and cortisol

Stress management techniques can help lower cortisol levels. Examples of these include: mindfulness, meditation, yoga, and spending time in nature. [18] Finding healthy outlets for stress can help break the cycle of stress-induced weight gain and support your goals.

What about hormone replacement therapy (HRT)?

HRT is a treatment that can help reduce menopausal symptoms by replacing oestrogen in your body. Research is mixed on whether this therapy can directly cause weight loss during menopause. One clinical study found a link between HRT and increased energy expenditure and insulin response. [19] However, another found that it had no direct effect on weight loss, although it did help redistribute abdominal fat to the waist and hips. [20] You can learn more about the effects of HRT on weight in this dedicated post.

GLP-1 medications and the menopause

Treatments such as GLP-1 medications like Mounjaro and Wegovy may support weight loss during menopause.

They work to promote weight loss in several ways. First, by slowing down how quickly food digests. This means food stays in your stomach longer, making you feel full and reducing overall food intake. GLP-1 medications also help stabilise blood sugar by promoting insulin release after eating. [21]

They also act on parts of the brain which control appetite, helping to reduce feelings of hunger. These combined effects can help reduce your caloric intake, which may lead to weight loss.

At MedExpress, we offer online consultations with regular clinical check-ins, and a range of weight loss treatments including Mounjaro, Wegovy Pen, Wegovy Pill and Foundayo and our team can help you find the right treatment for you.

References

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