Doctors Say This Is The Key To Avoiding Menopausal Weight Gain

Yahoo

10-02-2025

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There's been a lot of focus on perimenopause and menopause over the last few years and, frankly, a lot of the noise is scary. Cruise through social media and you'll see a ton of posts about how you're doomed to experience perimenopausal weight gain, with no hopes of ever seeing the number on the scale go down again.
But being proactive about menopause can make the transition period easier to manage and even empowering as you navigate through it, says Jessica Shepherd, MD, an ob-gyn in Texas and author of the book, Generation M.Weight gain is a common symptom that can happen during perimenopause, and it can be harder to lose weight as you get older, says Mir Ali, MD, medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California.
But it's not inevitable that you'll gain weight and not be able to lose it. Making small changes before you hit perimenopause across your diet, exercise routine, and overall lifestyle can help to set you up for success in the future, Dr. Shepherd says.
'The transition that is healthiest for menopause is one that looks at all the factors that impact our health over time,' she says. Meaning, the healthiest way to navigate menopause is to be the healthiest version of yourself in general.
Ali agrees. 'If you go into perimenopause and menopause at a healthy weight and maintain good habits, that will help prevent weight gain," he says.
Meet the experts: Jessica Shepherd, MD, an ob-gyn in Texas and author of the book, Generation M; Mir Ali, MD, medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA; Michael Snyder, MD, medical director of HCA HealthONE Denver Center for Weight Loss and bariatric surgery at Rose Medical Center and in-house obesity specialist at FuturHealth
Because living a healthy lifestyle is all about good habits, setting yourself up for success now will have a big impact on your future. Here's why weight management can be harder as you get into menopause, plus what you can do to reverse unwanted weight gain.
It's important to point out that you can gain weight during any phase of life, and that's probably something you're well aware of. But perimenopausal weight gain is slightly different.
During perimenopause, you're navigating a bunch of hormonal shifts (more on those in a sec) and that can mess with your ability to lose weight or even maintain your existing weight. While you're likely to gain weight during any phase of life if you start eating more than you did in the past or having more high-calorie foods, perimenopausal weight gain is different.
With perimenopausal weight gain, you may find that you gain weight by eating the same way you always have, and that it's harder to lose that additional weight than it was in the past, Dr. Ali says. While people gain weight differently, you may be more likely to gain it around your midsection when it's due to perimenopause, according to the Mayo Clinic.
There are a few things that happen during menopause that can make weight management more difficult. 'Women gain weight in this time of their life due to hormone shifts,' Dr. Shepherd says. That includes a drop in estrogen and an increase in the stress hormone cortisol, she says.
That increase in cortisol can impact how your body breaks down nutrients and may even encourage your body to store more fat, she says.
At the same time, you may also have a drop in your body's levels of testosterone, says Michael Snyder, MD, medical director of HCA HealthONE Denver Center for Weight Loss and bariatric surgery at Rose Medical Center and in-house obesity specialist at FuturHealth. Those hormonal shifts can impact how fat is broken down in your body, as well as where it's stored, he says.
To make things even more complicated, women tend to lose muscle mass and bone density during this time because of a combination of hormonal shifts and aging, Dr. Snyder says.
'That can make it easier to gain weight and harder to lose it,' he says. 'Factors like stress, sleep disturbances, and changes in activity levels can also contribute.'
All of the experts we spoke to recommended increasing your protein intake to combat perimenopausal weight gain. That's because protein helps support muscle mass, which can rev up your metabolism, Dr. Shepherd says. It also lowers the odds you'll lose muscle mass, which can help to support bone health as you get older, Dr. Ali says.
Protein is also filling, decreasing the risk you'll get hungry between meals and snacks and overeat, Dr. Ali says.
The exact amount of protein you need varies depending on other factors in your life. However, research suggests that people who are active need 1.2 to 1.5 grams per kilogram of protein to support tissue growth. That breaks down to about 30 to 35 grams of protein per meal for most people.
'Consider both plant and animal forms of protein,' Dr. Shepherd says. Meaning, poultry, eggs, beans, nuts—they're all on the menu.
Fiber isn't as hot a macronutrient lately as protein, but it's important. You can get fiber from foods that are traditionally viewed as "healthy," like fruits, vegetables, legumes, and whole grains.
Fiber can do a few things, and one is to support a good gut microbiome. 'As we age, the gut microbiome weakens and therefore fiber intake should increase,' Dr. Shepherd says.
Fiber is crucial for helping you to maintain a healthy weight, since it's filling and can help to regulate your blood sugar levels, lowering the chances you'll experience a blood sugar crash and feel hangry as a result, Dr. Shepherd says. Another perk: Fiber helps support good digestive health, i.e. it helps you poop.
Dr. Ali recommends trying to load up non-starchy vegetables like broccoli, cauliflower, cucumbers, and carrots, along with plenty of protein. Not only are vegetables packed with nutrients that can support your health as you get older, but they're also high in fiber and can help to fill you up, too, Dr. Ali says. Vegetables can also help to crowd out less healthy options from your plate.
Only about five percent of Americans get enough fiber, so having more of this macronutrient should be a goal. (Most women need to have at about 25 grams a day.) Just ramp up your fiber intake slowly—otherwise, you run the risk of dealing with uncomfortable bloating and gas.
While Dr. Ali says that weight management is largely about diet, he also stresses the importance of being physically active. Not only is exercise good for your overall health, it can help to maintain muscle and bone mass, he says.
The Centers for Disease Control and Prevention (CDC) recommends that everyone gets at least 150 minutes of moderate- to vigorous-intensity exercise every week.
Being active in any form is great, but weight-bearing exercises are especially good for bone strength, Dr. Shepherd points out. That's why it's good to have things like running, stair climbing, hiking, and dancing in the mix. Every person is different, but the CDC suggests aiming to do those 150 minutes of exercise a week (which can be broken down into 30 minutes, five days a week), along with two days of muscle-strengthening activity.
That basically breaks down to five days of cardio, with strength training in the mix, too.
This is something a lot of women are missing. As we just mentioned, the CDC currently recommends having at least two days of muscle-strengthening activity each week in your workout routine, and Dr. Shepherd says this is especially important as you near menopause—along with ramping up your protein intake.
'Make sure weight training is also a part of the increase in protein,' she says. 'As much as one can fit into a weekly routine is more important than none at all.' Why? It can help to build muscle mass and support the muscle mass you already have. 'If you lose muscle mass, you need fewer calories to maintain your weight,' Dr. Ali says. 'But increasing muscle mass can help.'
Not only can muscle mass support your bones and increase strength as you get older, it also helps keep your metabolism working well, he says.
Your body doesn't need added sugars, which are sugars that are added to foods. (Those are different from naturally-occurring sugars, which are found in things like fruit, by the way.)
Added sugars provide empty calories and can lead to weight gain, Dr. Ali points out. Not only that, sugar can be habit-forming, and eating a lot of added sugar now can make it tough to cut it out down the road.
The Dietary Guidelines for Americans recommends limiting calories from added sugars to less than 10 percent of your total calories per day. (So, if you eat a 2,000-calorie diet, that means having more than 200 of your calories from added sugars, or 50 grams.) But the American Heart Association (AHA) takes things a step farther, recommending that women have no more than 100 calories a day from sugar or 25 grams.
Dr. Snyder lists sleep as a crucial factor in lowering the odds of perimenopausal weight gain. Logging at least seven hours of quality sleep a night can do a few things for you.
One is that it can help you to wake up feeling refreshed, providing plenty of energy to do things like maintain your activity level and workout routine. Another is that it can help to control levels of the stress hormone cortisol in your body. You're also more likely to overeat when you're wiped out, making it important to get rest when you can, Dr. Ali says.
Unfortunately, the hormonal changes that happen in perimenopause and menopause can mess with your ability to get good sleep. But having a consistent exercise routine, eating a good diet, and limiting alcohol can help support good sleep, Dr. Shepherd says. (If you're really struggling, it's important to check in with a physician or sleep specialist to see if something else could be behind your sleep issues.)
Doctors stress that you're not doomed to gain weight in perimenopause and menopause. And, even if you notice the scale creeping up, it's still possible to lose it, Dr. Ali says. Taking up these habits now—even in your 20s and 30s—can help set you up for successful weight management down the road.
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