I’m an Endocrinologist: Here’s What I Wish More Women Knew About ‘Weight Gain’ in Menopause
A menopause doctor explains the real reasons behind midlife weight gain in women—and it's not what you think
There’s no guide for menopause, no single type of “menopause doctor” you call to get answers when it shows up. And yet, menopause is a time that can be rife with new challenges and anxieties, and questions without clear answers—like “why am I putting on weight during menopause?”
One study showed that most women were “completely uninformed” or only had a bit of knowledge about menopause before age 40. They point to having to turn to websites and friends as their main source of information. Yet there’s a wealth of knowledge and advice that doctors hold, especially ones who help perimenopausal women every day.
Here, endocrinologist Beverly Tchang, MD, Associate Professor of Clinical Medicine at Weill Cornell Medicine in New York City and Ro advisor, shares the top questions she gets about putting on weight during menopause and her advice on how to feel your best while staying healthy.
Woman's World Answers
Am I definitely going to put on weight during menopause?
No, that’s not how it works at all, Dr. Tchang shares. In fact, she calls the term “menopausal weight gain” a misnomer. Instead, research points to physical changes that can cause an increase in fat mass and a decrease in lean mass, but it doesn’t necessarily mean you’ll actually gain weight.
“Menopause actually varies quite a bit from one person to the next; some women gain weight while others don’t at all; some women never experience hot flashes while others have them for 10 years,” she says. So, don’t head into menopause feeling doomed to put on extra weight no matter what.
How do hormones impact weight gain?
Dr. Tchang shares that if a woman puts on weight in menopause, the cause varies. “Some women experience increases in hunger and food intake as estrogen levels fluctuate, as estrogen has been shown to suppress appetite in animal studies,” she says. “A small reduction in energy expenditure, such as a slower metabolism, also likely plays a role.”
She adds that you shouldn’t forget about the connection between sleep and maintaining a healthy weight. “About half of women also have undiagnosed sleep disorders in midlife, and disrupted sleep may further affect hormones that affect appetite and metabolism.”
While some women turn to hormone therapy, thinking it will help them lose weight, she says it does not significantly minimize weight gain. “There might be a small effect on minimizing fat mass gain, but only by a difference of two pounds over five years.”
How common is it to put on weight during menopause?
“Research shows that weight gain may be ethnicity-specific, with white women gaining about 0.5 percent per year, a rate that does not significantly change before, during or after menopause. In other words, the weight changes during menopause are actually due to general aging alone, not from menopause in particular,” Dr. Tchang shares. Women who are Black, Chinese or Japanese, on the other hand, tend to gain less or maintain their weight—some women even lose weight.
That said, Dr. Tchang estimates that women’s fat mass changes more than their body weight, as women may gain up to two percent fat per year during perimenopause. Anecdotally, many of us tend to notice this weight gain around our abdomen, hips or thighs, hence the term “menobelly.” (Discover Denise Austin’s top tips for getting rid of belly fat.)
How to prevent—or reverse—menopause weight gain
If you don’t already have a doctor you trust who takes your concerns seriously, you can find a menopause doctor at Menopause.org. Having a medical professional who can guide you through the best way to ease menopause symptoms based on your unique needs and concerns is your best starting point. Also smart: Following the menopause weight gain prevention essentials, such as eating a healthy diet, getting regular exercise (like brisk walking) and prioritizing sound sleep.
As for Dr. Tchang, she recommends the following strategies:
Know that you didn’t do anything wrong
Menopause weight gain is very normal. But, that doesn’t mean you have to be okay with it, and your physician might not be either—“normal can still be problematic [for your health],” Dr. Tchang shares. “It’s up to the woman and her healthcare team to decide whether it needs to be addressed.”
Consider GLP-1s
Tchang says sometimes GLP-1s are helpful to prevent putting on weight during menopause. Other times, you or your doctor might want to talk about “nutrition, physical activity, biology and hormonal changes, and what might be the next step in prevention and treatment,” she adds.
Skip unregulated supplements
What you should not do, Dr. Tchang says, is turn to untested and unregulated supplements that might actually make menopause symptoms like weight gain worse. “Some supplements may have hidden ingredients, like steroids, that feel good in the short term but cause diabetes, bone loss and weight gain in the long term.”
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