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Are You Destined to Gain Weight During Perimenopause?

a pear and an apple on a wood cutting board

You’re downward-dogging and green-juicing like usual, but suddenly your belly is bigger. Let us tell you what’s going on and what will help

“If you gain five or seven pounds, yes, it’s perimenopause. But 30 pounds? That’s something else.”

“I may be pushing 50, but I pride myself on my ‘cool girl’ wardrobe. I’ve spent a lot of time and a ton of money assembling,” says Brooke, 48, a shoe designer in Brooklyn, NY. “But now that I’m moving towards menopause, nothing fits! I’ve put on five pounds, and it’s all blubber around my middle.”

Relating? It’s extremely common for women to report weight gain as they transition from perimenopause, the time of declining hormone production (most notably estrogen), to menopause, the rite of passage that occurs when you have been period-free for a full year.

“Despite my usual yoga and Pilates routine,” says Kirsten, 50, of San Diego, “there’s definitely more of a roundness to my middle than, say, five years ago, when I was still menstruating regularly. I feel as if my body shape is morphing from a pear to an apple.”

A brown vase topped with a branch and loaves of bread.
Photo by Maria Leonova via Pexels

Why Perimenopause Can Put on the Pounds

Yes, not the happiest news, but don’t panic. According to Mary Jane Minkin, MD, a clinical professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the Yale University School of Medicine, a practicing gynecologist, and a North American Menopause Society Certified Menopause Clinician, “most of the literature says that the weight gain during the perimenopausal transition is five to eight pounds, without a drastic change in food intake or exercise.” While that’s not an insignificant amount, it’s heartening to know that double-digit gains are not be expected.

Another reason to be mindful of weight gain during perimenopause? Diet can influence what symptoms you may experience during menopause, says Kourtney Sims, MD, a board-certified gynecologist in Houston, TX and Phenology’s chief medical advisor. "For example, hot flashes can be exponentially worse for women with unhealthy BMIs," she says. "Our hormonal health benefits greatly from a diet rich in fruits and vegetables, essential fatty acids, fiber, and fermented foods."

Factors that Contribute to Weight Gain

As the years pass, muscle mass tends to diminish, which means fewer calories are burned. (Muscle tissue has a higher “burn rate” than fat.) If you don’t boost your level of physical activity, you may see the pounds add up.

Also, lifestyle issues come into play. You may join the insomnia club during perimenopause, and studies have found that insufficient sleep disrupts the hormones that regulate appetite and satiety. Ghrelin, the so-called hunger hormone, increases. At the same time, the body can become resistant to leptin, the chemical that signals to your brain to stop eating once you’re fulfilled. Sleep deprivation is also associated with growth hormone deficiency and elevated cortisol levels, both of which are linked to obesity.

Furthermore, lack of sleep can alter the way you metabolize your meals, plus cause you to crave calorie-dense, high-carbohydrate food. And the no-sleep stress doesn’t help with those food choices. (My friend Suzie refers to her nightly, can’t-sleep habit as “Netflix and Cheese n’ Crackers.”)

Those less-than-healthy eating habits are another factor in weight gain. Says Dr. Minkin, “If you gain five or seven pounds, yes, it’s perimenopause. But 30 pounds? That’s something else.”

Brooke of the sophisticated but too snug clothes struggles with this. “Now that I’m an empty nester, I don’t have that ‘cook healthy’ mandate on my mind,” she says. “I’m sick of cooking, so I have takeout pizza and Pad Thai on speed-dial.” As delicious, comforting, and convenient as those foods may be, they can contribute to weight gain. According to the Mayo Clinic, you probably need to shave about 200 fewer calories out of your daily intake when you are in your 50s to stay the same weight as you were a decade or two earlier.

Drinking is another path that can lead to additional pounds. And, given how the last few years have played out, it’s common for people to be having more wine or cocktails. “I used to only drink if we went out to dinner or a friend’s house,” says Kirsten. “But since the pandemic started, I am splitting a bottle of wine with my husband most nights.” Half a bottle of red is easily 300 calories.

How to Keep the Extra Pounds from Packing On

Burn, baby, burn. Build muscle mass, says Richa Mittal, MD, in Frisco, TX, and a Diplomate of the American Board of Obesity Medicine. This increases your metabolic rate, burns more calories even at rest, and helps with insulin sensitivity (meaning your body will be better able to regulate blood sugar levels). Need specifics? Do weight-bearing exercises a few times a week.

Fill up on fiber. “When we choose carbs with more fiber, like beans, lentils, edamame, fruit, and vegetables, you’ll feel fuller with less food and calories,” explains Dr. Mittal. And do your best to avoid the siren song of breads and baked goods. Research published in the British Journal of Nutrition reported that a reduced-carbohydrate diet may lower the likelihood of post-menopausal weight gain, so why not get a head start?

Keep your sweet tooth in check. Added sugars account for nearly 300 calories a day in the average American diet, says the Mayo Clinic. About half of these calories come from sugar-sweetened beverages. Maybe the next time you’re craving a latte, you skip the pumps of sugar syrup (or downshift to just one), and that big glass of juice would be a lot less caloric if it’s cut with seltzer.

Talk to a Phenology Coach. Get answers to your specific questions about nutrition, sleep, stress, movement and hydration by talking to a Registered Dietitian in the Phenology app. Connect via text-based chat to a Phenology Coach, who are all real live RDs trained in menopause-related topics. Download the Phenology App to get started.

Try tai chi. Here’s why: A study in the Annals of Internal Medicine found that people age 50-plus with weight focused in the belly area shrank their middles by doing tai chi for three months as well as those who did aerobics and strength training for the same duration.

Janet Siroto
Janet Siroto is a writer and content strategist specializing in lifestyle and wellness topics. She’s held senior editorial positions at Good Housekeeping, Vogue, Cosmopolitan, and other titles. She is also a trend tracker whose work has been presented on the main stage at SXSW, WSJ: The Future of Everything, Cannes Lions, and other summits.

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