Are You Destined to Gain Weight During Perimenopause?

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.