Weight gain is common during menopause, but there are ways to manage it sustainably. Dr. Shilpa Amin offers her professional advice, including eating a balanced diet, getting enough exercise and sleep, and relieving stress.

Menopause isn’t a health condition but rather a natural stage in life that millions of people worldwide reach every year.

But for such a common milestone, the discourse about it is minimal. We at Healthline aim to change this, which is why we recently asked Shilpa Amin, MD, CAQ, FAAFP, about weight management strategies during perimenopause.

A note on wording

Perimenopause refers to the years leading up to menopause, which can last anywhere from 2 to 8 years (and sometimes more or fewer years). You’ve reached menopause after going 1 year without a period.

Weight gain during perimenopause and menopause is common in at least 60% of women.

On average, women report a weight gain of 1.5 pounds per year during their perimenopausal and menopausal years.

The decline in estrogen and hormonal changes that affect your metabolism are associated with abdominal fat, or central fat redistribution.

Sustainable strategies for losing and maintaining weight loss may include a combination of:

Eating plan

Your diet should aim to limit:

At the same time, try to prioritize:

Exercise

You should aim for 150 to 300 minutes a week of moderate intensity (anything you can talk but not quite sing during) or aerobic exercise consisting of:

Doing so will help you build muscle mass and endurance, as well as preserve and strengthen bone density.

If you’re new to exercise or can’t reach this recommendation, that’s OK. Your goal for now could be to focus on moving your body more.

Stress reduction

Everyone approaches stress management differently. Find what best works for you to lower your levels of stress.

Some stress reduction techniques may consist of:

Sleep

Most older adults should aim to get 7 to 8 hours of sleep with no external stimuli (such as going on your smartphone before bed) to disrupt the sleep cycle.

However, everyone’s sleep requirements differ depending on lifestyle. If you have concerns about your sleep duration or quality, consider speaking with a primary care doctor.

Other strategies

Cognitive behavioral therapy (CBT) and acupuncture may support your overall quality of life, which in turn may help you maintain a moderate weight.

GLP-1 medications are effective at reducing blood sugar levels and body weight.

One 2021 study found that, on average, adults lost as much as 16% of their body weight with these medications over 68 weeks.

GLP-1 medications may help with abdominal weight loss, particularly improving body composition in those approaching or going through menopause.

A 2024 study in 106 postmenopausal women with obesity found that those who were treated with semaglutide (a type of GLP-1 medication) and menopausal hormone therapy (MHT) had an improved weight loss response compared with those who weren’t treated with MHT too.

These results emphasize the strong tie estrogen has with metabolism.

However, weight regain can occur if you stop taking these medications. Therefore, it’s necessary to pair GLP-1 medications with the sustainable lifestyle modifications we discussed above.

A “healthy weight” for those going through menopause depends on:

  • body mass index (BMI)
  • genetics
  • build or physique
  • physical activity levels
  • lifestyle

Generally, a BMI between 18.5 and 24.9 is classified as moderate for females, and a BMI (weight to height ratio) greater than 30 is high.

However, in older adults and adults in their middle years, BMI may be more of an indirect measure of fat tissue and obesity status.

It doesn’t account for the variation in body composition, including location (e.g., subcutaneous versus visceral fat), nor differentiate between:

  • lean or fat mass
  • decline in height
  • decreases in muscle mass
  • racial and ethnic variations

Waist circumference can help determine whether your weight is “healthy.” A circumference of 35 inches or greater for females is most consistent with obesity risk factors, including heart disease and diabetes.

Weight gain during perimenopause and menopause affects about 50% of women. This doesn’t mean it will happen to you, but if it does, you can be prepared with these strategies.

Start by taking a look at your current diet. Try to limit ultra-processed foods, alcohol, and added sugars. Prioritize fruit and non-starchy veggies, healthy fats, and lean protein.

Aim to be more active, working toward a goal of 150 active minutes every week. You can also consider stress reduction techniques and assess your sleep hygiene.

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