Menopause weight gain myths: Nutritionist advice on estrogen, fat loss and stopping middle-aged spread

Menopause has a reputation for causing instant weight gain for all women. But the truth is it is not biologically inevitable that all women will gain weight.

Hormonal changes can lower energy expenditure and redistribute fat especially to the abdomen but the thing is the women who proactively adjust their diet, sleep, stress and level of exercise can maintain their weight throughout their menopause even some can lose weight in the transition.

Many of the women I see who in my clinic for menopause and are struggling with their weight are not exercising, consuming too many liquid calories like wine and coffee, not sleeping well, feeling stress, binge eating or yoyo dieting. This is what drives weight gain which is often mistakenly attributed to menopause.

Menopause can drive women into a vicious cycle when they consume alcohol at night from stressful day — the alcohol interrupts sleep, they then don’ t go to the gym because they didn’t sleep well (from the alcohol), and then they have too many take away lattes to stay awake.

These women can have skipped breakfast after jumping on the scales in the morning, seeing a number they were not happy with, and then frame it as doing 16:8. These women fast until lunchtime, eat a tuna salad, then by 4pm at the slump are eating sugary treats and snacks as much as possible and not caring at all.

The breaking of the “diet” is linked to disappointment which then leads to a wine and the cycle begins again. This cycle needs to be broken.

Menopause is simply a time where we need to recalibrate our current diet and lifestyle choices, implement new ones to match what we need now and be consistent.

Here’s what’s actually going during menopause: as estrogen declines resting energy expenditure and total energy needs fall, while fat‑free mass (muscle) tends to drop and fat mass increases. Muscle loss is also related to ageing when we all start losing muscle around the age of 40 known as sarcopenia.

Longitudinal studies show that during menopause fat mass gain can double about 1 to 1.7 per cent per year. The average is an extra 1.6 kilos over 3.5 years, while lean mass decreases. Estrogen deficiency also promotes a shift from a “pear” to an “apple” shape, with more visceral (deep belly) fat. Visceral fat is linked to cardiometabolic risk

Weight really is individual, some gain more and some will stay the same and some women will lose weight. The average weight gain is around 2.5 kg across the menopausal transition. Not as much as you would expect.

Ageing itself, so completely independent of menopause, can reduce muscle and metabolic rate, so the combination of aging, less exercise and eating the same or even slightly more is what makes weight creep more likely.

Still the menopause weight gain for many women feels inevitable. The reason for this is our basal metabolic rate can drop by roughly 200–250 calories a day around menopause, largely due to loss of lean mass.

So it is really important to keep up your daily exercise especially in this period and also make sure resistance training is part of your regime. Plus if daily intake of food and calories stays unchanged, that very quiet calorie gap leads to gradual fat gain over months and years, especially around the waist.

Common menopause symptoms such as poor sleep, hot flushes, mood changes, anxiety and stress can drive emotional eating, carb cravings and reduced physical activity, further tipping energy balance.

You can prevent this from happening to you. There are lifestyle trials in peri‑ and postmenopausal women show that structured diet and exercise programs can prevent or reverse weight gain, and are more effective combined than diet alone.

Regular resistance training helps preserve or rebuild lean mass, supporting metabolic rate and limiting the shift toward higher body fat.

Plus making sure your diet is full of nutritious whole foods, portion controlled with an emphasis on lean quality protein, vegetables, whole foods, fruit, legumes, healthy fats and grains are linked with better weight maintenance and cardiometabolic profiles.

So is weight gain really inevitable? Well the biology of menopause is simply a strong push toward more fat and less muscle, especially around the abdomen. When you do nothing about it then you will gain weight.

The research shows that women who make the conscious decision to adapt by prioritising protein, resistance training, staying fit and active, eating clean portion controlled nutritious and healthy can improve their metabolic health and maintain or improve their weight.

Yes menopause will make it a little harder but women also respond very well to movement, good nutrition, lifestyle management and in some cases medical care can also help.