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Yes, “Menopause Belly” is Normal. Here’s What You Can Do About It.

Winnie the Pooh

If you’re feeling like the extra pounds are adding on for no reason (I haven’t changed my eating or exercise habits! What’s happening?!), know that you’re not alone. Weight gain around the midsection is one of the most common menopausal symptom complaints we hear from women. And while we know it’s difficult to accept, we also know that our bodies are meant to evolve. How we respond to it is within our control. To understand how to treat your body and self with the kindness and love it deserves, let’s start with the science behind why it happens.

The science behind menopausal belly fat

When you combine hormonal fluctuations with metabolism changes, age, and even genetics, things get, well, complicated.

Previously, it was thought that declining estrogen levels were the main culprit in menopausal weight gain, which can start during perimenopause. However, over the past few years, updated research has shown that follicle-stimulating hormone (FSH) — which is usually just thought of as a reproductive hormone causing eggs to develop in the ovaries — may play a bigger role in metabolism than scientists originally thought. Rising FSH levels, which signal hormonal change in menopause, may themselves contribute to weight gain.

Other factors contributing to weight gain during menopause include:

  • Age: slowing of metabolism, loss of muscle mass, and increased body mass with age
  • Genetics: certain body shapes are influenced by genetic variants, which govern how and where women’s bodies store fat
  • Increased insulin resistance: because of hormonal fluctuations associated with menopause, women are at increased risk for becoming insulin resistant. This means it’s harder for your body’s cells to take in glucose (aka blood sugar, from the breakdown of carbs and protein) with the same or even higher levels of insulin, a process that results in extra fat storage. This also causes you to feel tired and hungry. It’s a cascade of physiological events that gets stuck in repeat, leading to weight gain.

According to a study published in the academic journal, Menopause, abdominal fat accumulation puts women at a greater risk for health problems such as heart disease. It’s worth noting here the use of the word “accumulation,” which doesn’t necessarily mean the same thing as “extra weight.” Even if the number on the scale doesn’t change at all, insulin resistance and hormonal changes may lead to body fat redistribution from our hips and thighs to our waistline and abdomen.

What you can do about it

🧘 Focus on stress management

Cortisol is a hormone our bodies use to respond to stress and regulate our immune response/metabolism. Levels of our stress hormone increase with age (and with stress, duh!). Chronically high levels can then lead to insulin resistance (see above), which can then lead to weight gain.

READ MORE: Everything You Need To Know About Anxiety and Menopause

😴 Focus on high-quality sleep

Lack of sleep (or poor quality sleep) can cause hormonal fluctuations, including higher cortisol levels. Plus, because our bodies receive hunger signals from hormones such as ghrelin (increases our cravings) and leptin (causes feelings of satiety), a disrupted sleep cycle can lead to patterns of overeating. In fact, a study conducted by the American Heart Association found that people who slept an hour and 20 minutes less consumed 549 more calories than the control group.


🍅 Go all-in on the Mediterranean diet

While there isn’t one best diet for everyone, the Mediterranean diet has rightly earned a lot of hype for its positive effects on everything from mental health to weight loss. It’s low in saturated fats and cholesterol-rich animal proteins and rich in antioxidants, fiber, and healthy fats (avocado, olive oil, etc). It’s also anti-inflammatory, low-carbohydrate, and low-sugar. And because it kicks most processed foods and refined sugars to the curb and focuses instead of non-starchy veggies, beans, fruits, and whole grains, it’s considered a “low-glycemic index” diet — meaning it won’t dramatically spike our blood sugar. Because remember, increased glucose leads to increased insulin, which leads to excess weight.

⏰ Consider intermittent fasting

Elektra’s founding physician, Dr. Anna Barbieri, MD, likes intermittent fasting (IF) for its numerous benefits — namely sugar control and weight loss — however, some see more benefits from it than others (yet another reason why diet isn’t one-size-fits-all). In order to see results, a 16:8 schedule is recommended, which means 16 hours of consecutive fasting during a 24-hour period. Fasting hours include sleeping hours, so many find this to be a doable schedule (for example, eat between the hours of 12:00PM – 8:00PM, and fast overnight until noon the next day). During the fast, you can have things that don’t raise insulin at all, like water, coffee, tea and fat (for example, coffee with butter).


💪🏾 Keep up the cardio, but don’t forget about strength training also

Aerobic physical activity that gets our heart rates up is not only important for our cardiovascular health; it also helps with sleep, cognition, mental health, and more. But it’s important to incorporate strength training during the menopause transition as well. Why? It helps us maintain muscle mass (which we naturally lose), it keeps our bones strong (which protects us from osteoporosis), and also helps with weight management and increasing our metabolic rate. Here are a few of our favorite strength training videos to inspire your regular exercise routine:

💊 Be wary of supplements for weight loss

There are lots of supplements and blends marketed to help you “get rid of belly fat.” Unfortunately, if they sound too good to be true, they likely are — weight loss (and overall wellness) is not found in a bottle. Some contain excessive amounts of caffeine, for example, which could cause side effects. If you consider any specific weight loss supplements, we recommend discussing with your doctor to better understand potential health risks and benefits.


A note on BMI

Not all body fat is made equal. On the one hand, there’s something called subcutaneous fat (aka fat under our skin), which is much less of a health issue than visceral fat (aka deeper abdominal fat). This is why, when it comes to healthy weight management during perimenopause/menopause, body mass index (BMI) isn’t the holy grail…and the scale isn’t either.

Try focusing instead on non-scale victories — think things like walking a longer distance or making a healthier food decision — that won’t always show up on the scale but are still worth celebrating.

A note on body neutrality

No article on body weight and women’s health would be complete without a mention of our thoughts on body neutrality.

Now you may be familiar with the Body Positivity movement, which encourages people to accept and celebrate all aspects of their appearance. While we appreciate that idea in theory, let’s be real: loving every part of your body can be incredibly difficult, especially if you’re experiencing menopause symptoms. Instead of focusing on appearance or striving for an unwaveringly positive self-image, body neutrality challenges us to recognize and respect how our bodies are supporting us in the present. Learn more about this incredibly powerful way of “reframing the change.”

Just as frustrating as menopausal weight changes are hot flashes and night sweats. Learn why it happens and what you can do about it.

READ MORE: Are Weight Loss Drugs Safe & Effective For Menopause? (Ozempic, Wegovy, etc)