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How to Lose Weight in Menopause

Why is menopause weight loss so difficult? It's the number one complaint so many women have during this phase of life because it seems to come on so quickly, and then it feels impossible to get rid of the menopause belly. Here's the thing. The menopause tummy is something that happens to most women. You are not alone. When you enter into this new chapter in your life it can be daunting to figure out how to lose the weight but it is not impossible.

By gaining an understanding of how your hormones affect weight gain in perimenopause and menopause, you can gain valuable insights into the reasons behind this occurrence and find effective methods to control it.

Hormonal Changes During Menopause

Many of your metabolic processes are regulated by your hormones, which is essential for managing your weight. And during perimenopause and menopause, those hormones fluctuate a lot!

Here's the deal on what is going on with the hormones in your body when you go through perimenopause and menopause:


  1. Estrogen Decline: Before menopause, estrogen is crucial for controlling glucose metabolism, fat distribution, and lipid profiles, all of which are important metabolic functions. One of the primary hormones affected during menopause is estrogen. As estrogen levels decline, it affects the distribution of fat in the body, often leading to an increase in abdominal fat or the menopausal belly. Estrogen decline also increases the risk of osteoporosis, since estrogen affects how calcium is metabolized and helps regulate bone density.

  2. Insulin Resistance: Menopause can lead to increased insulin resistance, which makes it harder for the body to regulate blood sugar levels. This can contribute to weight gain and make it more difficult to lose weight.

  3. Lower Metabolism: With age, metabolic rate naturally decreases. During menopause, this slowdown can be more pronounced, leading to fewer calories being burned and more being stored as fat.

  4. Changes in Appetite and Cravings: Hormonal fluctuations can also influence appetite and cravings, leading to increased calorie intake and weight gain.


Progesterone works together with estrogen to regulate the menstrual cycle prior to menopause. Moreover, progesterone plays a role in metabolism by promoting the storage of fat.

Progesterone levels decrease significantly during perimenopause and menopause due to the body's reduced production of progesterone following ovulation. In perimenopause, ovulation becomes irregular, leading to a sharp decline in circulating progesterone levels. This rapid decrease can result in many of the challenging symptoms associated with menopause, such as mood swings, hot flashes, and fluctuations in energy levels. The change in energy levels can also have a notable impact on weight management. When experiencing lower energy levels, mood swings, and anxiety, it can affect various aspects of daily life, including motivation for physical activity. This may lead to decreased overall activity levels and a tendency to seek comfort foods leading to menopause weight gain.

Thyroid Function

Another harsh factor contributing to weight gain during menopause is the higher chance of thyroid dysfunction affecting your body's metabolism.

The thyroid gland has a significant impact on your metabolism. It controls your basal metabolic rate (BMR), which is the minimum number of calories your body requires to function. Unfortunately, during perimenopause and menopause, thyroid hormone levels can vary due to changing estrogen and progesterone levels. Reduced progesterone levels, especially, can worsen thyroid issues. Progesterone typically decreases first during perimenopause, sometimes as early as the mid thirties. When your thyroid function is not optimal, it can affect your BMR, leading to weight gain and fatigue. This fatigue can reduce your activity levels and motivation to exercise, contributing to weight gain during menopause. Additionally, it raises the risk of developing thyroid disorders like hypothyroidism, a major cause of weight gain.


When food is consumed, the body breaks it down into glucose, which is then used by the cells for energy with the help of insulin. Insulin also aids in storing glycogen in the liver and muscles, serving as a reserve source of energy. Insulin plays a crucial role in reducing blood sugar levels and additionally stimulates lipid synthesis while impeding fat breakdown, ultimately promoting fat storage. As women approach perimenopause and menopause, the likelihood of developing insulin resistance increases due to declining estrogen levels and decreased energy levels. This insulin resistance complicates the management of blood sugar levels and contributes to weight gain during menopause due to the fat-storing effects of insulin.


Cortisol is a hormone crucial for metabolism, as it helps in breaking down proteins and fats, regulating blood glucose levels, and providing anti-inflammatory effects, unless excessive due to chronic stress. It is a key player in the stress response and influences energy levels. Abnormal cortisol levels, either too high or too low, can result in fatigue. The adrenal glands produce cortisol, but when they are busy with cortisol production, they may not produce enough sex hormones. This can be problematic for menopausal individuals who require these hormones. Excessive cortisol can stimulate appetite and cravings, elevate blood sugar levels, and induce insulin resistance, leading to fat accumulation due to insulin's role as a fat-storing hormone.

Leptin and Ghrelin

Leptin and Ghrelin are hormones responsible for controlling hunger. Leptin indicates a feeling of fullness and manages energy levels by decreasing hunger, whereas Ghrelin stimulates appetite and promotes fat storage. Collectively, they influence hunger, food intake, and energy stores. A worrisome factor is that the levels of Leptin and Ghrelin can vary during menopause. Additionally, they are notably affected by sleep disruptions, which are prevalent during menopause. As a result, these hormones could heighten hunger and diminish feelings of fullness, potentially leading to excessive eating and weight gain.

Weight Loss in Menopause

While weight loss is a challenge during menopause, it is not impossible. Here are some of our top recommendations to get rid of your menopausal belly.

  1. Menopause Hormone Therapy (MHT) can be a great option for some women seeking weight loss. We recommend bioidentical hormones to address many of the toughest weight loss challenges. Bioidentical hormones, especially pregnenolone and progesterone, can also help alleviate symptoms like hot flashes, night sweats, anxiety, and brain fog. Are you a candidate for MHT? It is essential that you meet with a menopause educated provider to review your symptoms, goals, and family history to help you identify the best and safest methods for you. If you want to learn more about what we do at Follaine, book a complimentary call with us.

  2. Balanced Diet: Focus on a diet rich in whole foods, including plenty of fruits, vegetables, lean proteins, and healthy fats. Reducing refined sugars and processed foods to less than 25g of added sugar/day can help manage insulin levels and reduce fat storage. Eat a diet rich and fiber that include avocado, beans, broccoli, berries and chia seeds. Supplement with a fiber supplement if you are not getting enough fiber in your diet to aim for more than 25g of fiber per day. We love this one by Thorne. Protein intake: at least 1.3g of protein per kg of ideal body weight per day. We love Good's cottage cheese that yields 14g protein per half a cup. You can eat it plain or add it to your favorite smoothie. You can also supplement with protein powder. Ortho Molecular and Thorne make a delicious protein powder.

  3. Regular Exercise: Cardiovascular and strength training exercises is an unbeatable combination! It helps boost metabolism, preserve muscle mass, and promote fat loss. Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity each week, along with strength training three days a week. Resistance Training with your own body weight doing functional movements and lifting weights is the best exercise for menopausal women. Stretching and balance exercises are super important too. Spend 5 minutes a day to help decrease falls and increase the quality of your daily life.

  4. Stress Reduction: High stress levels can increase cortisol, a hormone that promotes abdominal fat. It also weakens your immune response, promotes high cholesterol, and reduces the use of glucose in your muscle tissues, thus increasing the risk of high blood sugar, insulin resistance, and Type 2 diabetes. Practices such as mindfulness, journaling, pilates, meditation, and deep breathing exercises can help manage stress. Counseling, such as Cognitive Behavioral Therapy, can also help.

  5. Sleep Optimization: menopause is a notorious sleep disruptor. It can cause night sweats, restlessness, sleep apnea, joint pain, or other conditions that interfere with restorative sleep. Poor sleep can disrupt hormones that regulate hunger and appetite, such as ghrelin and leptin. Aim for 7-9 hours of quality sleep each night. Set the temperature in your room between 60-67 degrees. Minimize light exposure - sleep with an eye mask if needed.

  6. Hydration: Staying well-hydrated is crucial for overall health and can help control appetite and maintain a healthy metabolism.

  7. Limit Alcohol Intake - It's common to think alcohol helps us relax. As we go through menopause our tolerance for alcohol tends to plummet as our hormones do. Drinking can exacerbate feelings of anxiety and dramatically disrupts our sleep. If you are drinking wine with dinner and waking up at 4 am, you know what I am talking about. The caloric intake with alcohol is sabotaging your weight loss goals.

Is Semiglutide good for Menopause Weight Loss?

Ozempic is currently very popular, with many people using it during menopause to aid in weight loss.

Recent studies suggest that Ozempic may be effective for weight loss during menopause. Additionally, hormone replacement therapy (HRT) also shows potential in this regard. A small study revealed that combining HRT with Ozempic resulted in greater weight loss in overweight individuals compared to Ozempic alone. At Follaine Health, our goal is to help women achieve their optimal health goals. If you are interested in learning more about medical weight management, please book a complimentary call with us to see if this is right for you.

The mighty power of hormones on weight gain in menopausal women combined with lifestyle modifications is the key to shedding those extra pounds during menopause. Who knew hormones could be such sneaky little troublemakers?

We are so passionate about women's health & wellness that we have designed a program that allows us to give you the information and the tools you need to take charge of your long term health.

At Folláine we look below the surface of the symptoms so we can get to the crux of your problem because we've been there. Because after 40 your body changes, your care should too.

Want more info? Make an appointment with us to chat. We can't wait to speak with you.




Follaine Health (Gaelic for Wellness) was born out of a desire to help real women with real health issues. 


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