Midlife, defined as ages 40 to 65, is a time of significant physical and hormonal changes for women. While aging is the primary driver of weight gain, menopause and hormonal shifts play a major role in redistributing fat—especially to the abdomen. This combination leads to higher rates of overweight and obesity in midlife women and increases the risk of heart disease, diabetes, and certain cancers.
🧬 Aging & Metabolism – Women naturally lose 3% to 8% of muscle mass per decade after 30. Since muscle burns more calories than fat, this slows metabolism and leads to weight gain—even if eating habits don’t change.
🌀 Hormone Changes – As estrogen drops during menopause, the body shifts fat storage to the abdomen, leading to central obesity, which raises the risk of metabolic and heart diseases.
⚡ Insulin Resistance & Blood Sugar Swings – Declining estrogen makes women more insulin resistant, meaning the body stores more fat (especially in the belly) and struggles to regulate blood sugar. This leads to weight gain, cravings, and increased risk of type 2 diabetes.
🏃♀️ Lifestyle Factors – Lower physical activity, stress, poor sleep, and changes in eating habits all contribute to weight gain. Sleep disturbances and hot flashes can further disrupt metabolism and increase cravings.
✔️ Eat to Balance Blood Sugar – Focus on fiber, protein, and healthy fats to support insulin sensitivity and prevent energy crashes.
✔️ Incorporate Strength Training – Preserving muscle helps boost metabolism and fight insulin resistance.
✔️ Manage Stress & Sleep – High cortisol from stress makes insulin resistance worse, leading to more fat storage. Prioritizing stress reduction and quality sleep can help!
I haven’t changed what I’m doing or eating, why have I put on weight around my belly?
Weight gain is one of the most common complaints I hear from women in midlife. You are not alone! On average, visceral belly fat accounts for 15 to 20% of body weight in post menopause, compared with 5 to 8% in premenopausal women. So, what is going on?
First, we have to acknowledge the complexity of our body weight. Body weight is not simply a function of what we eat. We all know this but let’s really acknowledge it is the result of a complex interaction of factors including socioeconomic status, education level, social cultures, presence or absence of food security, genetics, and a whole lot more. Why we make certain food choices, and how they impact us physically, are difficult questions without straightforward answers. We can spend forever breaking this down. Knowing this however, can help us be kinder to ourselves and allow us to remove the judgement that often accompanies issues of weight gain and nutritional behavior.
Our bodies are miraculous vehicles that allow us to do everything we want to do (and some things we don’t really want to do)!
There are a number of physiological changes that occur as you enter menopause which directly impact fat metabolization. Understanding the difference between the two types of fat cells in our body is an important place to start in getting a clearer picture of potential menopausal weight gain. We have both subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). SAT is the fat under your skin and VAT lines your organs. VAT is often referred to as the “bad” fat, as it carries a higher risk of mortality (1). It is also the type of fat we typically see around the abdomen in larger levels among males.
In our ovaries, estrogen is produced through a series of reactions, the final one being the conversion of testosterone to estrogen using aromatase. Why is aromatase important? As you enter menopause and the ovaries stop producing estrogen, that estrogen begins to be produced in small levels in VAT adipose tissues. According to this theory, the reason for this, is VAT is an environment high in aromatase and is therefore able to create estrogen. Some research has shown in fact that VAT increases among post-menopausal women (1,2). This may account for the increase weight around the abdomen that many women experience. While more research is needed, some evidence shows that hormone replacement therapy and exercise can prevent or help reduce weight gain around the abdomen (3). Scientists continue to explore why fat cell types and size shift during menopause (1, 2).
In women, SAT often leads to an increase in weight around the hips and thighs. For years people assumed this increase in weight is the result of a decreasing metabolism as we age. However, recent research by Herman Pontzer, a scientist who specializes in metabolism, suggests that our metabolic rate remains stable between the ages of 25 and 60. While it’s definitely possible that there are outliers, for most of us, midlife weight gain is not a symptom of a slower metabolism.
Additional contributors to weight gain that are impacted during perimenopause include sleep deprivation, gut hormones, a decline in physical activity, muscle loss, and others (3). With perimenopause marking a major shift in your life, take a look at how you prioritize your time to make sure you are on track for the healthiest version of you.
Meet Emily. She is a 54-year-old woman who owns her own fitness business, is a mother of two teenagers and is a former professional endurance athlete. She still competes in amateur running races. After a series of injuries, she found she had gained weight around her thighs as she often does when her weight fluctuates. However, for the first time she also gained weight around her belly. At first it bothered her, but she knew she would lose the weight when she returned to training and eating healthier. After months and months, the belly fat remained. She was grateful for her life including her healthy children, great marriage, and rewarding career, but it still bothered her. Have you ever felt this way?
What can we do to work with our ever-changing body? Remember that our bodies are supposed to change through the life cycle. You won’t look the same at 50 as you did at 30, or even 40, and that’s okay. This is a normal progression, despite what the diet industry wants you to believe. Maybe some of you recall the “What is Happening to my Body” puberty books showing our bodies from young girls into womanhood? It was missing a few pages for women after 40!
In addition, we often try to go against our genetics when we try to look a certain way. If you come from a family where women are in genetically larger bodies, the chance that you will be able to change the size of your body in a healthy way to meet society’s ‘thin ideal’ is not likely. Finding peace around food and honoring your body for what it does for you can be a freeing, positive experience.
Barring genetics, there are some common reasons for weight gain in women who are going through perimenopause and menopause. To tackle this, we have called on the expert of eating -over-40, dietitian Abby Langer to outline some strategies for modulating unwanted weight gain.
Rather than focus on ‘losing weight’ start with mindset of gratitude for how your body has supported you to date and a motivation to keep it as healthy as possible so you can continue to live life to the fullest in the next phase of life.
References:
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