How to Lose Weight During Menopause: Science-Backed Advice

Losing weight can be tricky at the best of times. But losing weight during menopause, when it feels like your body is conspiring against you — hello, hot flashes, sleep loss, and hormonal changes — can feel even trickier. But that doesn’t mean it’s impossible.

If you’re approaching that stage of life or already in the thick of it, you might be wondering how to lose weight during menopause. 

If you want to lose weight, lifestyle changes like eating nutritious foods, doing more movement, drinking more water, and getting enough sleep can help. Hormone replacement therapy and weight loss medications can also be helpful for some people. 

Read on to learn the causes and risks of menopausal weight gain, and what you can do about it.

Many factors go into menopause weight gain. The biggest one? Your hormones.

Hormonal changes can cause perimenopause weight gain, too. You may find your weight fluctuates during the years leading up to menopause. Goodbye periods, hello weight gain!

Let’s dive in. Several factors can contribute to menopausal weight gain.

Fluctuating hormones

During menopause, your levels of estrogen drop. These hormone fluctuations can mess with your hunger hormones, making you feel hungrier and eat more than usual.

Changes in estrogen can also affect your total and resting energy expenditure (how many calories you burn overall and while resting). Plus, it can promote belly fat gain, including moving fat distribution from your butt and thighs to your midsection — hence the term “menopause belly.”

Losing muscle

We naturally lose muscle as we age. But losing muscle can slow your metabolism because muscle burns more calories than fat. As your body composition changes, you might start burning fewer calories than you consume, which can lead to weight gain.

Food Cravings

You might be feeling hungry, stressed, and sleep-deprived (thanks, middle-of-the-night hot flashes), which can lead to eating more than usual, craving certain foods, or changing your eating patterns.

Moving Less

When menopause zaps your energy, it’s easy to fall out of your regular exercise routine. In addition to menopause symptoms, these years are often some of the busiest in a woman’s life. We all know how general life admin gets in the way of self care.

Poor Sleep

Insomnia is a common menopause problem, and other symptoms — like hot flashes and mood swings — can disrupt your sleep. A lack of sleep can make you feel hungrier and tank your motivation to do any physical movement, leading to weight gain.

Having excess weight or obesity at any time in life can increase your risk of:

• High blood pressure

• Metabolic syndrome

• Type 2 diabetes

• Stroke

• Heart disease

• Fatty liver disease

• Some cancers

• Mental health problems

In addition, menopause can specifically lead to visceral fat — abdominal fat stored deep within your abdomen around your organs.

This can increase your chances of the above health risks, as well as your risk of all-cause mortality (death from any cause).

It is possible to lose weight during menopause, and — more good news — research shows that doing so may help improve menopause symptoms like hot flashes.

Here are some steps you can take if you’re looking to lose weight.

Eat Nutritious Foods

Eating nutritious foods can help you naturally eat fewer calories than your body burns.

There’s no one best eating plan, so find what works best for you — just make sure it includes lots of nutrient-rich foods like fruits, vegetables, and whole grains while minimizing ultra-processed foods.

But if you want inspiration for dietary changes to make, consider the Mediterranean diet. Research shows that this diet can help you lose weight during menopause.

A 2020 study found eating a low-in-calorie Mediterranean diet for eight weeks helped menopausal women lose fat mass. Their blood pressure and cholesterol levels also improved.

The Mediterranean diet includes:

• Fruits

• Vegetables

• Whole grains like oats, brown rice, and whole-wheat bread

• Lean protein like chicken and turkey

• Legumes like lentils, beans, and chickpeas

• Fish

• Healthy fats like olive oil, avocados, nuts, and seeds

Along with fat loss, research shows that the Mediterranean diet could help prevent metabolic, bone, and cardiovascular diseases for postmenopausal women.

Another healthy diet tip is to make protein your new best friend, especially since people need more protein as they age. Increasing the amount of protein you eat can help you feel fuller and retain muscle mass.

Learn more in our guide to how much protein to eat for weight loss.

Get Moving

Try incorporating more movement into your week. This can help your body burn more calories.

General guidelines say you should aim for:

• 150 to 300 minutes of moderate-intensity aerobic exercise, 75 to 150 minutes of vigorous-intensity aerobic exercise, or a mix of the two each week. This could include jogging, swimming, cycling, sports, or workout classes.

• At least two strength training sessions a week. This could include resistance training with bodyweight exercises, dumbbells, resistance bands, or weightlifting in the gym.

Exercise doesn’t have to be all weights and cardio classes, though. General physical activity also counts.

That could include:

• Hiking with friends

• Playing fetch with your dog

• Doing physical chores like gardening

And don’t discount the humble walk. A 2014 study on 79 postmenopausal women found that those who walked 12,500 or more steps a day weighed less than those who did fewer steps.

Learn more about exercise recommendations by age group.

Drink More Water

Something as simple as drinking more water could help you lose weight during menopause.

Water can:

• Suppress your appetite

• Stimulate your metabolism

• Increase lipolysis (the breakdown of fat for energy)

• Keep you hydrated, which can help boost your energy levels and exercise performance

According to the National Academies of Sciences, Engineering and Medicine, women should consume 91 ounces of water a day from food and drinks combined.

Learn more about how water can help you lose weight.

Get Enough Sleep 

You might experience sleep problems during menopause, which can contribute to more weight gain. But, as much as you can, try to get a full night’s sleep.

To help, try:

• Going to bed and waking up at the same time each day

• Cutting back on caffeine and avoiding it in the afternoons

• Keeping your bedroom cool — this is especially important when hot flashes hit

• Unwinding before bed by taking a bath or reading a book

• Removing electronics from the bedroom

Consider Menopausal Hormone Therapy

Menopausal hormone therapy (MHT) is a treatment for menopause symptoms that involves taking hormones like estrogen and progesterone. You might have also heard of it called hormone replacement therapy or HRT.

MHT is the most effective treatment for vasomotor symptoms of menopause, such as hot flashes and night sweats. It can improve sleep, overall health, and quality of life, even if it doesn’t help you lose weight.

But it may play a role in your weight loss journey, too.

Research is mixed, but a small 2020 study on 32 women found that six months of hormone therapy decreased how much body fat women put on during early menopause.

MHT isn’t right for everyone, though. A healthcare provider can assess your situation and let you know if it could benefit you.

Weight loss drugs like semaglutide (the active ingredient in Wegovy®) may help with weight management during menopause.

Weight loss drugs work in different ways to:

• Suppress your appetite

• Curb food cravings

• Help you feel fuller after meals

• Control your blood sugar, which is important because getting older and going through menopause can lead to insulin resistance

There are a few options when it comes to weight loss drugs. Some are FDA-approved to treat obesity, while others are type 2 diabetes medications prescribed off-label for weight loss.

They’re not recommended for everyone, so you should connect with a healthcare provider to find out if they could help you.

Injections sometimes used to aid weight loss include:

• Ozempic, Wegovy, and compounded semaglutide

• Mounjaro®, Zepbound®, and compounded tirzepatide

• Victoza® and Saxenda® (liraglutide)

Oral medications sometimes used to aid weight loss include:

• Rybelsus® (semaglutide)

• Metformin

• Contrave® (naltrexone-bupropion)

• Qsymia® (phentermine-topiramate)

• Topamax® (topiramate)

• Xenical® (orlistat)

A healthcare provider can explain each medication's pros, cons, and side effects and help you figure out which may be suitable for you.

Want to learn more? We’ve compared Mounjaro vs. Ozempic as a starting point.

You’ll notice many changes in your body during menopause — and weight gain might be one of them. Midlife is a confusing time, but knowledge is power.

Here’s what you need to know:

• Does menopause cause weight gain? Yup. Falling estrogen levels cause menopausal weight gain. This can make you feel hungrier, burn fewer calories, and gain belly fat. Eating more calories, doing less movement, and getting poor sleep can all up your odds of weight gain before, during, and after the menopause transition.

• You can lose weight during menopause. We’re not saying it’s easy, but it is doable. Focus on healthy lifestyle changes like eating nutritious foods, doing more movement, drinking more water, and getting enough sleep. Menopausal hormone therapy may help reduce weight gain and other troublesome menopause symptoms.

• Weight loss medications may help you lose weight. They’re not for everyone, but weight loss medications like Ozempic, Wegovy, and metformin can help you get rid of extra weight during menopause and beyond.

What do menopause and weight loss have in common? They’re highly individual, and the best treatment will vary from woman to woman. You don’t have to figure it all out alone, though.

Take our free online assessment for expert advice and a tailor-made weight loss treatment plan.