What is menopause weight gain?

You haven’t changed your diet. You’re moving the same — or more. But your body’s changing in ways you didn’t expect. The weight’s creeping up, especially around your middle, and it feels harder than ever to shift.

This isn’t about willpower. It’s your hormones, your metabolism, and time — all working in the background. And once you understand what’s happening, you can start to work with your body, not against it.[1,2]

Why does it happen?

As oestrogen declines, your body starts to store fat differently, shifting it from the hips and thighs to the belly. This deep belly fat (called visceral fat) doesn’t just affect how you look. It impacts how you feel and it’s linked to higher risk of heart disease and insulin resistance.

Add in age-related muscle loss (which naturally slows your metabolism), disrupted sleep, and midlife stress — and suddenly, even small lifestyle changes can make a big difference.

UK data suggests women gain about 1.5 kg a year during menopause — often adding up to 10 kg or more by the time it’s over.[1,2,3] But it’s not inevitable. And it’s not a reflection of effort or worth. Here are some of the pieces of the puzzle:

Hormonal Fluctuations: Lower oestrogen levels, in particular, influence fat distribution, making the body more likely to store fat in the abdominal area rather than around the hips and thighs. This leads to an increase in visceral fat, which is stored deep in the abdominal cavity around internal organs and is associated with a higher risk of heart disease, insulin resistance, and other metabolic conditions. This visceral fat is harder to shift [4].
Muscle Mass Loss: Ageing leads to loss of muscle mass (sarcopenia), which lowers your resting metabolic rate. That means you burn fewer calories at rest, even if your diet and activity stay the same.[5].
Increased Insulin Resistance: Falling oestrogen can make it harder for your body to regulate blood sugar, leading to more fat storage and increased cravings, particularly for sugar and carbs. [4]
Stress and Cortisol: Midlife often brings increased stress, from careers, caregiving, or changing family dynamics and disrupted sleep raise cortisol, which is strongly linked to increased abdominal fat [6].
Sleep Changes: Poor sleep is common during perimenopause. This affects hunger hormones (ghrelin and leptin), increasing appetite and cravings for high-energy foods [7].
Sedentary lifestyle: Without realising it busy schedules, caregiving, and work demands can cause a shift in daily physical activity. Even small drops in daily activity can tip the balance between calories in and calories out, especially when metabolic rate is already reduced.

Does HRT cause weight gain?

No and this myth needs busting. There’s no strong evidence that HRT causes weight gain. In fact, it can do the opposite: by supporting oestrogen levels, it may help reduce central fat gain, improve sleep, stabilise mood, and lift energy. All of which can support healthy weight.[8]

How can you treat it?

Managing weight during menopause isn’t about rigid diets or punishment workouts. It’s about building sustainable habits that support your physical and emotional wellbeing.

HRT: It won’t make you lose weight directly, but it can reduce central fat gain and support better sleep, mood, and energy, all of which help with motivation and metabolism [8].
Eat with purpose, not perfection:[9]
- Focus on whole, nutrient-dense foods. Plenty of protein, fibre, healthy fats, and colourful plants. These support metabolism, gut health and mood.
- Eat plenty of protein to preserve muscle
- Include fibre and healthy fats for fullness and hormone support
- Minimise processed foods and added sugars
- Plan regular meals and snacks to avoid energy dip.
- A calorie deficit of 300–500 kcal per day can lead to healthy, gradual weight loss. But first, keep a food and activity diary to identify areas for change.
Movement that matters:[10]
- Strength training helps rebuild muscle and boost metabolism
- Add aerobic exercise like walking, swimming, dancing, or cycling
- Increase daily step count gradually — aim for more days of movement, not just longer workouts
- Even gentle movement makes a difference. Yoga, pilates, or stretching can support joint health, flexibility, and stress relief.
Prioritise sleep and mental wellbeing:
- Create a bedtime routine and limit screens before bed
- Practice stress-reduction tools: mindfulness, breathing exercises, therapy, or journaling
- Get support for low mood or anxiety, which can impact motivation and habits
Get checked:[11] Ask your clinician to review:
- Thyroid function
- Vitamin D levels
- Insulin sensitivity

These can all impact your weight, energy, and mood.

DisclaimerAt Voy, we ensure that everything you read in our blog is medically reviewed and approved. However, the information provided is not meant to replace professional medical advice, diagnosis, or treatment. It should not be relied upon for specific medical advice.

References

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British Menopause Society, 2023. Nutrition and Weight Gain in Menopause. [online] Available at: https://thebms.org.uk/wp-content/uploads/2023/06/19-BMS-TfC-Menopause-Nutrition-and-Weight-Gain-JUNE2023-A.pdf [Accessed 14 Aug 2025].

^²

Women’s Health Concern, 2023. Weight Gain and Menopause Factsheet. [online] Available at: https://www.womens-health-concern.org/wp-content/uploads/2023/06/31-WHC-FACTSHEET-Weight-Gain-and-menopause-JUNE2023-A.pdf [Accessed 14 Aug 2025].

^³

Greendale, Gail A., et al. "Changes in body composition and weight during the menopause transition." JCI insight 4.5 (2019): e124865 https://insight.jci.org/articles/view/124865

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Mayo Clinic. Menopause weight gain: Stop the middle age spread. https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menopause-weight-gain/art-20046058

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Narici, M.V. and Maffulli, N., 2010. Sarcopenia: characteristics, mechanisms and functional significance. British Medical Bulletin, 95(1), pp.139–159 https://pubmed.ncbi.nlm.nih.gov/20200012/

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NHS, 2023. Menopause - Symptoms. [online] Available at: https://www.nhs.uk/conditions/menopause/symptoms/ [Accessed 14 Aug 2025]

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Spiegel, K., Tasali, E., Penev, P., & Van Cauter, E., 2004. Sleep and obesity: the role of sleep duration and quality in the regulation of energy balance. Journal of Clinical Endocrinology & Metabolism, 89(6), 2562–2568. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4008703/

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