How to manage menopause weight gain

Published April 2023 | 5 min read
Expert contributors Dr Elizabeth Farrell AM, medical director, Jean Hailes for Women’s Health; Melanie McGrice, advanced accredited practising dietitian and director of Nutrition Plus
Words by Stephanie Osfield

Many women find themselves gaining kilos during perimenopause and menopause, but with the right diet you can stay at a healthy weight and boost your health for years to come.

Weight gain is a common complaint of women going through menopause. In the lead-up to menopause – called perimenopause – many women notice an increase in abdominal (belly) fat, and research from the International Menopause Society (IMS) found hormones are to blame. When the hormone oestrogen naturally lowers at this time of life, a woman’s body stores less fat in her thighs and hips and more around the tummy. Maintaining a healthy weight can reduce the risk of diseases like cancer and dementia, so creeping weight gain shouldn’t be shrugged off.

How do you avoid menopause weight gain? "Good nutrition and regular exercise can help women feel fitter and improve wellbeing, which are both very important around menopause," says Dr Elizabeth Farrell AM, medical director of Jean Hailes for Women’s Health.

Reassessing your daily habits and tweaking what you eat to add better nutritional choices means you can feel healthier and more energised during this time, and may help reduce menopausal symptoms like hot flushes, tiredness and anxiety.

How does menopause affect your weight?

Between the ages of 45 and 55, women gain on average half a kilo a year and a total of 2.3kg during their transition to menopause, according to the Australasian Menopause Society.

"This occurs because the drop in oestrogen changes the function of the hypothalamus (an area of the brain that produces hormones), affecting a woman’s appetite, food preferences and how fast she burns kilojoules," says Melanie McGrice, advanced accredited practising dietitian.

Lifestyle factors, like juggling work, family and ageing parents, may not help. "Being busy and tired can lead women to skip exercise, leading to loss of muscle mass, which can slow the metabolism," says Melanie. "If symptoms like hot flushes affect sleep, this can lead to increased hunger and high-kilojoule snacking."

What should I eat to stay healthy during menopause?

“A healthy diet plan at midlife should include whole grains, a handful of animal and plant protein at each meal and a rainbow of plant foods on your plate,” says Melanie. She also recommends that women: 

• Fill up on fibre. “Lower oestrogen levels slow digestion, which can increase constipation,” says Melanie. So choose high-fibre foods like brown rice, rolled oats, beans, berries and lentils.
• Prioritise protein. Protein keeps you full for longer and repairs and builds muscle, which women tend to lose as they age. Aim for a palmful at every meal. “Choose more plant-based proteins too, like tofu, nuts and legumes. Chickpeas are great as they’re high fibre but low kilojoule,” says Melanie.
• Include yoghurt. “It’s rich in calcium, which can reduce bone loss that occurs when oestrogen levels plummet as menopause approaches,” says Melanie. A daily serving of yoghurt is also linked to lower blood pressure.
• Rethink what you drink. Many soft drinks, juice and energy drinks contain more kilojoules and sugar than most people realise and can add to weight gain. Switch to herbal teas or English breakfast tea with a dash of milk. Drink mostly water with a sprig of mint or fruit for flavour.

How to minimise perimenopause and menopause weight gain

Here are some simple strategies you can adopt to feel better about your health and wellbeing:

• Downsize your meals. Serve smaller portions and stop eating once you feel satisfied.
• Eat more mindfully. Put your phone down, switch off the TV and focus on your food, eating slowly so you feel more satisfied. Use a smaller spoon or fork to encourage smaller bites, so you chew more, which signals to your brain that you’re full.
• Keep a food diary to track your meals and snacks or log them in an app like MyFitnessPal. "Recording [your food] helps people make healthier choices and think twice about that chocolate bar or packet of chips," says Melanie.
• Give up or cut back on alcohol. Alcohol can disrupt your sleep and may worsen menopausal symptoms, like night sweats.
• Strength train twice a week. Using weights at the gym or hand-held weights at home can help reduce body fat and increase muscle.
• Go to bed earlier. A 2022 study found that overweight adults who extended their sleep from six-and-a-half hours to eight-and-a-half hours a night decreased their kilojoule intake by an average of 1,130 kilojoules a day.
• Ask your GP about hormone replacement therapy. This may help reduce weight gain around the belly in some menopausal women.

Is the keto diet healthy for menopause?

It might be tempting to cut out certain foods or food groups or try an extreme diet to lose weight, but this could make you feel worse. "The keto diet is a high-protein, low-carb diet plan that may cause rapid weight loss but also rapid muscle loss, nutritional deficiencies and constipation, so I wouldn’t recommend it for menopausal women," says Melanie. 

"Long term, studies show that a healthy diet with carbs is just as good for maintaining a healthy weight, and carbs also benefit energy levels, mood and sleep." 

The benefits of a Mediterranean diet during menopause

Eating like you’re in Greece, Spain or Turkey can help reduce menopausal weight gain. The Mediterranean diet can also reduce the risk of heart disease, high blood pressure, high cholesterol and depression. Studies also show it can cut the risk of type 2 diabetes and boost bone density.

A Mediterranean-style diet includes dishes like Greek salad, seafood paella and ratatouille and is based around eating fresh and whole foods and very little processed food. This style of eating includes the following foods that are recommended to keep your body functioning optimally:

• olive oil
• fruits and vegetables
• fish and seafood
• wholegrain breads and cereals
• nuts and seeds
• legumes and beans.

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