August 7, 2025, 6:09 pm | Read time: 6 minutes
Menopause is already a sensitive topic for most women, causing not only physical but also emotional upheaval. When your favorite pants suddenly don’t fit and the scale keeps climbing, frustration levels can skyrocket. Dr. Heidi Gößlinghoff, a gynecologist and mentor for women and couples with unfulfilled desires for children, explains to FITBOOK what really happens to a woman’s figure during menopause and how you can maintain your weight healthily, sustainably, and with a good feeling.
How Does Weight Change During Menopause?
“Menopause (medically known as climacteric) is a phase of hormonal changes. Typically, between the ages of 40 and 50, estrogen levels begin to decline. This decrease in the female sex hormone affects our fat distribution and metabolism,” explains Dr. Gößlinghoff. “While in younger years, fat is stored more on the hips and thighs (the so-called pear type), during menopause, the distribution shifts with more fat being stored in the abdominal area (the so-called apple type).”
Are Abdominal Fat Deposits a Health Concern?
This redistribution of fat is not just a cosmetic issue, as abdominal fat (visceral fat) is metabolically active and can increase the risk of cardiovascular diseases, type 2 diabetes, and high blood pressure in the long term.
Do All Women Gain Weight During Menopause?
“Some weight gain during this time, especially in the abdominal region, is common. However, common does not mean inevitable. Some women gain only slightly or maintain their weight very well with the right strategies, even during menopause. It’s important to understand your own body and consciously counteract changes without succumbing to pressure or self-criticism,” says Dr. Gößlinghoff.
In Which Phase of Menopause Do You Gain the Most Weight?
Menopause occurs in several phases, from perimenopause (the time before the last menstrual period) through menopause (the time of the last menstrual period) to postmenopause (the period after). “The perimenopause is often particularly critical because hormone levels begin to fluctuate irregularly during this phase, leading to mood swings, sleep disturbances, hot flashes, and indeed weight gain,” says Dr. Gößlinghoff. “Many women gain about four to seven kilos during this time because the body operates in a kind of energy-saving mode, muscle mass decreases unnoticed, and the basal metabolic rate drops. And with each year beyond 40, it becomes a bit more challenging to maintain or lose weight if diet and exercise are not adjusted accordingly.”
Why You Gain Weight More Easily and Lose It More Slowly
Main Reason: Hormones and Muscle Mass
Estrogen not only affects your menstrual cycle but also influences how your body stores fat. When estrogen levels drop, metabolism changes. The body stores energy more easily in fat deposits, and at the same time, fat-burning muscle mass (sarcopenia) decreases, as women lose about three to five percent of their muscle mass every ten years if they do not engage in strength training.
Mental Changes
Sleep disturbances, mood lows, or stress are typical companions of menopause and lead to increased appetite, cravings for sweets, and less discipline in daily life.
Metabolic Changes
“The basal metabolic rate decreases, meaning the metabolism now works more slowly and the calorie requirement drops. If you maintain your lifestyle and eating habits, the result is calorie surpluses that show up on the scale,” says Dr. Gößlinghoff.
Insulin Resistance
During menopause, insulin resistance increases. This means the body responds less effectively to the hormone that transports sugar from the blood into the cells. This not only promotes cravings but also makes losing weight more difficult.
How to Maintain Your Weight During Menopause
Mindful Eating Instead of Crash Diets
Focus on a nutrient-rich, balanced diet with a high proportion of vegetables, good fats (such as from nuts, avocados, olive oil), and protein-rich foods like legumes, fish, eggs, or lean meat. Carbohydrates can still be on the plate, but preferably in the form of whole grains or millet instead of white bread and pasta. Prefer regular meals, little sugar, and conscious enjoyment instead of snacking.
Exercise and Strength Training
Women in menopause particularly benefit from muscle-building training, as more muscles increase the basal metabolic rate, the amount of calories the body burns at rest. Combine strength training with endurance sports like walking, swimming, and cycling, ideally at least three times a week.
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Healthy Sleep
Chronic sleep deprivation promotes weight gain because the body releases more of the so-called hunger hormone ghrelin and less of the satiety hormone leptin.
Stress Reduction
Cortisol, the stress hormone, also promotes the storage of abdominal fat. Strategies like yoga, meditation, breathing exercises, or conscious breaks help keep body and mind in balance.
Hormone Therapy
“For some women, a personalized hormone replacement therapy (HRT) can be beneficial. It not only alleviates severe symptoms but also helps stabilize metabolism. An HRT with estrogen can positively influence fat metabolism and limit weight gain in the abdominal area, but this decision should always be medically guided and individually considered,” advises Dr. Gößlinghoff.
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Weight Loss Tips for Menopause
- Protein-rich food: Protein keeps you full longer, protects against muscle loss, and helps with fat loss. Ideally, include a protein source with every meal.
- Intermittent fasting (e.g., 16:8): Intermittent fasting works well for many women. It involves eating only within a specific time window, such as eight hours daily, and fasting for 16 hours. This way, the body uses its fat reserves more effectively.
- Reduce alcohol: Alcohol slows down fat burning, provides empty calories, and disrupts sleep. All these factors make losing weight more difficult.
- Less sugar, more fiber: Sugar spikes insulin levels. Fiber, on the other hand, keeps blood sugar levels stable and aids digestion. Good sources include oats, flaxseeds, vegetables, and legumes.
The Best Diets for Menopause
Mediterranean Diet
A diet rich in vegetables, healthy fats, fish, and legumes is considered Mediterranean and can help with weight management, protect the heart, reduce inflammation, and support hormone balance.
Low Carb
Not everyone needs to drastically reduce carbohydrates, but a conscious reduction of sugar and white flour products can help tame cravings and stabilize insulin levels.
Cycle-Based Nutrition
Even if the cycle becomes more irregular, some women benefit from adjusting their diet to hormonal fluctuations, such as more energy and carbohydrates in the phase before the period, and more protein after ovulation.