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Understanding Perimenopause Weight Gain and How to Manage It

Published May 27, 2025
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Starting around age 46, women begin the menopausal transition, known as perimenopause. During this time, hormonal fluctuations can cause numerous symptoms, from hot flashes and poor sleep to mood swings and vaginal dryness. One symptom in particular is especially difficult: weight gain. Perimenopause weight gain can vary greatly from one pound per year to ten or more. Understanding what causes perimenopause weight gain can help take the mystery out of this significant life change and give you the tools to manage it. When it comes to perimenopausal weight gain, you’re not alone. With the proper education, you learn how to combat perimenopause weight gain and feel your best.

Key takeaways
  • The average age for a woman to begin perimenopause is 46.
  • There are numerous reasons why you may experience weight gain with perimenopause, including hormonal shifts, a slowing metabolism, and lifestyle changes.
  • Weight gain during perimenopause typically occurs in the upper body and abdomen.
  • The average weight gain during perimenopause ranges from one pound per year to ten pounds.
  • To help avoid gaining weight in perimenopause, it’s important to stay active, eat a healthy diet, manage stress, and talk to your doctor about hormone replacement therapy.

What causes weight gain in perimenopause?

If you’re beginning to see signs that you’re entering the menopause transition, you may wonder, “Can perimenopause cause weight gain?” The short answer is, “Yes,” weight gain and perimenopause are often tied together. But why does perimenopause make you gain weight? It all starts with your hormones. During perimenopause, your estrogen levels start to drop, which can cause a range of symptoms like hot flashes, poor sleep, vaginal dryness, and mood swings.

Lowered estrogen levels can impact your metabolism and cause increased hunger. It may also change how your body stores fat. As your stress levels rise, it can also increase cortisol levels, which may lead to emotional eating, increased appetite, and fat storage in the abdomen.

Along with hormonal changes, weight gain during perimenopause can also be due to a slowing metabolism. As women reach midlife, their muscle mass begins to decline, which can make it harder to burn calories, leading to a slowed metabolism. Additionally, perimenopause can increase your risk of developing insulin resistance, which makes it difficult to process glucose, leading to fat storage and weight gain.

Your lifestyle can also play a part in gaining weight during perimenopause. Some of the symptoms associated with perimenopause, like hot flashes, poor sleep, and fatigue, can make physical activity difficult, leading to weight gain. Emotional eating and cravings can also contribute. If you’re gaining weight, perimenopause lifestyle choices may be to blame.

Common areas of weight gain during perimenopause

Now that you know the answer to “Why am I gaining weight during perimenopause,” it’s time to discuss the most common areas where fat accumulation can occur. Whether you’re struggling with gradual or sudden weight gain, perimenopause can be a frustrating experience. When discussing weight gain, perimenopause generally causes fat accumulation in the abdomen and upper body. It’s also possible to see a shift in your fat distribution from the thighs and hips to the waist.

It doesn’t necessarily matter if you experience perimenopause rapid weight gain or if the process happens more slowly; the hormonal changes involved can impact fat storage and placement. But why does perimenopause cause weight gain in these specific areas? It goes back to estrogen. As we discussed earlier, estrogen is one of the main hormones that begin to decline during perimenopause. Since one of its roles is fat distribution, the lower levels can impact your body’s fat storage, shifting it upwards towards your abdomen. Along with being annoying, this transition can be harmful to your health.

Perimenopause rapid weight gain is often made up of visceral fat, which is linked to numerous health problems like heart disease, type 2 diabetes, and insulin resistance. Belly fat is also more stubborn and can be more difficult to eliminate. So, does perimenopause cause weight gain in specific areas? Yes, and these fat deposits can have a significant impact on your health.

Effective strategies to combat and manage perimenopause weight gain

Now that you understand what causes weight gain in perimenopause and where the excess fat can accumulate, it’s time to cover how to fight perimenopause weight gain. Although slow and rapid weight gain perimenopause symptoms can feel overwhelming, with the right tools and knowledge, you can learn how to stop perimenopause weight gain.

Diet

Knowing how to control perimenopause weight gain can make you feel empowered and take the fear out of your menopausal transition. Your diet has a significant impact on both your weight and how you feel. It is possible to slow or stop perimenopause weight gain simply by addressing the food you eat. You can do this by prioritizing nutrient-dense foods like vegetables, fruits, legumes, whole grains, seeds, and nuts.

Protein is your best friend, and ensuring you get between 20 and 30 grams per meal will keep you satiated and help you avoid perimenopause sudden weight gain. Limiting alcohol, sugary, and processed foods will help you keep your caloric intake within the correct range, making it easier to maintain a healthy weight. Maintaining a healthy diet is a powerful treatment for perimenopause weight gain.

Physical exercise

Since you know that when it comes to perimenopause symptoms, weight gain often tops the list, keeping your body moving should be a top priority. Eating a healthy diet and physical exercise are excellent perimenopause weight gain solutions. Not only can it help with weight loss, but it also aids in building muscle mass, which is key for your overall health. It also gives you more energy, helps you sleep better, and makes you less tired. But why can staying active help combat perimenopause fatigue and weight gain?

Muscles directly influence how your body uses and stores fat while increasing the number of calories burned, even while resting. Muscle tissue boosts your metabolic rate and reduces your risk of muscle loss as you age. The good news is you don’t have to do intense training or exercises for physical activity to be an effective perimenopause weight gain treatment. Walking, hiking, swimming, and biking are all great low-impact options. You can try classes like yoga or pilates or something a little more intense like pickleball. Perimenopause and weight gain may be common, but by staying active, you can help your body stay lean and fit.

Supplements

While there are no specific natural supplements for perimenopause weight gain, there are ones that can support your body’s health throughout the menopausal transition. Calcium and vitamin D can help support bone health and metabolic rates, while fiber and probiotics can protect your gut health. Overall, the best supplements for perimenopause weight gain are:

  • Magnesium
  • Calcium
  • Vitamin D
  • Vitamin C
  • Omega-3

If you’re looking for how to deal with perimenopause weight gain, adding supplements to your diet can give your body extra support.

Managing stress

Stress can wreak havoc on your body, especially when paired with hormonal fluctuations. Knowing what helps with perimenopause weight gain can make it easier to avoid and take the necessary steps to maintain a healthy weight. Stress management is an important part of supporting your hormonal health and reducing weight gain. There are many options, including:

  • Meditation
  • Journaling
  • Talking to a therapist
  • Enjoying a hobby

Lowering stress keeps your cortisol levels lower, making it easier to combat stubborn perimenopausal weight gain.

Medication

For many women, you do gain weight during perimenopause, and natural solutions may not be enough. Your doctor may prescribe hormone therapy medicine for distressing symptoms, but it is not intended to help with weight gain. Knowing what to take for perimenopause weight gain can be a bit tricky. HRT should only be taken under the care of a healthcare professional. They may also recommend weight control medication if they deem it necessary. The medicines they prescribe will depend on your unique circumstances and condition.

Final thoughts

So, do you gain weight in perimenopause? Yes, for many women, weight gain during perimenopause is a reality. However, through healthy lifestyle choices, staying active, and seeking the help of a healthcare professional when needed, you can successfully manage it. Hormona is excited to offer the award-winning hormone-tracking app designed by women for women. It offers comprehensive tools and insights into your hormonal health so you can understand your body better and feel your best.

FAQ

How to avoid weight gain in perimenopause?

You can help avoid weight gain during perimenopause by eating a healthy diet, staying active, taking hormone-supporting supplements, and utilizing HRT when needed.

How much weight does the average woman gain during perimenopause?

On average, women gain around 1 pound per year during menopause, but in some circumstances, they can gain 10 or more.

How can I speed up my metabolism during perimenopause?

Building muscle is one of the most effective ways to speed up your metabolism, especially when paired with a healthy diet and plenty of sleep.

How to know if weight gain is hormonal?

If you experience sudden, unexplained weight gain, irregular periods, mood changes, or decreased energy, it could be due to hormonal changes. It’s important to speak to your doctor about your symptoms, and they can decide whether hormone testing is appropriate.

Does perimenopause cause a big belly?

Since perimenopausal weight gain is typically in the upper body and abdomen, it can cause your belly to grow larger. This visceral fat accumulation can cause numerous health issues, including cardiovascular problems, insulin resistance, and type 2 diabetes.

Disclaimer: This website does not provide medical advice. The information, including but not limited to, text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.
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Dr Singh is the Medical Director of the Indiana Sleep Center. His research and clinical practice focuses on the myriad of sleep.

References
  1. Woods, N. F., & Mitchell, E. S. (2016). The Seattle Midlife Women’s Health Study: a longitudinal prospective study of women during the menopausal transition and early postmenopause. Women’s midlife health, 2, 6. https://doi.org/10.1186/s40695-016-0019-x 
  2. Chopra, S., Sharma, K. A., Ranjan, P., Malhotra, A., Vikram, N. K., & Kumari, A. (2019). Weight Management Module for Perimenopausal Women: A Practical Guide for Gynecologists. Journal of mid-life health, 10(4), 165–172. https://doi.org/10.4103/jmh.JMH_155_19
  3. Knight, M. G., Anekwe, C., Washington, K., Akam, E. Y., Wang, E., & Stanford, F. C. (2021). Weight regulation in menopause. Menopause (New York, N.Y.), 28(8), 960–965. https://doi.org/10.1097/GME.0000000000001792
  4. Menopause: Nutrition and Weight Gain. British Menopause Society. https://thebms.org.uk/wp-content/uploads/2023/06/19-BMS-TfC-Menopause-Nutrition-and-Weight-Gain-JUNE2023-A.pdf
  5. Bartosch, J. (2023). Why am I gaining weight so fast during menopause? And will hormone therapy help? UChicago Medicine. https://www.uchicagomedicine.org/forefront/womens-health-articles/menopause-weight-gain-hormone-therapy
  6. Anekwe, C., MD (2021). The link between abdominal fat and death: What is the shape of health? Harvard Health Publishing. https://www.health.harvard.edu/blog/the-link-between-abdominal-fat-and-death-what-is-the-shape-of-health-2021021821960
References
  1. Woods, N. F., & Mitchell, E. S. (2016). The Seattle Midlife Women’s Health Study: a longitudinal prospective study of women during the menopausal transition and early postmenopause. Women’s midlife health, 2, 6. https://doi.org/10.1186/s40695-016-0019-x 
  2. Chopra, S., Sharma, K. A., Ranjan, P., Malhotra, A., Vikram, N. K., & Kumari, A. (2019). Weight Management Module for Perimenopausal Women: A Practical Guide for Gynecologists. Journal of mid-life health, 10(4), 165–172. https://doi.org/10.4103/jmh.JMH_155_19
  3. Knight, M. G., Anekwe, C., Washington, K., Akam, E. Y., Wang, E., & Stanford, F. C. (2021). Weight regulation in menopause. Menopause (New York, N.Y.), 28(8), 960–965. https://doi.org/10.1097/GME.0000000000001792
  4. Menopause: Nutrition and Weight Gain. British Menopause Society. https://thebms.org.uk/wp-content/uploads/2023/06/19-BMS-TfC-Menopause-Nutrition-and-Weight-Gain-JUNE2023-A.pdf
  5. Bartosch, J. (2023). Why am I gaining weight so fast during menopause? And will hormone therapy help? UChicago Medicine. https://www.uchicagomedicine.org/forefront/womens-health-articles/menopause-weight-gain-hormone-therapy
  6. Anekwe, C., MD (2021). The link between abdominal fat and death: What is the shape of health? Harvard Health Publishing. https://www.health.harvard.edu/blog/the-link-between-abdominal-fat-and-death-what-is-the-shape-of-health-2021021821960
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