Why You’re Gaining Weight in Menopause – And What To Do

Let me start with this: you’re not broken, and you’re not doing anything wrong.

I can’t tell you how many women come to me in midlife and say, “I haven’t changed a thing — I’m eating the same, working out, and yet the scale keeps creeping up.”

Sound familiar?

The truth is, your body is playing by a new set of rules. And if no one told you the rules changed, of course it feels frustrating. So let’s walk through why this weight gain happens in menopause — and what actually helps.

Your Body’s New Hormonal Blueprint

Once you hit perimenopause and beyond, your hormones shift — and they take your metabolism with them.

• Estrogen drops, which changes where your body stores fat. What used to sit in your hips and thighs now moves to your belly — that deep, visceral fat that wraps around your organs and increases your risk for things like insulin resistance and heart disease.
• Progesterone dips, too. And when that happens, cortisol (your stress hormone) can take over. That’s why you may feel more bloated or more reactive than you used to.
• Testosterone declines, which matters more than most of us realize. It’s essential for muscle maintenance. Less muscle = lower metabolism.

It’s not your imagination. Your body is different now — and it needs different support.

Cortisol: The Midlife Belly Fat Culprit

Here’s where it gets even more real.

Cortisol is your body’s primary stress hormone. And when your estrogen and progesterone drop, your adrenal glands try to pick up the slack. That means you’re not only dealing with external stress (hello, midlife responsibilities), but also internal stress from shifting hormones.

Chronic cortisol can lead to:

• Belly fat (especially the kind that’s hard to lose)
• Poor sleep
• Cravings
• Blood sugar swings

So if your belly is growing while your willpower is maxed out, cortisol might be the one running the show.

The Diet Lies You’ve Been Told

For decades, we’ve been told to “eat less and move more.” But that advice? It was based mostly on men. It doesn’t work the same way in a hormonally shifting female body.

In fact, eating too little — especially while also over-exercising — can slow your metabolism even further. Your body perceives this as a famine, and it starts holding onto fat.

And cardio-only workouts? They don’t do much for muscle maintenance, which is key to burning more calories at rest.

What Actually Works: 5 Solutions That Matter

Here’s what I recommend to my clients — and what I practice myself.

1. Eat More Protein

Protein helps build and maintain muscle, supports blood sugar balance, and keeps you full longer.
Aim for 0.5–0.75g of protein per pound of body weight (1.0–1.6g per kilogram).

Try this:

• Aim for 30g of protein at every meal
• Add a scoop of protein powder to your smoothie or oatmeal
• Snack on Greek yogurt, hard-boiled eggs, or cottage cheese
• Pair your carbs with protein (no “naked carbs”) — e.g., apple + almond butter, toast + eggs

Start by increasing just one meal a day. Build from there.

2. Strength Train 3-4x Per Week

Muscle is your metabolic engine. Lifting weights improves metabolism, supports bone health, and reduces visceral fat.

Try this:

• Start with Simply Strong — a strength training program made just for busy women
• It's only 3 days a week, 30 minutes per session, and can be done at home
• Focuses on progressive overload to build strength and preserve lean muscle
• No guesswork — just open the app and follow along

Strength training isn’t optional in midlife — it’s essential. Simply Strong makes it doable.

3. Prioritize Sleep

Lack of sleep increases cortisol, which drives fat storage. Sleep is when your body repairs, balances hormones, and resets.

It’s not optional — it’s vital.

Try this:

• Set a consistent sleep + wake time, even on weekends
• Cut caffeine after 2 p.m. (yes, even “just one more” cup)
• Put your phone in another room — screens mess with melatonin
• Try magnesium glycinate before bed to calm your nervous system

Pro tip: If you're still waking up hot, wired, and exhausted — it's not just about habits. Hormonal shifts may be driving it.

4. Consider HRT

Hormone Replacement Therapy (HRT) is one of the most effective ways to preserve muscle, reduce belly fat, and improve insulin sensitivity. It's also powerful for improving sleep, energy, and mood — the very things that make healthy habits easier.

Or you can add it in the bottom section, like:

Want to understand the HRT debate better?
Here’s where I break it down: The WHI Study That Scared Women Off HRT

And yes, weight gain is more than just estrogen loss — which is why some women benefit from pairing HRT with a GLP-1 medication.

Try this:

• Take the free quiz at Join Josie — they specialize in helping midlife women get access to bioidentical HRT and GLP-1s – my clients rave about them. They love how simple the process is – all online.
• If you're insulin-resistant or gaining fat fast, ask about a GLP-1 like compounded semaglutide
• Use your patient portal to ask questions and adjust your care plan — Join Josie includes messaging access with real providers

Bottom line: You’re not lazy — your hormones have shifted. You deserve tools that meet you where you are now.

5. Smart Supplements

Not magic pills — but useful tools, especially when paired with lifestyle changes.
Some I often recommend (with your provider’s approval):

• Magnesium glycinate – stress, sleep, and blood sugar support
• Omega-3s + CoQ10 – inflammation and heart health
• Creatine – helps muscle, brain, and mood
• Berberine or myo-inositol – for insulin resistance
• Vitamin D3 + K2 – bone support

Bottom Line: You’re Not Broken

Your body is doing what it’s supposed to do — it’s adapting.

The key is learning how to work with it, not against it.

Start small:

• Add protein to breakfast
• Swap a walk for a workout
• Prioritize sleep this weekend
• Lift something heavier than a laundry basket
• Talk to a hormone-literate provider

You’re not failing. You’re in transition. And with the right tools, you can feel strong, capable, and in control again.