Teresa Branco
Exercise Physiologist
Director of TO BE.
“How Can I Avoid Gaining Weight During Menopause?”
It’s a question many women ask before they experience the first signs of hormonal changes—and for good reason. Prevention is always easier than treatment. Weight gain during menopause is common and physiologically understandable, but with the right approach, it is largely preventable.
Why Weight Gain Tends to Occur During Menopause
The weight gain that many women experience during menopause is not solely due to eating more or being less active. It involves specific hormonal and metabolic mechanisms that act simultaneously:
- Decrease in energy expenditure at rest: Metabolic studies have shown that energy expenditure decreases during the menopausal transition, even when caloric intake remains constant;
- Fat redistribution: Estrogen directs fat to subcutaneous areas (hips, thighs). As estrogen levels drop, fat accumulates primarily in the visceral abdominal area;
- Increased insulin resistance: a drop in estrogen impairs the cells’ response to insulin, hindering glucose metabolism and promoting fat storage;
- Loss of muscle mass: The sarcopenia that accompanies aging is accelerated during menopause, and muscle mass is a key determinant of basal metabolism.
A systematic review published in 2014 in the *Journal of Obesity*, which analyzed lifestyle interventions during the menopausal transition, concluded that it is possible to control weight during this phase through structured interventions that target these mechanisms, although it identified only three eligible studies, underscoring the need for further research.
What to Do to Avoid Gaining Weight During Menopause
Based on the available evidence, these are the most effective strategies:
- Regular strength training: Two to three resistance training sessions per week help preserve muscle mass, improve insulin sensitivity, and increase energy expenditure. It is likely the most effective lifestyle intervention for preventing weight gain during menopause;
- Adequate protein at every meal: sufficient protein intake (approximately 1.2 g/kg of body weight per day, with 20–30 g per meal) helps preserve muscle mass, regulate appetite, and stabilize blood sugar levels;
- Controlling refined carbohydrates: diets with a lower glycemic load help manage insulin resistance by reducing insulin spikes that promote fat storage;
- Dietary fiber: A daily intake of 25–30 g of fiber supports the gut microbiota, helps regulate appetite, and improves markers of insulin resistance;
- Quality sleep: Sleep deprivation increases cortisol levels and alters hunger markers (leptin and ghrelin), promoting abdominal weight gain. Sleep hygiene is a therapeutic factor during menopause;
- Stress management: Chronic cortisol promotes the accumulation of visceral fat and worsens insulin resistance. Stress management techniques—whether formal (meditation, yoga) or informal (regular breaks, social support)—help mitigate this effect.
A controlled study as a reference
A randomized clinical trial published in 2025 in the *Journal of Mid-life Health* evaluated 160 perimenopausal women: the intervention group followed a program that combined a low-calorie diet rich in protein and fiber with physical activity and psychological support. After six months, this integrated approach resulted in significant reductions in weight, BMI, waist circumference, and body fat percentage, validating the importance of a multidisciplinary and personalized approach.
Avoiding weight gain during menopause starts before the first symptoms appear
The ideal time to implement lifestyle changes is during perimenopause—the years leading up to the last menstrual period. During this phase, the metabolic mechanisms that contribute to weight gain are already developing, but the response to interventions is still more robust.
At TO BE., we work with women in different stages of hormonal transition. The goal is not just to avoid weight gain during menopause, but to build a metabolic and hormonal foundation that supports health and longevity.
Note: The recommendations in this article are lifestyle-related and apply in general terms. Any clinical evaluation, request for lab tests, or prescription—including medication and hormone replacement therapy—is always provided by a physician on the TO BE. team during a consultation. Prof. Teresa Branco, an exercise physiologist and Director of TO BE., coordinates the multidisciplinary plan and the exercise and body composition component.
About TO BE.
TO BE. is a medical clinic where scientific rigor is combined with an integrated care model. Through a multidisciplinary team—bringing together Endocrinology, Internal Medicine, Clinical Nutrition, Exercise Physiology, and Healthy Longevity Medicine—we provide personalized care to address the needs that most impact women’s health and longevity.
Our commitment is to transform science into quality of life. During hormonal transition—whether perimenopause or menopause—we support each woman with an individualized, evidence-based plan tailored to her stage of life.
Is weight gain during menopause inevitable?
No. It’s common and has a clear hormonal and metabolic explanation, but with structured interventions—strength training, proper nutrition, sleep, and stress management—it’s largely preventable, especially if changes begin as early as perimenopause.
What is the most effective way to avoid gaining weight during menopause?
Regular strength training. Two to three resistance training sessions per week help preserve muscle mass, improve insulin sensitivity, and increase energy expenditure; this is likely the lifestyle intervention with the greatest impact at this stage.
How much protein should I eat to prevent weight gain?
The recommended intake is about 1.2 g of protein per kg of body weight per day, divided into 20 to 30 g per meal. This amount helps preserve muscle mass, regulate appetite, and stabilize blood sugar levels.
Why does fat accumulate more around the belly after menopause?
Because a drop in estrogen changes the way the body distributes fat. Previously, estrogen directed fat to subcutaneous areas such as the hips and thighs; as estrogen levels decrease, fat begins to accumulate primarily in the visceral abdominal area.
Do sleep and stress really affect weight during menopause?
Yes. Sleep deprivation increases cortisol levels and alters hunger hormones (leptin and ghrelin), promoting abdominal weight gain. Chronic stress has a similar effect, as it promotes the accumulation of visceral fat and worsens insulin resistance.
How can I get a personalized plan for this phase?
At TO BE., the evaluation is multidisciplinary and individualized, combining endocrinology, internal medicine, clinical nutrition, and exercise physiology. The recommendations in this article are lifestyle-based and apply in general terms. Any clinical evaluation, request for lab tests, or prescription—including medication and hormone replacement therapy—is always provided by a physician on the TO BE. team during a consultation. Prof. Teresa Branco, an exercise physiologist and Director of TO BE., coordinates the multidisciplinary plan and the exercise and body composition component.
