Teresa Branco
Director of TO BE.
“How can I lose weight during menopause?”
It’s perhaps the question I hear most often during consultations. Strategies that used to work no longer do, and weight seems to pile on even without major changes in habits. There’s a clear physiological explanation for this difficulty—and, more importantly, there’s a solution.
Why Weight Gain Tends to Occur During Menopause
During menopause, women tend to gain weight because their metabolism slows down due to hormonal changes. These changes are not limited to a single hormone; they involve several systems simultaneously:
- Decline in sex hormones: estrogen, progesterone, and testosterone decrease gradually, and it is this decline that causes the metabolic slowdown;
- Decrease in growth hormone: less available at this stage, it also contributes to a loss of metabolic efficiency;
- Decrease in adrenal hormones: the adrenal axis follows the same downward trend, reinforcing the combined effect on metabolism.
This combination explains why losing weight during menopause isn't just a matter of eating less or exercising more. It depends, first and foremost, on addressing the hormonal cause at the root of the problem.
What to Do to Lose Weight During Menopause
Based on my clinical experience, these are the interventions that make a difference:
- Hormone replacement therapy with bioidentical hormones: helps restore the balance the body has lost and reactivate a metabolism that otherwise tends to slow down progressively. This decision should always be tailored to the individual and made following a prior clinical evaluation;
- Adjusting caloric needs: if we need fewer calories, we should also consume fewer calories—and choose calories that are right for us, that are low in inflammatory properties, and that help reduce inflammation in the body;
- Weight training: This is the exercise I recommend at this stage of life, because there’s a natural tendency to lose muscle, and muscle plays a key role in metabolism;
- Preserving muscle mass: Losing one kilo of muscle reduces our daily calorie expenditure by 13 kilocalories, while losing one kilo of fat reduces it by only 4 kilocalories. Therefore, losing muscle is not the same as losing fat.
Note: This decision is always made in consultation with a physician from the TO BE. team, based on test results and medical history. Prof. Teresa Branco, an exercise physiologist and Director of TO BE., coordinates the multidisciplinary plan and the exercise and body composition component; she does not prescribe hormone therapy or medication.
Because muscle is the key at this stage
Muscle isn't just about strength or appearance; it directly influences your basal metabolic rate. Maintaining (or gaining) muscle mass during menopause means maintaining a higher calorie expenditure even at rest, which makes it easier to lose weight during menopause and, above all, to maintain that weight loss over the long term.
Losing weight during menopause starts with a diagnosis
It all starts with an assessment. At TO BE., we conduct this initial evaluation and, from there, take a multidisciplinary approach to help each woman lose weight. Only after understanding her hormonal, metabolic, and physical profile can we design an effective and sustainable plan.
This initial evaluation is conducted by a physician on the team, who orders and interprets the necessary tests and determines any necessary prescriptions. The exercise, body composition, and clinical nutrition components are then integrated in a coordinated manner with the rest of the team’s professionals.
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 significantly impact women’s health and longevity.
My commitment is to turn science into a better quality of life. During hormonal changes—whether perimenopause or menopause—I work with each woman to develop a personalized plan tailored to her stage of life.
Why does menopause make it so hard to lose weight?
Because the decline in estrogen, progesterone, testosterone, growth hormone, and adrenal hormones simultaneously reduces metabolic efficiency. It’s not a lack of willpower; it’s a real hormonal change that should be evaluated and treated at its source by a doctor during a consultation.
Is hormone replacement therapy with bioidentical hormones safe?
Bioidentical hormone replacement therapy can help restore lost hormonal balance, but it should always be an individualized decision. At TO BE., this evaluation and the corresponding prescription are provided by a doctor on our team during a clinical consultation, based on each woman’s hormonal, metabolic, and health profile. This treatment should not be started without a medical evaluation.
Is eating less enough to lose weight during menopause?
No. It’s important to adjust your calorie intake to your body’s new needs, but the quality of your diet is just as important as the quantity; it should be low in inflammatory foods and help reduce inflammation in the body. Without addressing the hormonal cause, calorie restriction alone tends not to be enough.
What kind of exercise is most recommended at this stage?
Weight training. During menopause, there is a natural tendency to lose muscle mass, and muscle plays a key role in metabolism: losing one kilo of muscle reduces daily energy expenditure by 13 kilocalories, while losing one kilo of fat reduces it by only 4.
How long does it take to see results?
It varies from woman to woman, depending on each woman’s hormonal and metabolic profile. That is why the process always begins with a comprehensive evaluation, which allows us to develop a personalized plan with more realistic expectations regarding the timeline.
How can I schedule a diagnostic appointment at TO BE?
You can schedule your diagnostic appointment directly with the TO BE team, who will conduct an initial multidisciplinary assessment to develop the plan best suited to your current life situation.
