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Understanding and Managing Weight Gain During the Menopausal Transition

Understanding and Managing Weight Gain During the Menopausal Transition

For many women in their mid-30s to 50s, perimenopause marks the beginning of significant hormonal changes. While hot flashes, night sweats and sexual changes often grab the spotlight, there's another common yet less discussed challenge: weight gain. If you're experiencing changes in your weight during this time, you're not alone—and there's solid science behind why this happens.

What Exactly Is Perimenopause?

Perimenopause typically begins in your mid-40s, though it can start as early as your mid-30s.1 During this time, your ovaries produce varying amounts of estrogen before stopping altogether, leading to various changes in your body. The transition continues until menopause (defined as 12 consecutive months without a period), which usually occurs 5-7 years after perimenopause begins.1 The timing of perimenopause and menopause varies according to a number of factors, including race, ethnicity, lifestyle factors and body size.1

Why Weight Gain Happens: The Estrogen Connection

Estrogen does far more than regulate your reproductive cycle—it's a key player in managing your appetite, energy use, and metabolism. When estrogen levels begin to fluctuate during perimenopause, several things happen:2,3

  • Increased appetite and food cravings, particularly for sweet foods
  • Changes in how your body uses energy
  • Shifts in where your body stores fat

The numbers are significant: studies show that up to 70% of women gain weight during perimenopause, with an average gain of about 3.3 lbs/1.5 kgs per year.4,5 By the time they reach menopause, many women have gained around 22 lbs/10 kgs.5

More Than Just Weight Gain: Understanding Body Composition Changes

During this transition, your body undergoes important changes in how fat is distributed. Visceral fat (fat around your organs) increases from 5-8% to 10-15% of your total body weight and body shape often shifts from a "pear" to an "apple" pattern.5 But it’s not just abdominal organs that become cloaked in more fat; fat around the heart and blood vessels may also increase.6

In addition, muscle mass declines (which slows down metabolism) and bone density may decrease.5,6 As you lose muscle mass you may seek out protein, which is great, but unfortunately it’s often part of a diet that includes a lot of fats and sugars.6 You may find yourself exercising less, as menopausal symptoms like hot flashes, night sweats and poor sleep sap your energy. All these factors contribute to the weight gain of perimenopause and beyond.

These changes aren't just cosmetic—they can increase your risk of various health conditions, including osteoporosis (thinning bones), type 2 diabetes, dyslipidemia (abnormal levels of fats in the blood), liver problems and cardiovascular diseases like high blood pressure, heart attacks and strokes.4,6

Practical Steps for Managing Perimenopausal Weight Gain

  1. Consider Hormone Replacement Therapy

If appropriate for you, hormone replacement therapy (HRT) can help address many metabolic changes. Benefits may include:4,7

  • Reduced visceral fat and body mass index
  • Increased lean muscle mass
  • Improved insulin sensitivity and blood lipid profile
  • Enhanced sleep quality, which can help with weight management

HRT requires medical guidance; if you’re interested in it, you should talk to your doctor about it. You may want to consider bioidentical HRT (using hormones that are identical to those produced by our bodies, rather than pharmaceutical equivalents).

 

  1. Adjust Calorie Intake

Women in their 50s typically need about 200 fewer calories daily compared to their 30s and 40s, to avoid annual weight gain.8 This doesn't mean dramatic dieting—just mindful adjustments to portion sizes and food choices.

  1. Reduce your Appetite Using a Natural Supplement

Recent research has shown promising results with a natural supplement, Calocurb®, which contains the extract Amarasate®, derived from New Zealand hops flowers. Calocurb® helps reduce calorie intake by activating so-called “bitter taste receptors” in the gut to release GLP-1, the hormone that’s mimicked by injectables like semaglutide (Wegovy and Ozempic) and tirzepatide (Zepbound and Mounjaro). GLP-1 activates the ‘fullness’ center in the brain and slows down stomach emptying, both of which are signals to stop eating. It normally rises when we eat; in one clinical study, when Calocurb® was taken an hour before eating, the usual amount of GLP-1 produced was doubled, and almost 20% fewer calories were consumed at the subsequent meal.9 In another study, women on a 24-hour, water-only fast took Calocurb twice in the last part of the fast, leading to overall reductions in hunger and food cravings by 30% and 40%, respectively.10 What’s more, at the meal they were given after the fast, the women ate almost 14% fewer calories.10 If you ate 1800-2200 calories daily in your 30s-50s, a14% reduction in one meal is approximately 250-300 calories—plenty more than the recommendation to reduce your daily food intake by 200 calories once you’re in perimenopause.

Adverse events with GLP-1 injectables are quite common, especially gastrointestinal effects such as nausea, vomiting, diarrhea or constipation. In contrast, they are less common with Calocurb®. Calocurb® capsules are specially designed to open beyond the stomach, so nausea, vomiting and heartburn are rare.9,10 However, up to 10% of users may experience diarrhea, so it’s best to gradually increase your dose over a few days when you start it, beginning with one capsule an hour before one meal, and working up to two capsules an hour before two meals. Most people require this dose to noticeably reduce their hunger and food intake, though some may need less and others more, to get the same effect. With Calocurb®, it’s very easy to adjust the dose to your own perceptions of fullness. Calocurb® has been available in New Zealand for over 5 years, where there have been no reports of any problems taking it if you’re on HRT.

The Bottom Line

While perimenopausal weight gain is common, it's not inevitable. Understanding the role of estrogen in your metabolism can help you make informed decisions about managing your weight during this transition. Whether through HRT, dietary adjustments, or natural supplements, there are various tools available to help you maintain a healthy weight during this important life phase.

Remember: these changes are a normal part of aging, but you have options for managing them effectively. Always consult with your healthcare provider about the best approach for your individual needs.

References

  1. Gold EB. The timing of the age at which natural menopause occurs. Obstet Gynecol Clin North Am. 2011;38(3):425-440. doi:10.1016/j.ogc.2011.05.002
  2. Hallam J, Boswell RG, DeVito EE, Kober H. Gender-related differences in food craving and obesity. Yale J Biol Med. 2016;89(2):161-173. Published 2016 Jun 27.
  3. Dragano N, Milbank E, López M. Estradiol and appetite: To eat or not to eat. Molec Metab. 2020;42:101061. doi:10.1016/j.molmet.2020.101061
  4. Hurtado MD, Tama E, Fansa S, et al. Weight loss response to semaglutide in postmenopausal women with and without hormone therapy use. Menopause. 2024;31(4):266-274. doi:10.1097/GME.0000000000002310
  5. Denby N. Menopause: Nutrition and weight gain. British Menopause Society; 2023. https://thebms.org.uk/wp-content/uploads/2023/06/19-BMS-TfC-Menopause-Nutrition-and-Weight-Gain-JUNE2023-A.pdf
  6. Simpson SJ, Raubenheimer D, Black KI, Conigrave AD. Weight gain during the menopause transition: Evidence for a mechanism dependent on protein leverage. BJOG. 2022;130(1):4-10. doi: https://doi.org/10.1111/1471-0528.17290
  7. Muscogiuri G, Verde L, Vetrani C, Barrea L, Savastano S, Colao A. Obesity: A gender-view. J Endocrinol Invest. 2024;47 (2):299-306. doi:https://doi.org/10.1007/s40618-023-02196-z
  8. Mayo Clinic Staff. The reality of menopause weight gain. Mayo Clinic. Published July 8, 2023. Accessed October 27, 2024. https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menopause-weight-gain/art-20046058
  9. Walker EG, Lo KR, Pahl MC, et al. An extract of hops (Humulus lupulus L.) modulates gut peptide hormone secretion and reduces energy intake in healthy-weight men: a randomized, crossover clinical trial. Am J Clin Nutr. 2022;115(3):925-940. doi: https://doi.org/10.1093/ajcn/nqab418
  10. Walker E, Lo K, Gopal P. Gastrointestinal delivery of bitter hop extract reduces appetite and food cravings in healthy adult women undergoing acute fasting. Obes Pillars. 2024;11:100117. Published 2024 Jun 20. doi:10.1016/j.obpill.2024.100117