Let’s talk about it.
Menopause weight gain caught me off guard. I knew it was common—I’ve cared for many women over the years navigating perimenopause and menopause—but when it happened to me, I still felt blindsided.
The scale started creeping up even though my habits hadn’t changed. I was eating well, staying active, and still, I watched my body soften around the middle.
It wasn’t just the number. It was the frustration of doing “everything right” and not seeing results.
That’s when I started looking deeper—not just as a woman in her mid-40s, but as a nurse who wanted to understand what was really going on.
You're not imagining it. Hormones are part of it.
One of the biggest culprits? Estrogen. As levels of this hormone decline, fat distribution changes—specifically shifting toward the abdomen.
This isn’t just anecdotal; it’s well-documented in the medical literature. A review published in Climacteric (the journal of the International Menopause Society) explains how hormonal changes during menopause impact body composition, often leading to an increase in central body fat.
Why is belly fat such a common complaint? Because estrogen plays a role in regulating fat storage, metabolism, and even insulin sensitivity. When it drops, your body doesn’t just feel different—it functions differently.
I noticed this myself. It wasn’t just about aesthetics. I felt more sluggish, less responsive to exercise, and more easily affected by what I ate. It took me a while to realize that my metabolism wasn’t broken—it was shifting.
The science of weight is more complex than we’re often told.
As a nurse, I’ve seen the way weight loss is oversimplified—“calories in, calories out” as the end-all-be-all. But our bodies are more complicated than that.
Studies show that metabolism is influenced by a host of factors, including hormones, gut health, muscle mass, sleep, stress, and more. One study published in Science even found that basal metabolic rate (BMR)—the number of calories your body burns at rest—remains mostly stable throughout adulthood, only declining slightly after age 60.
That means weight gain in our 40s and 50s may be less about a “slowed metabolism” and more about a perfect storm of hormonal, behavioral, and lifestyle shifts.
For me, the wake-up call came when I realized my old tools—eating a bit less, moving a bit more—weren’t working the way they used to. That doesn’t mean they stopped working altogether. It just means the rules had changed.
Sleep, stress, and the invisible load
I can’t talk about menopause without talking about sleep. Once my sleep quality declined, so did everything else—my mood, my energy, and yes, my cravings.
This isn’t a coincidence. Sleep loss affects hormones like ghrelin and leptin, which regulate hunger and fullness. Poor sleep can increase appetite and decrease your ability to resist sugary, high-calorie foods, according to this clinical research.
Stress? That’s another layer. Many of us are caring for aging parents, teenagers, or trying to keep up with demanding careers while our bodies change in ways we can’t control. Chronically high cortisol levels (a stress hormone) have been linked to increased abdominal fat, especially in midlife women (source).
What I found is that sleep and stress sabotaged my weight loss efforts in a very impactful way.
I noticed that when I started prioritizing better sleep and recovery, even over intense workouts, things began to shift. I felt less bloated. More grounded. More like me.
Weight ≠ Health—but Strength is Powerful
Something else I’ve learned: weight isn’t the best—or only—indicator of health.
A study from the Journal of the American Heart Association found that women with more muscle mass had lower cardiovascular risk, regardless of weight. Another study published in BMJ found that thigh and hip fat (which women tend to store more of) is actually protective in many cases.
When I started strength training—not to burn calories, but to build muscle and protect my bones—I felt better. My energy improved, and so did my mindset. I started caring more about how I felt, and less about what the scale said.
Final thoughts: You’re not broken. You’re shifting.
If you’re in perimenopause or menopause and wondering why your body feels unfamiliar, you’re not alone. This transition is real, and it’s powerful.
We’re not test tubes. We’re not broken. We’re shifting. And we deserve solutions, support, and compassion that reflect that truth.
You can adjust. You can feel better. You can be strong. And you don’t have to go at it alone.
