Why perimenopausal weight gain happens

One of the things we're often warned about as we approach menopause is the weight gain that comes with it.

Often jokingly called the 'middle-aged spread' (thanks to the many women who experience increased abdominal fat during the perimenopause phase), weight gain is something many women feel concerned about.

Menopause is considered a high-risk phase for weight gain, which can place women at a higher risk of cardiovascular and metabolic disease.

This begs the question: is it really possible to prevent weight gain during this time? How do you keep a healthy weight (and a healthy diet) during perimenopause? Luckily we've done the heavy lifting for you with a full explainer on perimenopause, plus 6 tips to help keep your body weight in a healthy range.

What is perimenopause?

Perimenopause is the phase of life before your very last period. It officially ends 12 months after your very last period, which then transitions into postmenopause. Some of the symptoms can be similar to those experienced by menopausal women and might include:

• Irregular periods that can be shorter/longer/heavier/lighter than you are used to
• Hot flashes that skyrocket your body temperature
• Mood swings
• Sore muscles
• Night sweats and difficulty sleeping
• Tiredness or difficulty concentrating
• Low libido
• Weight gain

How long does perimenopause last?

Perimenopause can last anywhere from 1-10 years but typically is around 4-6 years for women aged 44-55. It takes years because your ovaries gradually slow down over time, which impacts the hormone levels in the body.

What is perimenopause weight gain?

Perimenopause weight gain is a bit of a misnomer because perimenopause itself doesn't cause weight gain. What causes weight gain is the effects of ageing and lifestyle factors. Typical perimenopausal women gain weight an average of 500 grams each year.

Can perimenopause cause rapid weight gain?

During the perimenopause period, it's normal to experience a huge range of symptoms. Hormonal changes mean that the overall body composition changes as women lose muscle mass and experience a slowing metabolism.

Losing muscle mass means increased fat, which in perimenopausal women settles around the belly rather than your hips or thighs. Belly fat mass is around 20% in postmenopausal women compared to up to 8% in premenopausal women.

Around half of women report weight gain or diminished sleep quality as part of their perimenopausal phase.

Why is it so hard to lose weight during perimenopause?

After menopause, our oestrogen levels plummet and our metabolism slows, both of which make it harder to lose weight.

More than that, many women find that menopausal symptoms like hot flashes, poor sleep and low mood make it harder to maintain a healthy diet and exercise regime which, in turn, can make it more difficult to maintain a healthy weight.

Women's health may also be impacted by general life pressures like work, raising children, caring for elderly parents and other life stressors. These pressures may also place women at higher risk of chronic diseases such as high blood pressure, high cholesterol or type 2 diabetes.

How to approach weight loss during perimenopause

There are plenty of things you can do to help avoid gaining weight or losing weight during perimenopause. Here are 6 of the best.

1. Eat more protein

Research out of the University of Sydney found that as women approach the menopause transition, their body's need for protein increases at the same time their energy expenditure falls.

This means if you don't up your protein, you'll likely overeat on carbs and fats your body can't use. They advise increasing your protein by about 3% whilst decreasing your overall caloric intake by 5% should help you through the transition [1].

When you need a quick and easy snack to reach your daily protein requirements, there’s nothing better than a protein shake. Juniper’s Nourish Shakes are made with whey protein containing all 9 essential amino acids, plus 20 more important vitamins and minerals, fibre, and pre and probiotics.

2. Aim to eat a balanced and healthy diet

This is the time to increase the amount of healthy whole foods in your diet including adding in whole grains (like brown rice and quinoa) and healthy fats (avocado, nuts, seeds). Many women see the benefits of a plant-based diet to get through the menopausal transition.

Reducing your sugar and alcohol intake can also help maintain a healthy weight. It's also important to not skip meals, as that can cause your metabolism to slow down even more. If you need some additional holistic support a programme like Juniper’s Weight Reset Programme can be beneficial.

Whether it's having medical guidance, 1-to-1 health tracking or medication to support digestion, or changing your relationship with food, you can stay focused and supported with Juniper.

You can kickstart your weight loss journey with Wegovy or Mounjaro, two groundbreaking weight loss medications that mimic the GLP-1 and GIP hormone respectively to help control cravings, delay stomach emptying, and keep you feeling fuller for longer.

Plus, we have a team of expert dietitians and health coaches you can consult with, to help you work through any challenges you're experiencing during your weight management journey. This holistic approach sets you up for sustained weight loss, rather than a quick-fix solution.

Weight gain and body fat vary from person to person and it's not just about what you eat and how much you exercise, either. Genetics play a big role in your body composition and this is why we've created a programme that takes all of that into consideration, while also offering you personalised support on your health journey.

3. Create a regular exercise routine (and stick to it)

Moderate-intensity physical activity has huge benefits on our overall health (not just on our body mass index).

Combining regular exercise with a caloric deficit is key to losing excess weight — especially if you're often prone to sedentary behaviour (this is particularly common for those who work in an office).

Finding ways to add in different forms of movement like aerobic exercises, resistance exercises and muscle strengthening activities are all important for women's health.

Try to hit your 5:2 — that's 5 hours of moderate-intensity physical activity like swimming, mowing the lawns or brisk-paced walking; coupled with 2 hours of more intense team sport, jogging or aerobics.

If you're not into intense exercise, don't panic — a study found the regular practice of Tai Chi was just as effective as aerobic exercise and strength training [2].

4. Ask your healthcare provider about hormone replacement therapy

Hormone replacement therapy (HRT), sometimes known as menopausal hormone therapy (MRT) is a medication prescribed to help relieve menopause symptoms and can actually be an effective way to prevent weight gain. It can come as a tablet, gel, spray, or skin patch.

5. Get plenty of high-quality sleep

Sleep disturbances are common amongst menopausal women and can be really damaging to overall health. Waking up exhausted makes it harder to exercise and can make us hungrier by messing with our hunger hormones ghrelin and leptin, leading to weight gain.

One study even found not getting enough sleep can lead to an increased risk of higher abdominal fat [3].

6. Check your vitamin D

Both perimenopausal women and postmenopausal women are at risk of a vitamin D deficiency. Vitamin D deficiency puts women at an increased risk of developing cardiovascular disease and osteoporosis as it is critical for bone health.

The good news is that it can be easily supplemented if you are deficient.

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