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“These diets used to work, but now they don’t. I eat the same things and gain weight instead of losing it.” In perimenopause and menopause I hear this from so many women. Perhaps you’re eating less, walking regularly and doing everything you know how to do — yet the scale won’t budge, and your waistband keeps getting tighter. Let me say this clearly first: it isn’t a matter of willpower, and your body isn’t betraying you. Your hormones have shifted, and the rules of the game have shifted with them.
Why Losing Weight Gets Harder in Menopause
During this time your oestrogen levels gradually fall. As oestrogen declines, body fat tends to settle less evenly and more around the waist and abdomen, including deep around the organs (visceral fat). So much of the change you see in the mirror is fat redistributing rather than simply “gaining”.
The second big shift is in your muscles. Muscle mass naturally declines with age, and the hormonal changes of menopause can speed that along. Muscle burns energy even at rest, so as it shrinks your resting metabolic rate drops too. Research suggests this slowdown owes far more to ageing and muscle loss than to menopause itself — and the encouraging part is that muscle is tissue you can rebuild when you work at it.
Third, fat stored around the middle, together with the hormonal changes, can make the body less sensitive to insulin. That can mean blood sugar swings more easily, along with sweet cravings and dips in energy. On top of this, the stress hormone cortisol may rise more readily, sleep quality can suffer, and the balance of gut bacteria can change. The evidence on these last few is still emerging, but together they help explain why things no longer behave “the way they used to”.
What Actually Works in Menopause
Let’s name the most common mistake first: eating less and less. Living on very few calories for long stretches tends to drive muscle loss and fatigue more than steady fat loss; your metabolism slows further, and it often backfires in bouts of uncontrolled eating. The answer isn’t “less” — it’s “better”. Here’s the approach that genuinely helps:
- Enough protein at every meal. Protein keeps you fuller for longer and protects your muscle. Starting the day with a protein-rich breakfast — eggs with greens, or yoghurt with oats and chia — is a good place to begin.
- Strength (resistance) exercise. Walking alone isn’t enough. Adding resistance training two to three times a week protects muscle, helps rebuild it and supports your metabolism. In menopause it may be the single most valuable habit.
- Fibre and blood-sugar balance. Fibre from vegetables, wholegrains, pulses and fruit keeps you satisfied and steadies blood sugar. Pairing protein and fibre in each meal smooths out the swings.
- Avoid crash diets and long fasts. Leaving huge gaps between meals and living in permanent “diet mode” backfires for most women. Regular, satisfying meals are far more sustainable.
- Sleep and stress. Poor sleep and chronic stress can push up appetite and sweet cravings. Investing in your sleep, and in small routines that lower stress, matters just as much as what’s on your plate.
In short, your body isn’t working against you in menopause — it simply no longer works the way it used to, or the way your partner’s or friend’s body does. What pays off now isn’t eating less; it’s eating well and protecting your muscle. If you’re wondering about hormone replacement therapy (HRT), that’s a decision to talk through with your doctor — and, for the record, the idea that “HRT makes you gain weight” is a common myth. With small, consistent changes it’s entirely possible to feel your energy return and your clothes start to fit comfortably again. You’re not alone in this.
This article is for general information and isn’t a substitute for individualised advice from your own doctor or dietitian.
Merve Tığlı, Dietitian
Sources: British Menopause Society / Women’s Health Concern — “Weight gain and menopause” (2023); British Dietetic Association (BDA) — Menopause and diet; NHS — Menopause and perimenopause: things you can do; Pontzer et al., Science (2021) — Daily energy expenditure through the human life course.