While we’d love to go through life without putting on unwanted weight, gaining a couple of pounds here and there is perfectly normal. However, if the scale keeps creeping up or you’re struggling to lose weight no matter what you do, you may be dealing with perimenopause weight gain. Fortunately, there are easy ways to shed those excess pounds and maintain your health goals during this transition. Here, learn why perimenopause causes sudden weight gain and simple changes you can make to reach your happy weight.
What is perimenopause weight gain?
Weight gain is a relatively common symptom of perimenopause. Many women who have never experienced excess weight gain in their lives find that their body’s ability to regulate weight changes at this time, explains Katherine H. Saunders, MD, DABOM, obesity physician at Weill Cornell Medicine and co-founder of FlyteHealth
Perimenopause is a time of significant change, especially where your hormones are concerned. So it’s unsurprising that hormone fluctuation contributes to sudden weight gain in addition to more talked about symptoms such as hot flashes and night sweats or mood swings.
What causes perimenopause weight gain?
When approaching perimenopause, experts say progesterone is usually the first hormone to decrease. “When this happens, women tend to have more issues with water weight before and during their period,” says Sue Decotiis, MD, NYC weight-loss doctor at Westchester Medical Weight Loss Doctor. Some may also experience increased hunger before their period, which can lead to higher calorie intake and weight gain.
The other hormone that plays a big role in perimenopause symptoms? Estrogen.
Your estrogen levels impact how you metabolize fat, explains Dr. Deotiis. “When both these hormones really start to go down, other hormones in the body become imbalanced—but it varies from person to person and some people don’t gain as much weight.”
Aside from hormone fluctuations, an “increase in insulin resistance and changes in body composition and metabolic rate” can also contribute to perimenopause weight gain, says Dr. Saunders.
Other factors, such as poor sleep quality and certain medications (such as sleep medications and antidepressants), can play a role, too.
Insulin resistance affects weight during perimenopause
Hormone imbalances combined with insulin resistance create a perfect storm for weight gain during perimenopause. “During menopause, your body may become less sensitive to insulin, which leads to higher blood sugar levels and increased fat storage,” says Dr. Saunders. “This creates a vicious cycle where more abdominal fat leads to even more insulin resistance, which leads to even more fat storage.”
How to lose weight during perimenopause
Dr. Saunders says lifestyle interventions such as a sustainable dietary strategy, physical activity that you enjoy and personalized behavioral changes are the cornerstones to perimenopause weight management.
You’ll also want sustainable changes to prevent weight gain and lose unwanted pounds. Dr. Decotiis notes that you shouldn’t starve yourself and that there shouldn’t be any quick fixes. If you’ve tried adjusting your nutrition and fitness habits and aren’t noticing any weight loss, then it might be time to see a doctor who can tailor a health plan to your needs.
Worth noting: If you have underlying medical conditions or your body mass index (BMI) is over 30 (or over 27 with weight-related health problems), obesity medications could be an option. “These medications can counteract the effects of insulin resistance and help your body overcome the hormonal, metabolic and neurobehavioral ways your body prevents you from losing weight,” says Dr. Saunders.
When to see your doctor about perimenopause weight gain
Gaining weight during perimenopause is extremely common—it’s just not talked about enough. “So many women blame lack of willpower for their weight gain and their difficulty losing weight, but it’s not your fault and it’s treatable,” says Dr. Saunders.
Like other perimenopause symptoms, weight gain can impact your daily health and well-being. And if changing your lifestyle hasn’t worked, don’t be afraid to speak with your primary care provider, gynecologist or weight management provider (if you have one).
Dr. Saunders says they can give you a thorough check up focused on your weight and design a personalized treatment plan to address everything causing weight gain and anything stopping you from losing weight.
This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.
