6 things to know about perimenopause and weight gain

Menopause means you have not had a period for 12 months in a row. Perimenopause is the time leading up to that point. It can start in your 40s (sometimes earlier) and last several years. Your period may still come, but it can be irregular. Hormones begin to shift. And you may notice changes in sleep, mood and energy.

Weight gain is one issue many women face, especially in the belly area. If this sounds familiar, you are not alone. These are common changes driven by hormones, aging and daily habits. 

The good news? Small, smart choices can make a big difference. Here are six things to know about perimenopause and your weight—and what can help.

1. Hormone changes shift fat stores

As estrogen drops, fat stores can shift around the body. Instead of storing fat in the hips, fat tends to settle more around the belly. Fat in this area, called visceral fat, increases during perimenopause. It’s linked to higher health risks like heart disease. 

Estrogen also affects how your body handles insulin and blood sugar. Less estrogen can make it slightly easier to store fat.

What helps: Focus on whole foods, balanced meals and regular activity. A plant-forward diet rich in vegetables, lean protein and healthy fats supports overall health. 

2. Metabolism slows and fewer calories are needed

Your metabolism—the system that turns food into fuel—naturally slows with age. During perimenopause, this slowing can be exaggerated a bit. Losing both estrogen and muscle means your body burns fewer calories at rest than it once did. 
 
Muscle burns more energy than fat, so as you lose muscle, the number of calories your body needs decreases too. While changes in hormones like estrogen and progesterone during perimenopause may be responsible for some of this muscle loss, aging also plays a large role. Muscle mass and strength can decline at a rate of 3% to 8% every 10 years after your 30s. That’s part of why many women find weight creeping up even when eating and moving the way they always have.

What helps: Strength activities like lifting light weights or using resistance bands can help build muscle. Ask a trainer or doctor if a weight-bearing exercise plan is right for you. Eating enough protein can help build and maintain muscle too.  

3. We become less active

Busy schedules, stress and fatigue can make exercise harder to fit in. Many women move less during this stage of life without even realizing it. Being less active means your body uses fewer calories daily. When hormones are shifting and metabolism slows, this added inactivity can make weight gain easier.  

What helps: Small changes add up. Park farther away, walk after dinner, take the stairs, walk during calls, or do mini workouts as you can fit them in. Getting in three 10-minute walks throughout the day is the same as walking for 30 minutes. Consistency matters more than perfection. Aim for 150 minutes of moderate-intensity exercise each week. Two strength training sessions per week are also suggested.

4. Poor sleep fuels appetite and cravings 

Night sweats and hot flashes can disrupt sleep. A lack of rest affects your appetite hormones. When you’re falling short on shut-eye, hunger hormones like ghrelin rise and fullness hormones like leptin fall. This makes you feel hungrier and more likely to crave sugary or salty foods. 

What helps: Try calming bedtime habits. Keep a cool, dark room and turn off screens as you wind down for bed. Keep a consistent sleep schedule. Better sleep helps keep your hunger in check.  

5. Stress may lead to extra eating and belly fat

Chronic stress raises a hormone called cortisol. When cortisol is high, the body may store more fat around the midsection. This can trigger cravings for sugary or high-fat foods. Stress also makes it harder to sleep and to make time for healthy habits. This creates a cycle that makes it tricky to manage your weight. 

What helps: Find simple ways to relax. Breathing exercises, short walks, hobbies and spending time with friends can lower stress levels. They can also help keep cortisol lower in general. Even five minutes can help lower stress.  

6. Old eating habits may need updating 

Your body doesn’t absorb and use food the same way it did in your 20s or 30s. Your body’s needs change, and those in perimenopause should focus on protein, healthy fats, fiber and other nutrients. If you aren’t getting enough fiber, protein or healthy fats, you may feel hungrier. This can cause you to overeat calories that your body doesn’t need.

What helps: Drink water and limit sugary drinks when you can. Focus on balanced meals, low in ultra-processed foods and rich in:

• Protein: eggs, fish, beans, yogurt

• Fiber: vegetables, fruit, whole grains

• Healthy fats: nuts, seeds, avocado

These foods help keep hunger in check and support stable energy.

The takeaway

Weight gain during perimenopause can be frustrating. Hormones, sleep, stress and muscle loss make it easier to gain weight.  

The key is not perfection—it’s consistency. Moving your body and eating balanced meals with fiber, protein and healthy fats can help. Getting enough sleep and managing stress can help your body stay healthy. 

If weight gain or symptoms feel overwhelming, talk with your doctor or a dietitian. You don’t have to go through this alone.