Midlife weight gain can start long before menopause – but you can take steps early on to help your body weather the hormonal shift |
You’re in your mid-40s, eating healthy and exercising regularly. It’s the same routine that has worked for years.
Yet lately, the number on the scale is creeping up. Clothes fit differently. A bit of belly fat appears, seemingly overnight. You remember your mother’s frustration with the endless dieting, the extra cardio, the talk about “menopause weight.” But you’re still getting your periods. Menopause should be at least half a decade away.
So what’s really going on?
We are a primary care physician with expertise in medical weight management and an endocrinologist and obesity medicine specialist. We hear this story nearly every day. Women doing everything “right” suddenly feel like their bodies are working against them.
And while lifestyle choices still matter, the underlying cause isn’t willpower. It’s physiology.
Most women expect the weight struggle to begin after menopause. But research suggests the real metabolic shift happens years earlier. During the multiyear transition to menopause, women’s bodies begin processing sugar and carbs less efficiently, while their metabolism slows down at rest. That can drive weight gain – especially around the midsection – even if a person’s habits haven’t changed much.
There are physiological processes that begin long before menopause itself, but weight gain around the menopause transition isn’t necessarily inevitable. Recognizing this early window makes it possible to intervene while your body is still adaptable.
Menopause is officially defined as 12 months without a period. But the body’s hormonal transition, which comes from changes in signaling between the brain and ovaries, begins years earlier during a