Losing weight during menopause: Understanding the changes and finding the right strategy

How does menopause affect weight and body composition?

As oestrogen levels fall, the body's metabolism and fat distribution begin to change. Before menopause, fat is more commonly stored around the hips, thighs and buttocks. After menopause, fat is more likely to accumulate around the abdomen and internal organs.

At the same time, muscle mass naturally declines with age, a process that may become more pronounced during menopause. Because muscle tissue contributes to the body's energy expenditure, this can make it easier to gain weight and harder to maintain weight loss over time.

Research shows that menopause itself does not necessarily cause dramatic weight gain. For many women, weight increases gradually over several decades. The main change during menopause is body composition, with a higher proportion of abdominal fat and a lower proportion of muscle mass. Abdominal fat is more metabolically active than fat stored under the skin and is associated with a higher risk of conditions such as type 2 diabetes, cardiovascular disease and fatty liver disease.

The role of oestrogen in metabolism

Oestrogen influences much more than reproduction. The hormone and its receptors are involved in several systems that regulate energy metabolism, appetite and metabolic health. Oestrogen supports healthy insulin sensitivity, helps regulate hunger and fullness, contributes to muscle maintenance and promotes a favourable fat distribution pattern. It also plays an important role in bone density and cardiovascular health.

As oestrogen levels decline, the risk of conditions such as type 2 diabetes, cardiovascular disease and osteoporosis increases. These risks may be even more relevant for people living with overweight or obesity.

At the same time, menopause is a period when healthy lifestyle habits can make a significant difference. Regular strength training, nutritious eating, good sleep and, where appropriate, medical treatment can support weight management, help preserve muscle mass and improve metabolic health throughout the menopausal transition and beyond.

Nutrition for lasting weight loss during menopause

During menopause, hormonal balance, muscle mass and energy requirements all change. This makes the quality of your diet particularly important. A nutrient-rich diet that includes enough protein, healthy fats, fibre, vegetables, fruit and berries, along with calcium and vitamin D, can help improve fullness, support muscle maintenance and promote bone health.

Adequate protein intake is especially important during weight loss because it helps preserve muscle mass and supports recovery after exercise. Good sources of protein include fish, eggs, poultry, pulses, dairy products and high-protein yoghurt.

After menopause, the risk of reduced bone density increases. It is therefore important to consume enough calcium and vitamin D, ideally alongside regular exercise, to support long-term bone health.

Physical activity and recovery during menopause

Regular physical activity is one of the most effective ways to support health and wellbeing during and after menopause. Strength training, cardiovascular exercise and activities such as yoga all offer unique benefits and complement one another by supporting body composition, metabolism, cardiovascular health and quality of life.

Strength training helps preserve muscle mass and physical function, which is particularly important because muscle mass naturally declines with age and falling oestrogen levels. During weight loss, the body typically loses both fat and muscle. Regular strength training can help preserve muscle and support a healthier body composition. It also places healthy stress on the skeleton and may help maintain bone density, which is important because the risk of osteoporosis increases after menopause.

Cardiovascular exercise has positive effects on heart health, blood pressure and the body's ability to use energy efficiently. Regular cardio can improve fitness, increase energy expenditure and support better blood sugar regulation and insulin sensitivity. As the risk of cardiovascular disease increases after menopause, cardio is an important part of a long-term health strategy.

Yoga and mobility-focused exercise can be valuable additions to both strength and cardio training. Alongside improvements in balance, flexibility and body awareness, yoga may help reduce stress, support recovery and improve sleep quality. Since many women experience increased stress sensitivity, sleep disturbances and joint stiffness during menopause, these benefits can be particularly valuable.

For the best results, a combination of strength training, cardio, everyday movement and activities that support recovery is recommended. Together, these can help preserve muscle mass, reduce abdominal fat, strengthen bones and improve both metabolic health and quality of life throughout menopause and beyond.

Medical support for weight loss during menopause

For some women, lifestyle changes may be enough to achieve and maintain a healthy weight during menopause. For others, hormonal changes combined with biological mechanisms that affect hunger, fullness and energy balance can make weight loss more challenging.

In these cases, medical treatment may be considered alongside nutrition, physical activity and other lifestyle measures. Modern weight-loss medications, including GLP-1-based treatments, work by affecting the body's systems for appetite regulation, fullness and blood sugar control. Treatment may help reduce appetite, increase feelings of fullness and lower calorie intake over time, making long-term weight loss more achievable for many people.

In large clinical studies, treatment with semaglutide resulted in average weight loss of around 15% of body weight after approximately 68 weeks. Studies of tirzepatide have shown average weight loss of up to around 20% or more after approximately 72 weeks. In all studies, medication was combined with advice on nutrition, physical activity and lifestyle changes.

Weight loss achieved through lifestyle changes and medical treatment may also help reduce abdominal fat and improve several metabolic risk factors, including blood sugar, blood pressure and cholesterol levels.

At Yazen, treatment begins with an individual medical assessment by a qualified doctor. Medication is combined with support from the care team around nutrition, physical activity and sustainable lifestyle habits, with the aim of creating long-term improvements in health and weight management.

Frequently asked questions about losing weight during menopause

Why does it feel harder to maintain my weight during menopause?

Research suggests that menopause itself does not cause significant weight gain. Weight often increases gradually before menopause and continues at a similar pace during the menopausal transition. As oestrogen levels fall, the body's fat distribution changes, leading to a greater proportion of fat being stored around the abdomen and internal organs rather than around the hips and thighs. At the same time, muscle mass naturally declines with age, which can contribute to lower energy expenditure over time.

Many women also experience sleep problems, fatigue and increased sensitivity to stress during menopause. These factors can affect appetite, recovery and physical activity, which may further contribute to changes in body weight and body composition.

What type of exercise is best during menopause?

There is no single type of exercise that is best for everyone during menopause. For most women, a combination of strength training, cardiovascular exercise and regular daily movement provides the greatest health benefits.

Strength training is particularly important because it helps preserve muscle mass, bone density and physical function as oestrogen levels decline. Cardiovascular exercise supports heart health, fitness and blood sugar regulation.

Yoga and mobility-focused exercise can also be valuable additions. As well as improving balance, flexibility and body awareness, yoga may help reduce stress and support recovery, which is especially relevant because many women experience sleep difficulties and increased stress sensitivity during menopause.

The most important thing is finding a form of exercise that feels sustainable and can be maintained over time. Regular movement is often more beneficial for long-term health than occasional intense workouts.

How can modern weight-loss medications help?

For some women, weight loss may become more challenging during menopause due to hormonal changes, shifts in body composition and increased hunger or appetite. If lifestyle changes alone do not produce the desired results, medical treatment may be an option.

Modern weight-loss medications, including GLP-1-based treatments, work by affecting the body's systems for hunger, fullness and blood sugar regulation. Treatment may help reduce appetite, increase feelings of fullness and reduce food cravings, making it easier for many people to create and maintain a calorie deficit over time.

These medications do not replace healthy lifestyle habits, but they can provide support that makes long-term changes to nutrition, physical activity and weight management easier to maintain. For many people, treatment combined with lifestyle changes also helps reduce abdominal fat and improve metabolic risk factors such as blood sugar, blood pressure and cholesterol levels.

All medical treatment should be preceded by an individual assessment to determine whether it is appropriate based on a person's health, risk factors and treatment goals.