Weight Gain in Perimenopause

Source: Daria Pimkina/Unsplash

Saturday night. All day you’ve been looking forward to meeting friends for dinner, drinks, and good conversation.

Shower. Check. Hair and makeup. Done.

Time to get dressed. You open the closet door, take a deep breath, and consider the options:

Those pants are uncomfortably tight, with zero room for after-dinner expansion. Squeezing into that dress is not happening. Ugh. Even my favorite jeans feel suffocating.

No. Nope. No.

One after the other, your once-adored pieces now leave you feeling constricted, miserable, and exasperated.

Forget it. I give up. I’m staying home.

Does any of this sound familiar? If so, you are not alone. And, if you are a female in your 40s or 50s, chances are even higher that it rings true.

Weight gain in perimenopause is a near-universal grievance.

During this time of great hormonal fluctuation, many women find that—seemingly overnight and despite zero alteration to diet, exercise, or habits—their body composition shifts substantially.

Whether or not the number on the scale increases, fat once stored primarily in the legs, hips, and butt is redistributed to the midsection. What once consistently worked to maintain a healthy weight and muscle tone is no longer effective.

What causes weight gain in perimenopause?

According to Dr. Jen Gunter, author of The Menopause Manifesto, “During the menopause transition, women are more prone to gaining visceral fat [fat inside the belly around the organs, as opposed to subcutaneous fat, which is just below the skin and can be grabbed with the hands]. This may be why many think they’re gaining more weight than they are, because their waistbands may be getting tighter.”

The verdict is still out regarding the exact mechanisms causing perimenopausal weight gain. What we do know is that it is a multifaceted, complex process. When estrogen decreases, our metabolic rate and muscle mass decrease, and fewer calories are burned at rest.

Fluctuating levels of estrogen can also trigger fat storage in the belly—and, guess what—a little extra belly fat is actually necessary to offset our changing hormones.

Hormones absolutely play a role. Weight gain, therefore, is not simply a function of aging. It is one potential perimenopausal symptom among many. The extensive changes our bodies undergo during perimenopause are real, normal, and often challenging.

Why does it matter?

Whether we like it or not, most of us, to some degree, care about our appearance. Our posture, body composition, and how we feel in our bodies and clothes all play a role in self-esteem and confidence. (Some might call it vanity. I call it being human, not to mention long-held societal pressure—a discussion for another time.)

The insula is the part of the brain that scans for threats by evaluating how we view ourselves in relation to others (and even to our younger selves—not fair). When we deem ourselves lacking (My pants are tight.), strong feelings of disgust and frustration can arise, leading to plenty of negative self-talk (Eww, you look awful. Or worse).

When chronic, this cycle can lead to feelings of overwhelm, melancholy, and hopelessness. Not only can weight gain affect one’s body image, self-esteem, and energy, but also self-identity, relationships, and mental health.

Sleep disturbance, another prevalent symptom of perimenopause, can increase ghrelin, known as the hunger hormone, causing a spike in appetite and cravings for comfort food. Sleep deprivation is also associated with a rise in cortisol, the stress hormone, which, over time, contributes to inflammation. And when we’re exhausted, we are much less inclined to exercise.

Carrying extra weight around the midsection is also associated with a number of possible negative health effects, such as Type 2 diabetes, several cancers, cardiovascular disease, and early death.

Why are you telling me this?

Before we can talk about coping, it helps to understand what we’re working with.

Menopause Essential Reads

Menopause as a Catalyst for Psychospiritual Development

Menopause Brain Drain

Part of being a healthy midlife woman is likely to include carrying a little extra weight around the midsection. Remember, a little extra belly fat is actually useful to offset our changing hormones. Let that sink in.

Now. This is in no way permission to give up or give in. Rather, it’s about striking the best unique balance of acceptance and action for each of us.

A reflection tool to get you started: The Perimenopause Serenity Prayer

Grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference. —Reinhold Niebuhr

Acceptance does not equate to loving our new reality or entirely relinquishing control. It is about no longer resisting what is out of our control.

First, we need to assess what is and is not in our power to change. How much is fixed, and how much is alterable? (This may take a bit of time and patience to discern.)

And: How much action am I willing to take? How important is the hoped-for result? What is it I really want to focus on? What matters most?

When it comes to changing body composition, how much precious time, energy, and resources do I want to devote to it?

Ultimately, it’s about striking the right balance of acceptance and action for each of us—one that feels both empowering and attainable.

Finally—and I will get to this in Part 2 of this series—what might that action look like, specifically?

My next post will share specific action steps and ideas to get you started. Until then, go slide into some comfy pants and get out there with your friends. I hope the Perimenopause Serenity Prayer helps.