Dr. Jaime Seeman
Menopause and perimenopause are transformative phases in a woman's life, typically occurring between the ages of 45 and 55, marking the end of fertility and bringing with them significant hormonal shifts. These changes can make weight management more challenging, particularly with the tendency for weight to accumulate around the belly. Despite these challenges, I want women to know that they are not alone and that managing weight effectively during this time with the right approach is possible and can boost both metabolic health and overall well-being.
Understanding the Impact of Hormones on Weight
As women enter perimenopause, estrogen and progesterone levels begin to fluctuate and eventually drop. These hormonal changes can significantly impact metabolism, fat distribution, and muscle mass. As estrogen declines, women may find that their bodies store more fat around the abdomen and experience a slowing of metabolism. Factors like reduced physical activity compound this shift, along with disrupted sleep patterns, and aging, all of which contribute to difficulty losing weight.
However, it's important to remember that while weight loss during menopause may require a little more effort, with the right strategies, it's entirely achievable. By focusing on nutrition, exercise, sleep, and stress management, women can reach and maintain a healthy weight while improving their energy levels and overall quality of life.
Key Strategies for Weight Loss During Perimenopause
Nutrition
A balanced diet is critical when it comes to weight management. Women in perimenopause and menopause should prioritize a diet rich in protein, healthy fats, and complex carbohydrates. These nutrients help stabilize blood sugar levels, support muscle mass, and maintain energy levels throughout the day. Avoiding alcohol, processed foods, and added sugars is equally essential, as these can exacerbate hormonal imbalances and contribute to weight gain.
Strength Training and Exercise
Resistance training is a key component for maintaining and building lean muscle mass. It's recommended to incorporate strength training 2–3 times a week. Muscle mass naturally decreases with age, and strength training helps to combat that decline, revving up metabolism and enhancing fat burning. In addition, regular cardiovascular exercise—such as brisk walking, cycling, or swimming—is essential. Aim for 150 minutes of moderate exercise per week, with high-intensity interval training (HIIT) or sprinting sessions included to accelerate changes in body composition and increase calorie burn.
Sleep
Quality sleep plays a significant role in weight management, especially during menopause. Poor sleep can disrupt the hormones that regulate hunger and appetite, often leading to overeating. Improving sleep hygiene—avoiding late-night meals, limiting screen time before bed, and keeping a consistent sleep schedule—can help support healthy sleep patterns, reduce cravings, and enhance weight loss efforts.
Stress Management
Chronic stress can lead to increased cortisol levels, a hormone that may contribute to belly fat storage. Managing stress through mindfulness, meditation, yoga, and breathing exercises is vital for keeping cortisol levels in check and supporting overall weight loss efforts.
For Women Taking GLP-1s
For some women, especially those experiencing significant weight gain during menopause, medications such as GLP-1s (glucagon-like peptide-1 receptor agonists) like Ozempic® or Wegovy® may be prescribed as part of their weight loss strategy or overall health strategy. While these medications can be effective in aiding weight loss by reducing appetite and slowing gastric emptying, they are often associated with gastrointestinal (GI) side effects, including nausea, bloating, constipation, and diarrhea.
Even when using GLP-1 medications, nutrition remains crucial. Focus on balancing macronutrients (proteins, fats, and carbohydrates) and micronutrients (vitamins and minerals) to support overall health. A diet rich in high-quality protein is essential to preserve muscle mass as metabolism naturally slows during menopause. Healthy fats (like those from avocados, nuts, and seeds) and complex carbohydrates (such as whole grains and vegetables) will provide sustained energy, help stabilize blood sugar, and support hormonal balance.
Another key aspect is calorie intake. While GLP-1s can help reduce appetite, women in perimenopause and menopause still need to be mindful of their caloric intake. As metabolism slows due to hormonal changes, it's important to focus not only on the quantity of food but also the quality. Consuming nutrient-dense, calorie-controlled meals ensures that the body is getting the necessary fuel without overconsuming calories, which can lead to weight gain. Calorie needs may decrease during menopause due to reduced muscle mass and physical activity levels, so adjusting calorie intake is important. This doesn’t mean severely restricting calories but optimizing the balance of nutrients to help support weight loss while maintaining energy levels and health.
Supporting gut health is particularly important for women taking GLP-1 medications, as these medications can cause discomfort in the digestive system. One natural supplement to consider is Relesium, a new product specially formulated for GLP-1 users that’s been shown to help alleviate GI issues commonly associated with GLP-1s. By supporting the digestive tract, Relesium can help minimize discomfort, allowing you to stay on track with your weight loss goals while managing your nutrition effectively.
Ultimately, while GLP-1s may help with appetite control, it's essential to prioritize balanced nutrition and be aware of calorie needs during this life stage. Consulting with a healthcare provider can help determine the most effective and sustainable approach for weight management during perimenopause and menopause.
Hormone Replacement Therapy (HRT) and Other Therapies
For some women, hormone replacement therapy (HRT) may help alleviate symptoms associated with menopause, such as hot flashes and mood swings, which in turn can support weight management. Additionally, consulting with a healthcare provider is essential for women considering GLP-1 medications or other medical therapies to determine the most appropriate treatment. For those using GLP-1s, it's crucial to monitor any GI side effects and seek products that can aid in any negative side effects.
The Bigger Picture
It’s important to remember that weight loss may be slower in your 40s and 50s compared to your 20s and 30s, but that doesn’t mean it’s impossible. Embracing a holistic approach that includes a balanced diet, consistent exercise, quality sleep, and effective stress management can help you reach your wellness goals and improve your overall health. Whether you’re managing menopause symptoms with HRT, GLP-1s, exercise, or nutrition, remember that each woman’s journey is unique. Consult with your doctor to find the best approach for your individual needs and experience this life stage in the healthiest way possible.
Dr. Jaime Seeman, is a board-certified Obstetrician-Gynecologist with a background in Nutrition, Exercise and Health Science. She is also a current Fellow in Integrative Medicine and a Board Certified Ketogenic Nutrition Specialist. For more, visit: www.doctorfitandfabulous.com.