Muscle mass naturally declines with age and falling estrogen, which slows down your metabolism. Strength training twice a week or more helps build and preserve lean muscle, which supports metabolism and may help reduce menopause-related weight gain.

While strength training helps preserve lean muscle, incorporating aerobic exercise into your routine can help you burn calories. Aim for 150 minutes of aerobic exercise per week. You might consider walking, swimming, running, or practicing high-intensity interval training (HIIT). 

When your estrogen levels decline, your body may become more insulin-resistant. For some people, this means blood sugar spikes more easily. Cutting back on refined carbs (like white bread or pasta) and added sugars (like those in soda or desserts) can help stabilize blood sugar, reduce fat storage (especially around the abdomen), and sustain energy. 

Protein helps keep you feeling full and preserves muscle mass during weight loss. During the menopause transition, women should aim for a daily intake of 1.2 grams of protein per kilogram of their body weight. Tasty high-protein options include fish, chicken, eggs, lean beef and pork, beans, and nuts.

Fiber slows digestion, promotes feelings of fullness, feeds beneficial gut bacteria, and helps stabilize blood sugar. You should aim for 25 to 30 grams of fiber per day to support both weight management and overall gut health. Reach for fruits like apples or blueberries, vegetables such as kale, nuts like almonds, and whole grains, including brown rice and quinoa.

Intermittent fasting is the practice of only eating during a defined window (such as six or eight hours per day), which can help reduce overall calorie intake and improve insulin sensitivity. Some research suggests intermittent fasting may help reduce visceral (abdominal) fat, although it’s not proven to work better than other calorie-reduction approaches. Fasting isn’t for everyone, and if you have a history of disordered eating, proceed with caution.

Professional advice can be helpful when you’re overwhelmed by menopause. A registered dietitian can create a personalized eating plan that accounts for menopause-specific metabolic changes, food preferences, and any other health conditions. You can ask your doctor for a referral or seek out a telehealth option. 

Estrogen plays a role in how your body distributes and stores fat, but during perimenopause your body starts producing less estrogen. Menopause hormone therapy (also known as hormone replacement therapy or HRT) may help limit the accumulation of abdominal fat and improve insulin sensitivity in some people. Menopause hormone therapy is considered weight neutral, meaning it has not been shown to cause weight loss.

For some women, antiobesity medicines can help with weight loss. You may be curious about medications such as tirzepatide (Zepbound) and semaglutide (Wegovy), which are glucagon-like peptide 1 (GLP-1) receptor agonists. They mimic a hormone that regulates appetite and blood sugar. 

When combined with lifestyle changes, some GLP-1s have shown strong results for weight loss in women of all ages, including those in perimenopause and menopause. They’re typically reserved for people with a body mass index (BMI) score in the obese category or those who are overweight with other health conditions. Check with your doctor to see if this medication is right for you. 

Weight-loss medications usually require long-term use because stopping the medication leads to weight regain.

An underactive thyroid (known as hypothyroidism) causes fatigue, slows your metabolism, and can lead to weight gain — symptoms that overlap significantly with menopause. Because they're so easy to confuse, ruling out a thyroid issue with a blood test can be an important first step. If you have symptoms that could be related to thyroid disease, your doctor can request a thyroid panel.

Chronic stress elevates a hormone called cortisol, which directly promotes fat storage around the abdomen. Practices like meditation, yoga, and breathwork can help manage stress and support healthy lifestyle habits.

Poor sleep can lead to weight gain or difficulty maintaining a balanced weight. Practice good sleep hygiene by having a regular bedtime and avoiding screen time before bed. 

If you struggle with insomnia, seek an evaluation from your medical provider. You may need a sleep study, which can diagnose sleep disorders and help determine the best treatment.