Among women entering or in menopause, it's common to notice an unwelcome change in the form of added body fat around the midsection. In fact, menopausal women gaining weight in their abdominal area is such a common phenomenon that it even has a nickname: “menopause belly fat” or “menopause tummy.”
Meno belly, another common term for menopause belly fat, often starts to appear as you enter menopause, typically around your late 40s to early 50s. It's that stubborn belly fat that settles around the midsection during these years and won't seem to budge even though your diet or exercise habits haven't changed much since your younger years.
In this article
- What Causes Meno Belly (Menopause Belly Fat)?
- Risks of Weight Gain During Menopause
- How Menopause Impacts Muscle Mass and Exercise
- Using Hormone Replacement Therapy for Menopause Belly Fat
- How to Get Rid of Meno Belly Without Hormones
- Can GLP-1s for Weight Loss in Menopause Help?
- Conclusion: Causes of Menopause Weight Gain and How to Get Rid of Meno Belly
What meno belly really refers to is increased visceral adiposity—or deep abdominal fat that surrounds the internal organs.
Unlike subcutaneous fat, which is located just under the skin, visceral fat is problematic for overall health, especially with increasing age. Its buildup goes beyond being a cosmetic concern, as it's a serious issue that's linked to a higher risk for diseases1 like:
- Diabetes
- Hypertension
- Metabolic syndrome
- Cardiovascular diseases (the leading cause of death among menopausal women)
Managing your overall health during menopause is more crucial than ever, not just for your appearance but for your long-term health. In this article, learn strategies to help target the underlying causes of increased menopause belly fat, including foods, supplements, exercises, and potentially hormone replacement therapy (HRT) if you're a good candidate for it.
What Causes Meno Belly (Menopause Belly Fat)?
During the menopause transition, up to 70% of women2 experience weight gain. Studies show that on average, women in their 50s and 60s gain about 1.5 pounds per year and that many will gain 12 pounds within eight years of the onset of menopause.
Belly fat accumulation during menopause, in particular, is mostly attributed to hormonal changes, especially declining estrogen levels. During menopause, both estrogen and testosterone levels fluctuate, affecting body composition and overall health. Other hormonal changes take place too, including those affecting FSH (follicle-stimulating hormone) and insulin levels.
Changes in body fat composition and distribution in the abdominal area have been shown to occur specifically during the menopausal transition. One study found that over the course of five years, postmenopausal women gained 36% more trunk fat3, 49% more intra-abdominal fat, and 22% more subcutaneous abdominal fat on average compared to premenopausal women.
| Menopause Hormones That Contribute to Menopause Abdomen | Levels |
| Estrogen | Low |
| Testosterone | Elevated |
| Insulin | Elevated |
Here's more about hormonal changes that take place during menopause that can contribute to meno belly:
Declining Estrogen
Estrogen's role is not limited to reproductive functions; it also influences how fat is distributed in the body.
When estrogen levels drop, there’s a natural propensity to accumulate more visceral fat (postmenopausal belly fat), along with overall increased body fat and decreased skeletal muscle mass, further compounding health risks.
Additionally, lower estrogen levels are associated with lower dopamine and serotonin, which can negatively impact mood, motivation, food choices, energy levels, motivation, and workout satisfaction.
There’s also evidence that lower estrogen levels potentially decrease microbial diversity in the gut and may play a role in body composition.
Low Testosterone
Changes in testosterone during menopause are not as commonly discussed as those of estrogen, yet testosterone levels also tend to decrease during this phase and impact body composition.
Testosterone is not just a “male hormone,” but one that's found in both sexes and that is crucial for muscle mass and overall metabolic health. It's common for testosterone, along with estrogen and progesterone, to decline in menopause, which can lead to a decrease in muscle mass and slowed down metabolism. A slower metabolism means the body burns fewer calories at rest, which can contribute to weight gain over time, especially in the belly area.
With the decline in muscle mass, there's often an increase in fat accumulation, particularly around the abdomen. This abdominal fat, or visceral fat, is not only harder to lose but also contributes to various health risks such as cardiovascular disease and type 2 diabetes.
Testosterone also impacts energy levels and overall vitality, which can lead to lower activity.
High Testosterone
Some women also experience an imbalance in the ratio of androgen to estrogen4 during menopause, which can contribute to weight gain by promoting the accumulation of belly fat and altering the distribution of body fat towards a more masculine pattern. Studies show that high testosterone in menopause is associated with increased visceral adipose tissue5. In fact, one study found that testosterone that is active in the bodies of menopausal women was the strongest predictor of visceral fat6.
For women struggling with an imbalance ratio of testosterone, which can be confirmed with the help of hormonal testing, treatments like spironolactone, metformin, and glucocorticoids are available to help address the testosterone imbalance, although they aren't FDA-approved for women specifically. You can learn more about lifestyle changes, supplements, and medications that can help address high testosterone in women here.
Risks of Weight Gain During Menopause
As mentioned above, cardiovascular disease is the leading cause of death7 in postmenopausal women—and being overweight or obese, and especially having significant visceral fat, is a major risk factor for developing heart disease.
Visceral fat, considered a “dangerous fat,” refers to the fat stored within the abdominal cavity, surrounding vital organs such as the liver, pancreas, and intestines.
Visceral adiposity is linked to a higher incidence8 of:
- Hypertension (high blood pressure)
- Type 2 diabetes and insulin resistance
- Metabolic syndrome (a combination of insulin resistance, high blood pressure, and high triglycerides)
- High cholesterol
- Cardiovascular diseases
In addition to causing weight gain, low estrogen can affect the way the body uses insulin, a hormone that regulates energy usafe and fat storage. As estrogen drops, insulin resistance becomes a bigger threat. And with insulin reistance often comes increased fat storage, including in the belly.
How Menopause Impacts Muscle Mass and Exercise
Researchers including Dr. Vonda Wright, have recently introduced a new term to describe muscle-related symptoms associated with the loss of estrogen during menopause: the “musculoskeletal syndrome of menopause9.”
These types of menopause symptoms affect about 70% of women during this stage of life—and about 25% severely affected. They're associated with changes in muscle mass, bone density, body fat, and joint health.
As we age, our muscle mass tends to decline, especially if we don't eat adequate protein (upwards of 100 grams per day) and do regular strength training exercises. Here's a closer look at why this happens and how it specifically impacts menopausal women.
Estrogen's Effects on Muscle Mass
Estrogen not only impacts body fat but also the maintenance and function of skeletal muscle, which is essential for growth, repair, mobility, exercise performance, and overall health.
Estradiol, the most biologically active form of estrogen, also has an influence on our bones, tendons, cartilage, ligaments and adipose tissue.
Many menopausal women experience a decline in muscle mass and metabolic rate, making it more challenging to maintain a healthy body composition and avoid increased belly fat.
Menopausal women also have a higher risk for sarcopenic obesity, a condition characterized by the loss of muscle mass combined with an increase in body fat. Sarcopenic obesity, like having visceral fat, is linked to health risks like cardiovascular disease, diabetes, osteoporosis, dementia, and other chronic health conditions.
Another issue is that estrogen helps to regulate the turnover of bone tissue, promoting the activity of cells that build bone, so with less estrogen, bones become weaker. The activity of cells that break down bone tissue becomes relatively higher, leading to an overall loss in bone density, which can predispose women to osteoporosis.
How Menopause Impacts Physical Performance
Estrogen enhances the regenerative capacity of muscle stem cells, promoting faster recovery and greater resilience against muscle damage. This process is vital during exercise, as it helps in repairing the micro-tears that occur in muscle fibers, leading to stronger and more efficient muscles over time.
During menopause, the reduction in estrogen levels can lead to decreased muscle repair and regeneration, making it harder to maintain strength. This can affect physical performance and increase the risk of injuries during exercise.
Using Hormone Replacement Therapy for Menopause Belly Fat
Hormone replacement therapy (HRT), also called menopausal hormone therapy (MHT), can be an effective method to manage menopausal symptoms and risks, including changes in body composition such as increased belly fat.
Recent studies show that HRT/MHT can offer many benefits for women in menopause, including:
- Reduction in dangerous visceral fat10 and total body fat.
- Improved heart health and greater protection against changes in lipid profiles and arterial health.
- Alleviation of hot flashes, night sweats, mood swings, and vaginal dryness.
- Cognitive benefits, including protection against cognitive decline.
- Enhanced skin elasticity and tone.
MHT helps slow down the loss of estrogen11, easing the transition through menopause and reducing symptoms related to muscle and bone health as well as weight gain.
This type of therapy involves using topical estrogen, and if the woman has a uterus, progesterone is also included. There are other cases when progesterone may be used and testosterone, thyroid, and other hormones may also be considered. MHT can be administered through various forms like pills, patches, or sprays.
If you're struggling with menopause belly fat and other issues during menopause, talk to a knowledgeable healthcare provider about your options.
Keep in mind that many providers, especially those who might not be as familiar with the musculoskeletal effects of menopause (such as orthopedic surgeons), might not recommend HRT on their own, so you might need to be proactive about requesting it. Dr. Wright's research shows that many practitioners overlook menopause-related causes when middle-aged women present with joint pain, muscle loss, or similar symptoms. It's time to change that!
How to Get Rid of Meno Belly Without Hormones
Hormone replacement therapy isn’t an option for everyone and even with it, there are still important lifestyle and nutrition factors to consider.
If you're looking for help preventing or getting rid of belly fat during menopause, consider incorporating these strategies, which we’ll discuss in more detail bellow:
- Strength train 3 to 5 days per week.
- Eat 100+ grams of protein per day.
- Consume 25+ grams of fiber.
- Limit added sugar to no more than 25 grams.
- Eat a Mediterranean-style diet.
- Get 7 to 9 hours of sleep per night.
- Manage stress.
- Consider menopausal supplements such as phytoestrogens, myo-inositol, vitamin D, omega-3s, and adaptogenic herbs.
- Talk to your doctor about Menopause Hormone Therapy (MHT)
1. Strength Training in Menopause
Exercise is a natural metabolic booster and incredibly important for women going through menopause because it helps counter many of the negative effects of decreasing estrogen levels.
Getting regular exercise can boost strength and power, burn calories to help decrease body fat, and increase bone density, not to mention that it's great for sleep and your mood.
Weight training (or resistance and strength training) is especially beneficial for postmenopausal women because it stimulates muscles to help maintain their mass. To increase muscle power more effectively, try lifting heavier weights with fewer repetitions rather than lifting lighter weights with more repetitions.
For the greatest results, do a mix of both aerobic exercise and strength-training each week, aiming for 3-4 weekly resistance training sessions.
2. Eat Adequate Protein
Incorporating more protein into your diet— and possibly supplements like creatine or protein powders—can help improve bone density and muscle mass. Your muscles need a steady supply of protein to maintain their mass and recover from physical activity, especially as you age.
Aim to eat at least 100 grams of protein each day (and about 30 grams with breakfast) by emphasizing foods like fish, poultry, grass-fed meat, eggs, yogurt, legumes, beans, nuts, seeds, and whole grains.
3. Consume a High Fiber, Mediterranean-Type Diet
A diet rich in fiber (at least 25 grams per day) and low in added sugars (less than 25 grams daily), alongside adequate protein intake, is vital for maintaining a healthy weight during and after menopause.
Fiber helps slow down the absorption of sugar in the bloodstream and assists in maintaining stable blood sugar levels. Fibrous foods are also filling and can help reduce your overall calorie intake, and they support gut health, which is important for detoxification and hormonal balance.
To consume enough fiber on a regular basis, aim to eat a Mediterranean-style diet, which includes a variety of different plant foods, such as vegetables, lentils, and whole grains. Studies have found that adherence to the Mediterranean diet is associated with lower abdominal fat gain12 and lower incidence of obesity13.
Foods high in fiber to eat regularly include:
- Beans and legumes: lentils, black beans, chickpeas, and others.
- Whole grains: Opt for quinoa, oats, brown rice, and whole wheat.
- Fruits: Apples, bananas, oranges, and berries are excellent choices.
- Vegetables: Include broccoli, carrots, peppers, mushrooms, Brussels sprouts, etc..
- Nuts and seeds: Chia seeds, flaxseeds, and almonds are great sources of fiber.
Related: Best Prebiotics for Gut and Hormone Health
4. Manage Stress
Managing stress is crucial in reducing belly fat because high stress levels can disrupt hormonal balance and trigger the release of the hormone cortisol, which is known to promote fat storage, especially in the belly.
Elevated cortisol levels can increase appetite and drive cravings for high-fat, high-sugar foods, contributing to further belly fat. Additionally, chronic stress can disrupt sleep patterns, which in itself is linked to weight gain and healthier food choices.
Implementing stress-reducing practices into your daily routine—such as meditation, deep breathing, yoga, and exercise—are among the best ways to help lower cortisol and support metabolic health.
5. Consider Menopause Supportive Supplements
Supplements are one of the tools available to support our health during the menopause years. It’s important to understand that there are no supplements that will stimulate the ovaries to produce estrogen once you are postmenopausal. But supplements can certainly aid in other ways, like supporting insulin sensitivity, helping fight inflammation, and supporting bone health, along with other benefits.
Women in menopause who are experiencing symptoms tied to low estrogen may benefit from menopausal supplements such as:
- B vitamins: B vitamins, particularly B6 and B12, are critical for the metabolism of fats and proteins. Their inclusion can aid in the utilization of stored energy14, potentially reducing belly fat accumulation, especially during menopause when metabolic rates can decrease.
- Vitamin D: While findings about its effects have been somewhat mixed, research suggests that higher levels of vitamin D are linked to reduced risk for obesity15 and fat accumulation as well as improved weight management. This nutrient can help mitigate the storage of belly fat, which tends to increase during menopause due to hormonal shifts. Because deficiency is common, Vitamin D3 supplementation is recommended for most adults.
- Chromium: Chromium has been shown to help increase insulin sensitivity16 and stabilize blood sugar levels, which can curb excessive eating and help reduce fat accumulation, including in the midsection. It may also help regulate fat storage and metabolism and increase lean muscle mass, contributing to a generally healthier body composition.
- Probiotics: These beneficial bacteria influence the balance of the gut microbiome, which is directly linked to nutrient absorption17, hunger, weight management, and fat distribution18. Probiotics, such as Women's Probiotics supplements, can also improve digestion and reduce inflammation, which are also helping in preventing bloating and belly fat accumulation during menopause.
- Green tea extract: Rich in catechins, green tea extract helps to naturally boost your metabolism and enhance the body’s ability to burn fat through a process called thermogenesis. Studies show19 that the antioxidant properties of green tea can significantly reduce visceral belly fat over time.
- Carnitine: Carnitine facilitates the burning of fatty acids for energy20, directly influencing fat stores and potentially helping to reduce belly fat. It becomes particularly beneficial during menopause when decreasing hormone levels can slow down the metabolism.
- Fiber supplements (like guar gum): This fiber supplement, as well as the type called glucomannon21 and prebiotics, can help with weight control by promoting a feeling of fullness22, reducing the absorption of fat in the intestines, and delaying gastric emptying. During menopause, fiber supplements and prebiotics are a simple and expensive way to help ward off weight gain and potentially reduce visceral fat deposition.
- Magnesium: Magnesium plays a pivotal role in over 300 enzymatic reactions in the body, including those involved in the metabolism of food23. Adequate magnesium levels, which can be achieved with help from supplements like Magnesium Plus, can enhance the breakdown of abdominal fat by improving insulin sensitivity and reducing inflammation.
- Omega-3s: These fatty acids are known for their anti-inflammatory effects, which can be beneficial in reducing overall body inflammation and aiding in the reduction of belly fat24. Omega-3 supplements may also help regulate hormones and can improve metabolic health during menopause, helping to manage weight and reduce belly fat.
For more help choosing supplements specifically to manage low estrogen, check out this article: What's the Best Supplement for Estrogen?
Additionally, those with elevated testosterone in proportion to estrogen may find these supplements from Dr. Brighten's Essentials to be helpful: Balance, Adrenal Support, Saw Palmetto Plus, Myo Inositol Plus, and N-Acetyl Cysteine.
For example, Balance Women's Hormone Support formula contains Vitex and calcium d-glucarate, which help support estrogen and testosterone metabolism.
Can GLP-1s for Weight Loss in Menopause Help?
GLP-1 is a hormone secreted by the intestines in response to food intake. It plays a pivotal role in glucose metabolism, insulin secretion, and appetite regulation.
Recent studies25 highlight the potential of GLP-1 medications in managing menopausal weight gain, particularly when used along with HRT, which can boost their effectiveness. GLP-1 drugs and estrogen are thought to have synergistic effects26—meaning together, they help to control food intake and support a healthy metabolism.
GLP-1 can be obtained through medications known as GLP-1 agonists, which include semaglutide (Ozempic™, Wegovy™) and liraglutide (Victoza™, Saxenda™). These drugs may be used to treat type 2 diabetes and obesity and to reduce the risk of heart disease.
Research indicates27 that GLP-1 agonists can offer a number of benefits that can support menopausal women's health, including:
- Slowed digestion and stomach emptying
- Increased feelings of fullness
- Reduce appetite and food intake
- Lower blood sugar levels
- Reduce glucagon secretion
- Weight loss
- Potentially reduced inflammation
- Support for cardiovascular health
Learn more about how Ozempic can support weight loss in this article.
There are also foods and supplements that can be thought of as “natural Ozempic” alternatives since they stimulate the release of GLP-1 and promote fullness, which can lead to weight loss. These include foods rich in beta-glucans28, fiber, protein, and other essential nutrients.
Additionally, a number of natural foods, herbs, and products29 can be used to support weight loss, including those that contain caffeine and spices30, such as: green tea, garcinia cambogia, turmeric, ginger, coffee, chili pepper, spirulina, licorice, hibiscus, and yerba maté.
Conclusion: Causes of Menopause Weight Gain and How to Get Rid of Meno Belly
- Menopause abdominal weight gain is caused by hormonal changes, especially declining estrogen, often in combination with lifestyle and behavioral changes.
- Postmenopausal belly fat is more than just a vanity concern; it's also called visceral fat, and it raises the risk for many chronic health conditions, including diabetes and heart disease.
- Women struggling with meno belly should focus on eating adequate protein and fiber, limiting sugar, and strength-training regularly.
- Hormone replacement therapy (or Menopause Hormone Therapy) is another effective option that can offset many symptoms tied to lower estrogen levels, including weight gain and loss of muscle and bone mass.
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