Perimenopause is often accompanied by weight gain and is always accompanied by shifts of fat stores from the hips, thighs, and buttocks to your mid-section. To add insult to injury during perimenopause, changes to your metabolism and your personal life can make it extremely difficult to lose weight. This combination frequently leaves women feeling frustrated and “stuck.”
As a behavioral health doctor at Massachusetts General Hospital, I helped hundreds of patients lose weight. I can safely say that often the patients who had to work the hardest to achieve their weight loss goal were those in perimenopause. The women I worked with frequently said things like “the things I normally do to lose weight just aren’t working” and “in the past, I’d adjust my diet to lose weight, and that’s no longer enough.” I quickly realized that I needed to figure out what types of habits women in this life stage could practice in order to lose weight.
So I read numerous books and worked with a steady group of perimenopausal women seeking to lose weight, and together we figured out a formula that worked for nearly all of them. In this article, I’ll review these perimenopausal weight loss promoting habits and explain why losing weight during perimenopause is so challenging.
What Causes Weight Gain Around Menopause?
Women often gain 5-10 pounds or more during perimenopause. This weight gain is associated with shifts in hormones, a slow down in metabolic rate related to muscle loss, and an increase in life demands often associated with this life period.
Perimenopausal women typically gain weight and almost always see a shift in fat distribution from their hips, thighs, and buttocks to their abdominal region. This shift in fat stores is caused by a decrease in estrogen levels, which plays an important role in fat distribution. Estrogen also plays a role in metabolism speed, which is why lower estrogen levels have been linked to a decrease in metabolic rate. This deceleration of your metabolism is compounded due to the muscle loss taking place during this time of life.
After the age of 30, you will begin to lose 3-5% of your muscle mass each decade if you have not been performing strength training. This could equate to around an 8% loss of muscle mass by the time you reach the typical start of the menopause window, at age 45. Since your metabolic rate is closely tied to the amount of muscle mass you have, this degree of muscle loss can bring your metabolism speed to deficient levels by the time you reach perimenopause. Of course, the slower your metabolism, the easier it will be to gain fat and the harder it will become to lose it. For many women coinciding with this loss of muscle mass is an onslaught of life demands.
Many women about the time they reach menopause are also reaching peak levels of the demands put on them by their career, family, or both. A woman’s peak earning years come between ages 35 and 54, which generally corresponds with the greatest amount of responsibilities at work. Also, during this time, many women are juggling family life demands, many of them having to wrangle moody teenagers. Of course, this is all taking place during perimenopause which can impact stress levels and sleep patterns.
When stressed, your body releases cortisol, a hormone that slows down your metabolism. Research shows that chronic stress (one or more stressful events per day) can cause you to burn 100 fewer calories per day1. When considered over a year, this can lead to over 10 pounds of weight gain. When chronic stress is paired with a lack of sleep, the weight gain effects can be cringe-worthy.
During perimenopause, sleep can be disrupted due to high levels of stress, hormone shifts, and hot flashes. When we sleep, our body produces the hormones leptin and ghrelin, which affect feelings of hunger. When we are sleeping enough, our hunger levels are well regulated. On the other hand, when we don’t get enough rest, we end up feeling hungrier than normal throughout the day and, as a result, consume additional calories. This, in turn, leads to weight gain2.
What Can You Do To Lose Weight During Perimenopause?
Perform Strength Training
Strength training may be the most critical part of a perimenopausal weight loss plan as it is the only way to offset the muscle loss that comes with age. By performing strength training regularly, you can not only stop the loss of muscle mass, but you can begin to regain muscle. By gaining muscle, you will increase your metabolic rate and, as a result, lose weight much easier.
To gain muscle through strength training, you’ll need to perform a full-body strength training routine at least twice a week. This routine doesn’t need to be lengthy; in fact, you can usually complete a full-body strength training circuit in about 15 minutes. You can perform strength training using your body weight, bands, free weights, or strength training machines.
To keep your hunger hormones in check, you should aim to sleep at least 7.5 hours each night. To promote a good night’s rest, it is important to get your sleeping environment and your head in the ideal state before bed. To create a sleep-promoting bedroom, these techniques:
- Get your temp right– studies show that the ideal sleeping temperature is 65 degrees. Adjust your heat or air conditioning thermostat to reach this perfect temperature.
- Use white noise– a white noise machine can help you fall asleep and fall back asleep after waking, especially if you wake up with your mind racing. Focusing on the white noise can help you ease yourself back to sleep.
- Shut off the screens- the blue light from device screens can suppress the release of melatonin which can make it harder to fall or stay asleep. To promote sleep, discontinue the use of devices at least an hour before bed and make sure to leave them in another room.
In addition to preparing your bedroom for a soothing night’s sleep, make sure to clear your head before bed. You can do this by:
- Writing a to-do list: if you wake up in the middle of the night worrying about what is on your plate the next day, it can be helpful to write out a to-do list, either before you leave work or before bed. Putting your thoughts on paper can help relieve the nighttime worry about what you need to accomplish the next day.
- Getting in a workout- cardiovascular exercise and strength training have a positive effect on stress levels, making it easier to sleep through the night. Exerting yourself throughout the day can also help your body be more ready for bed.
- Calming your mind- mindfulness activities like meditation, deep breathing, and yoga have all been shown to help with sleep. They can be done before bed or at any time during the day. When practiced regularly, they have been shown to reduce stress and increase sleep no matter when you practice them.
Perimenopause can be a stressful time in a woman’s life. Chronic stress can slow down your metabolism and can make it difficult to make healthy eating choices. Carving out time in your day to perform intentional stress-reducing practices can be an important part of a successful weight loss plan.
To reduce stress, make time in your schedule each week to perform one or more of the following:
- Exercise-cardiovascular, strength training, and yoga all have a positive effect on stress levels
- Relaxation techniques– meditation, mindfulness, deep breathing, and progressive muscle relaxation are just some of the relaxation techniques you can implement
- Preferred activities– make sure to perform activities that make you feel relaxed and happy (take a walk on the beach, see a movie, curl up with a good novel, take a bubble bath, call a good friend)
Perform Cardiovascular Exercise
Perimenopause often brings with it a reduction in your daily movement. By this point in a woman’s life, many women are no longer chasing their toddlers around and may have a higher-level job that promotes extended periods of sitting. This shift, of course, causes you to burn fewer calories throughout the day and for your metabolism to slow down.
To reverse this course, you should aim to perform some type of moderate or vigorous-intensity cardiovascular activity at least once a day. This activity should last for at least 30 minutes if moderate (i.e.; walking) or at least 20 minutes if vigorous (i.e.; jogging). This intensity and length of cardiovascular activity will help you to increase your energy expenditure. Plus, it will promote more restful sleep and will help you manage your stress levels.
Fill Up on Fewer Calories
Unfortunately, due to muscle loss and often lower levels of physical activity, the amount of calories perimenopausal women need to consume to lose weight is on the low end. Women in this life stage often need to eat as few as 1,100-1,200 calories per day to reach their weight loss goal. To hit this caloric target and not feel hungry all the time, it is imperative to choose filling but calorically light foods.
These types of foods include things like salads with protein, soups with vegetables and protein, and well-designed protein shakes, to name a few. These types of foods are low in calories but high in fiber and water, which make our stomach feel full. Additionally, the high protein content delays gastric emptying, which makes you feel full for longer periods of time. To read more about what types of foods you can eat to lose weight without feeling hungry, please read Weight Lost: 5 Steps to Achieving Your Ideal Weight and Gaining the Life You’ve Always Wanted.
Perimenopause is often accompanied by weight gain and is always accompanied by shifts of fat stores from the hips, thighs, and buttocks to your abdomen. This change is caused by shifts in hormones, muscle loss, and an increase in life demands. However, you can successfully lose and keep weight off during perimenopause by:
- Performing strength training
- Getting adequate amounts and restful sleep
- Reducing/managing stress
- Performing cardiovascular exercise
- Filling up on fewer calories
Establishing these five lifestyle changes can help you reach and maintain your weight loss goals. Still, if you like to explore how to establish a successful and sustainable weight loss plan in more detail, you can do so by reading WeightLost: 5 Steps to Achieving Your Ideal Weight and Gaining the Life You’ve Always Wanted.
- Kiecolt-Glaser, J. K., Habash, D. L., Fagundes, C. P., Andridge, R., Peng, J., Malarkey, W. B., & Belury, M. A. (2015). Daily stressors, past depression, and metabolic responses to high-fat meals: a novel path to obesity. Biological psychiatry, 77(7), 653-660.
- Al Khatib, H. K., Harding, S. V., Darzi, J., & Pot, G. K. (2017). The effects of partial sleep deprivation on energy balance: a systematic review and meta-analysis. European journal of clinical nutrition, 71(5), 614-624.