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The same meals, yet more on the scales – and the weight suddenly settles around the abdomen: many women experience this from their mid-40s. There are physical reasons for this; it has nothing to do with a lack of discipline.
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The menopausal transition, known medically as the climacteric, is the transitional period in which the ovaries gradually stop producing hormones. It usually begins in the second half of a woman’s forties and extends over several years. The menopause itself is a single point in time: the last menstrual period.
During this time, it is mainly the levels of the hormones oestrogen and progesterone that fall. This can trigger hot flushes, sleep disorders, mood swings and joint pain – how severely varies greatly from woman to woman. And it changes how and where the body stores fat.
Many women notice that habits that have kept their weight stable for years are suddenly no longer enough. Several reasons come together here.
Before the menopause, women store fat mainly on the hips, bottom and thighs, under the skin. As oestrogen falls, this shifts: more fat is stored around the abdomen and between the internal organs. This so-called visceral belly fat is metabolically active and is linked to type 2 diabetes, fatty liver and cardiovascular disease. What it is and how you can reduce it is explained in the guide Visceral belly fat.
During the menopause, many women gain fat mass and lose muscle mass – often even before their weight changes noticeably. Muscles use energy even at rest. Less muscle therefore means a somewhat lower basal metabolic rate, i.e. fewer calories that the body burns without exercise. At the same time, strength and stamina decline, which can make everyday activity more of an effort.
Hot flushes at night interrupt sleep. Lack of sleep throws the hormones for hunger and satiety off balance and weakens impulse control – when you are tired, you reach for sweet things more often and move less. In addition, this stage of life often brings pressures at work and in the family. Chronic stress raises the level of the hormone cortisol, which is associated with an increase in belly fat.
Not every weight gain around the age of 50 is related to the menopause. An underactive thyroid, certain medications or less exercise after an injury can also be behind it. If you gain significant weight for no apparent reason, it is worth having it checked by a doctor.
A widespread belief is that metabolism collapses at 40. What changes in your forties and fifties is above all body composition – less muscle, more fat – and often everyday activity.
It follows that “boosting” your metabolism mainly means maintaining muscle and moving more. Capsules, teas or powders that promise a faster metabolism are no substitute for this.
Strength training is particularly valuable at this stage of life: it maintains muscle, supports the bones and makes everyday movement easier. It doesn’t have to be a gym – exercises with your own body weight, resistance bands or dumbbells at home are just as suitable.
Incidental movement also counts: stairs instead of the lift, walking, standing while on the phone. Over the day, this adds up to more than many people expect.
Protein helps to maintain muscle – especially when you eat less in order to lose weight. It is also very filling. Good sources are pulses, dairy products, eggs, fish and lean meat, spread across the day’s meals.
Regular sleep times, a cool bedroom and little alcohol in the evening can improve sleep. If hot flushes are severely disrupting your sleep, talk to your gynaecologist about it.
There is no need for a special “menopause diet”. The basis remains a moderate calorie deficit that fits into everyday life in the long term. At this stage of life, very strict diets can easily cause the body to break down additional muscle – exactly what is already declining.
Whether intermittent fasting, fixed meals or smaller portions: what is good is what you can stick to in the long term. What matters is the total amount over weeks, not a single rule. Personal nutrition coaching can help you find a plan that suits your everyday life and your health.
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Yes, significant weight loss is possible even at 60. It usually happens more slowly than at 30, and how much you lose varies from person to person.
From 60 onwards, one thing matters in particular: protecting your muscles and bones. A moderate pace, enough protein and strength training ensure that you mainly lose fat rather than muscle. If you take medication – for high blood pressure or diabetes, for example – you should have greater weight loss supervised by a doctor, because your need for medication can change with your weight.
Rather than only looking at the scales, it is worth looking at your waist circumference. With the WHtR calculator and the BMI calculator, you can see where you stand and whether anything is changing.
Hormone therapy during the menopause – oestrogens prescribed by a doctor, usually together with a progestogen – is used to treat symptoms such as severe hot flushes. It is not a means of losing weight. If it relieves hot flushes and improves sleep, this can make everyday life easier and thus indirectly also make weight loss easier. Whether hormone therapy is an option for you is something you weigh up with your gynaecologist in terms of benefits and risks.
In the case of obesity or weight-related conditions, changing your diet and exercise is often not enough – this is not a question of willpower but of biology. In that case, there are medically supervised options.
In the consultation, we look together at your starting point – weight, waist circumference, pre-existing conditions – and at the approach that suits it: from Weight Doctors® 360° nutrition coaching with the Weight Doctors® App, in which Weight Doctors® Mira answers questions about nutrition, exercise and motivation around the clock and suggests recipes to suit your taste, to the medically led Weight Doctors® GLP-1 pharmacotherapy. The consultation is 100% no obligation. Book a consultation
Your question isn’t listed? Your specialist will take time for it during the consultation.
With the menopause, muscle mass decreases and the body needs slightly less energy at rest. At the same time, falling oestrogen levels shift fat storage towards the abdomen. Sleep problems and stress can additionally affect hunger and eating behaviour. The same amount of food can therefore lead to weight gain today that did not happen before.
It is not possible to lose weight only on your stomach – the body reduces fat as a whole. However, a moderate calorie deficit, endurance and strength training, enough protein and good sleep do reduce belly fat in particular. Your waist circumference often shows progress better than the scales.
What changes is above all muscle mass. Strength training, more movement in everyday life and enough protein help to maintain muscle and with it your energy expenditure.
Yes, it is possible, even if it usually happens more slowly than when you were younger and varies from person to person. A moderate pace, protein and strength training are important so that you mainly lose fat rather than muscle. If you take medication, have greater weight loss supervised by a doctor.
No, hormone therapy is not a means of losing weight. It is used to treat menopausal symptoms such as severe hot flushes. If it improves sleep, this can indirectly make weight loss easier. Whether it is an option for you is something to clarify with your gynaecologist.
A balanced diet with plenty of vegetables, pulses, wholegrains and protein in slightly reduced amounts. Calcium and vitamin D are important for your bones, because the risk of osteoporosis increases after the menopause. Very strict diets are unfavourable because they increase the loss of muscle.
If you gain significant weight for no apparent reason, if your waist circumference or BMI is raised, or if you have related conditions such as high blood pressure or raised blood sugar. It is also worth having a conversation if several serious attempts to lose weight through diet and exercise have not worked.
* For patients with German statutory health insurance: if the medical indication is established in line with the DGAV guidelines, reimbursement may be possible.
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