If menopause has made your body feel like it’s working against you — you’re not alone. Weight gain during menopause is frustratingly common, and it often shows up no matter how well you eat or how much you move. But that doesn’t mean you’re stuck with it.

Here’s the truth: hormonal changes in perimenopause and menopause affect metabolism, appetite, sleep, insulin sensitivity, and fat storage. So if you're gaining weight and nothing seems to work anymore, it’s not a moral failing — it’s biology.

The good news? There are real, sustainable, evidence-based ways to support your body through this hormonal shift. This guide breaks it down: what’s happening, what actually helps, and how medical weight care could help support you in reclaiming your energy, confidence, and health.

feet on a scale

What is the average weight gain during menopause?

Let’s start with what’s normal — and what’s not your fault.

Most people gain an average of 1 pound per year during the menopausal transition, with around 20% gaining 10 pounds or more. But that number can vary depending on genetics, lifestyle, and how your body responds to shifting hormones like estrogen, progesterone, and insulin. What’s especially frustrating? A lot of this weight tends to settle around the belly, even if your habits haven’t changed.

Research shows that falling estrogen levels can lead to increased fat storage in the abdomen and changes in body composition — including muscle loss, which can lower your resting metabolism over time.

It’s not just the number on the scale. It’s the bloating, the fatigue, the sense that you’re not quite at home in your own body anymore. But there are ways to shift things — and it doesn’t have to involve cutting out carbs or spending hours at the gym.

Does menopause weight ever go away?

Yes — but it may take a different approach than what worked in your 20s or 30s. Your hormones, metabolism, and muscle mass are all evolving, which means your weight care strategy needs to evolve too.

Weight gain during menopause isn’t “permanent,” but it can be persistent if underlying hormonal factors aren’t addressed. That's where medical support can make a real difference. A comprehensive plan might include:

  • Hormonal evaluation and support (like HRT or non-hormonal treatments)
  • Addressing insulin resistance
  • Building muscle through resistance training
  • Personalized care that supports your biology, not just your willpower

If you’ve tried everything and nothing’s budging, you're not lazy — you might just need more than the usual advice. That’s where something like LifeMD’s weight management program comes in. Their doctors take a whole-body approach, offering personalized support and access to FDA-approved GLP-1 medications when appropriate — with costs starting as low as $0–$25* with insurance.

woman in menopause taking weight loss medication

During perimenopause, estrogen levels drop while cortisol and insulin resistance often increase. This hormonal shift can trigger stubborn weight gain — especially around the belly — that isn’t always tied to diet or exercise.

Will HRT help with weight loss?

Hormone Replacement Therapy (HRT) can support weight management in menopause — not by being a magic weight loss pill, but by helping stabilize some of the hormonal chaos that can make weight gain more likely.

Some studies suggest that HRT may help reduce belly fat, improve insulin sensitivity, and preserve lean muscle mass. That said, it’s not primarily prescribed for weight loss — it’s used to treat menopausal symptoms like hot flashes, vaginal dryness, and mood swings. But if those symptoms are making it harder to exercise, sleep, or eat well, HRT may indirectly help with weight regulation.

HRT isn’t right for everyone. Your provider can help you weigh the benefits and risks based on your medical history. And even if HRT isn’t on the table, you’re not out of options — other treatments and tools can help support your metabolism and appetite regulation.

What is the best exercise for menopause weight loss?

When it comes to exercise during menopause, consistency matters more than intensity. You don’t need to crush 60-minute HIIT workouts to see results. In fact, a combination of strength training and walking may be the most effective, sustainable approach.

Strength training is key to rebuilding and maintaining muscle mass — which naturally declines with age and hormone shifts. The more muscle you have, the more calories your body burns at rest.

And walking? It’s seriously underrated.

menopausal woman walking in a park

Will walking get rid of menopause belly?

Walking won’t spot-reduce belly fat (nothing can), but regular movement — especially when combined with strength training and balanced eating — absolutely helps reduce overall fat and support hormone regulation. Walking also helps manage stress and cortisol, which is often elevated during menopause and can contribute to abdominal fat gain.

Even 20–30 minutes a day can make a noticeable difference over time, especially when paired with quality sleep, protein intake, and mindful eating.

Don’t underestimate small, doable changes. You don’t need to overhaul your life overnight — just start stacking habits that make you feel better and build momentum.

Why your hormones impact your weight — even when your habits haven’t changed

Your metabolism is regulated by a complex network of hormones — including insulin, estrogen, leptin, ghrelin, and cortisol. When these hormones shift during menopause, your body may start storing more fat (especially around the belly), feel hungrier even if your eating habits haven’t changed, burn fewer calories at rest, and respond to stress in ways that make weight gain more likely.

In other words, your body isn’t broken — it’s adapting to a new hormonal landscape. That’s why weight care during menopause needs more than the old “eat less and move more” advice. Medical weight care, including GLP-1 treatments, can provide real, science-backed support that works with your biology instead of against it.

woman holding a glp-1 injectable

How GLP-1s work — and why they’re changing menopause weight care

GLP-1 medications (like Wegovy and Zepbound) mimic a natural hormone in your body that helps regulate appetite and blood sugar. They’re not a quick fix or a replacement for healthy habits — but for some women, they can be a powerful tool to finally feel like themselves again.

Studies have shown that patients using GLP-1s like Zepbound or Wegovy can lose 15–20% of their body weight when combined with a reduced-calorie diet and increased physical activity.

For women in perimenopause or menopause — especially those dealing with insulin resistance, emotional eating, or sudden fat redistribution — GLP-1s can be a game-changer when traditional methods stop working.

Weight gain during menopause is biological. And biology deserves medical care, not shame or outdated advice. Whether you’re walking daily, starting strength training, trying HRT, or exploring GLP-1 options with LifeMD, your path to feeling good in your body again is valid.

Struggling with weight gain during menopause? LifeMD offers access to virtual GLP-1 care, personalized treatment, and insurance support — plans may start as low as $0-$25 copay.* See if you qualify here.

You’re not alone — and you’re not out of options.

 

* See GLP-1 side effects. If a family history of thyroid cancer, do not use. Individual results may vary. 15% body weight loss based on the average weight loss in three 68-week clinical trials of patients on Wegovy without diabetes who reached and maintained a dose of 2.4 mg/week of GLP-1 treatment, along with a reduced-calorie diet and increased physical activity. In a 72-week Zepbound (tirzepatide) study of adults without diabetes, average weight loss was 15.0% (34 lbs) for 5 mg, 19.5% (44 lbs) for 10 mg, 20.9% (48 lbs) for 15 mg, and 3.1% (7 lbs) for placebo. Copay determined by insurance coverage. $0-$25 is based on our average patient copay that is approved and covered for GLP1 treatment through LifeMD.

Tassia O'Callaghan is an experienced women's health content writer and SEO content strategist, having written for brands like Peanut App Ltd, Scary Mommy, Fertility Mapper, Tally Workspace, and Office Christmas. She's an advocate for realistic sustainable living, supporting small businesses (author of A-Z of Marketing for Small Businesses), and equity across all walks of life. Follow her on LinkedIn or TikTok, or see more of her work on Authory or her website.