You’re eating the same way, your activity level has not changed, and yet the scale keeps creeping up especially around your midsection. For many in their 40s and 50s, this is a familiar story. But is menopause to blame? The answer isn’t as straightforward as you might think.
The idea that menopause directly causes weight gain is a common misconception. What menopause does impact, however, is how fat is distributed in the body. During menopause, lower estrogen can cause fat to be stored more around the stomach, often called a “menopause belly”(Journal of Clinical Investigation Insight, 2019)(1). But aging— rather than menopause itself—is the primary factor in overall weight gain.
Why Does Weight Gain Matter?
Midlife weight gain impacts more than just how we look—it affects our health. Extra belly fat increases our risk of conditions like heart disease (American College of Cardiology, 2016) (2) and type 2 diabetes (Journal of American Medical Association, 2017) (3) . At the same time, losing muscle can make our bones weaker, limit our movement, and increase the chances of joint pain and osteoporosis (International Journal of Molecular Science, 2021) (4).
When we add the impact of menopause—like its toll on bone health and the decline in bone density (Climacteric The Journal of Adult Women’s Health and Medicine, 2024)(5) - it’s a double whammy. This combination not only raises the risk of osteoporosis but also makes managing our weight during midlife even more important for protecting our overall health and risk of chronic illness (The Journal of The Menopause Society, 2017)(6) and well-being.
These changes affect how we feel every day and can profoundly impact our health span—the years we live in good health, free from chronic illness or major limitations.
By understanding what’s happening in our bodies and focusing on strategies that truly make a difference, we can feel stronger, more energized, and set ourselves up for a healthier future.
What the SWAN Study Teaches Us About Weight Gain in Midlife
As menopause gains more attention, it’s easy to come across oversimplified claims like “Menopause causes weight gain.” But in reality, there is much more to it. The 18 year Study of Women’s Health Across the Nation (Journal of Clinical Investigation Insight, 2019)(1) (SWAN) gives us a clearer picture of what’s really happening.
While hormonal changes during menopause, like declining estrogen, can change where fat is stored—especially around the belly—they don’t directly cause weight gain. The main factor? Aging and a decrease in metabolism – we burn fewer calories at rest than we used to.
As we age, it’s common to gain around 1-1.5 pounds per year in our 40s and 50s (Obstetrics and Gynecology Clinics of North America, 2011)(7). While this might not seem like much, it adds up overtime.
This is partly because we lose muscle over time, and muscle is metabolically active, which means it burns more calories than fat, even when we’re not moving. So, when we have less muscle, the number of calories our bodies burn each day decreases as well.
It’s not just about how we look—these shifts in weight and body shape can affect our health too. More fat around our midsection and less muscle can increase the risks of diabetes, heart disease, and even mobility challenges.
Understanding how aging, metabolism, and muscle interact can help us focus on what really matters—supporting our muscles, staying active, and making small but meaningful changes that help our bodies work more efficiently.
How Protein Can Help Preserve Muscle Mass
Keeping our muscles is one of the most effective ways to combat midlife weight gain, and protein plays a big part. As we age, we lose muscle faster, so eating enough protein becomes even more important to help repair and grow muscle.
Experts suggests we try to get 1.2 to 1.6 grams of protein per kilogram of our body weight per day (American Journal of Clinical Nutrition, 2024)(8). For example, if we weigh 150 pounds (about 68 kilograms), that means about 82 to 109 grams of protein each day. To give you an idea:
- One large egg contains about 6 grams of protein.
- A 3-ounce (85-gram) serving of chicken breast provides about 26 grams of protein.
- A half-cup of cooked lentils offers 9 grams of protein.
Spreading protein evenly across meals helps. Instead of loading up on protein in one meal, aiming to include it at every meal and snack is ideal. For example, we could start the day with Greek yogurt topped with nuts, enjoy a salmon salad for lunch, and keep a handful of edamame or almonds on hand for an afternoon snack.
If eating this much protein through food alone is difficult, protein-whey supplements can help. Choosing the right one can feel overwhelming with all the choices out there, so don’t hesitate to seek guidance from our clinical team.
The Role of Exercise in Midlife Weight Management
While eating enough protein helps keep our muscles, pairing it with regular exercise is the next step in supporting our strength, metabolism, and reducing abdominal fat. Exercise not only helps us maintain the muscle we already have but also rebuilds what we’ve lost over time. Together, protein and exercise create a powerful team to keep our bodies stronger and more efficient.
The best approach combines strength training, aerobic activity, and regular movement:
- Strength training: Activities like weightlifting, resistance bands, or bodyweight exercises like Pilates can help us maintain and even build muscle while protecting our bones. Aim for three sessions per week to see real benefits. And strength training doesn’t have to mean heavy lifting—simple exercises like squats, push-ups, or using light dumbbells can go a long way.
- Aerobic exercise: Whether it’s walking, swimming, cycling, or even dancing, aerobic exercise keeps our hearts healthy and burns calories. The goal is 150 minutes of moderate-intensity exercise each week, which can be broken into manageable chunks—think three 10-minute walks throughout the day.
- Daily activity: Don’t underestimate the value of staying active in our everyday lives. Little things like taking the stairs, gardening, or playing with our kids or grandkids keep us moving, adding to our overall activity levels without feeling like a formal “workout.”
The key to success is finding activities we genuinely enjoy. If lifting weights feels daunting, maybe a fun Pilates class is more your style. If the gym isn’t your thing, a brisk walk outside with a weighted vest can be just as effective. When we choose activities that fit into our lives and feel enjoyable, it’s easier to stay consistent—which is what really makes a difference over time.
Eating for Energy and Health in Midlife
In addition to increasing protein intake and exercise, focusing on nutrient-rich foods is also important when it comes to managing midlife weight gain and supporting overall health. Protein is only one part of the picture—our bodies also need a variety of nutrients to stay strong, energized, and balanced. Choosing foods that nourish us can make a big difference in how we feel and how our bodies respond to the changes of midlife.
A Mediterranean-style diet has worked well for many midlife women. This way of eating focuses on whole grains, fruits, vegetables, lean proteins, and healthy fats, like olive oil and avocados. Experts recommend that it can lessen inflammation, improve gut health, and balance blood sugar levels, which are all crucial for our well-being.
Actionable Tips to Get Started
- Prioritize whole foods: Fill your plate with colorful vegetables, lean proteins like chicken or fish, and healthy fats such as olive oil, avocados, and nuts. These foods are packed with nutrients that fuel our bodies and help us feel full and satisfied.
- Keep an eye on hidden sugars: Sugars sneak into so many foods we eat without us even realizing it—products we wouldn’t expect, like salad dressings, granola bars, cereals, and savory sauces. It’s also hiding in our drinks, such as alcohol and soda. These hidden sugar adds up quickly, contributing to weight gain and energy crashes. Track your sugar intake for a week to build your awareness. Using an app like Lose It makes it easy to log meals, snacks and drinks and can show us just how much sugar we’re consuming and help us spot the biggest culprits.
- Cut back on processed foods: Packaged snacks and ready-made meals often pack in unhealthy fats, extra calories, and little nutritional value. Choosing whole, minimally processed foods wherever we can help us avoid these pitfalls and keeps our bodies better fueled. With this knowledge, we can make smarter choices and reduce those hidden sugars that might be holding us back.
- Avoid late-night eating: Eating too close to bedtime can throw off both our metabolism and our sleep quality-both of which impact weight management. Aiming to finish our last meal or snack at least 2–3 hours before bed gives our bodies time to digest and sets us up for a better night’s rest.
Staying on Track: How CBT Brings It All Together
Even with the best intentions, keeping to a new health routine—whether it’s eating healthier, moving more, or making better choices for our well-being—can feel overwhelming when faced with emotional triggers or hectic schedules. Life happens—stressful days, unexpected challenges, or just plain exhaustion—and those good intentions often fall by the wayside. Sticking with healthier habits beyond a week, or even a few days, can feel overwhelming. That’s where Cognitive Behavioral Therapy (CBT) can be a game-changer.
CBT works by helping us understand and reframe the thoughts and patterns that make sticking to healthy choices so difficult. For many of us, eating or skipping exercise can become an emotional response—to stress, boredom, or feeling overwhelmed. CBT gives us simple tools to identify these triggers and replace them with healthier habits that stick. It’s not about perfection or deprivation but about building habits that feel doable and empowering, even on tough days.
Research supports the effectiveness of CBT in helping people make and sustain healthier lifestyle changes. Studies have found that people using CBT along with diet and exercise have more success with weight management and feel better overall (European Journal of Clinical Nutrition, 2020)(9), (Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity, 2005)(10) (Journal of the Academy of Nutrition and Dietetics, 2009)(11), (International Journal of Nursing Practice, 2018)(12). In fact, people who use CBT are more likely to stick with their health goals in the long term compared to those who only focus on diet and exercise changes. This highlights how addressing our emotional and psychological challenges is key to building lasting, healthy habits.
And it’s not just about food. CBT can help us change how we think about exercise or self-care, too. For example, we may feel like we don’t have time for a workout, or we might feel guilty about taking time for ourselves. CBT helps challenge those thoughts and find small ways to prioritize what matters, like fitting in a 10-minute walk or preparing a simple, healthy meal. These small steps, repeated consistently, help build momentum toward bigger changes.
Working with a trained CBT professional can support us set realistic goals, track progress, and navigating the inevitable ups and downs with compassion rather than self-criticism. When combined with practical nutrition and exercise plans, CBT becomes a powerful tool to help us stay on track, to make lasting changes, and take more control of our health.
Understanding the Bigger Picture
Midlife weight gain isn’t just about what’s happening in our bodies—it’s also an emotional and cultural challenge. Society has long tied a woman’s value to her appearance, leaving many of us frustrated by the natural changes our bodies go through. By understanding the science behind these changes, we can shift our focus from appearance to overall health and well-being.
At sanoLiving, we get how tough it can be to make lasting changes, especially when life is already busy. That’s why our coaches are here to help. They provide personalized strategies that fit into our lives, not just as guides, but as cheerleaders, offering support, compassion, and encouragement when things get tough.
Midlife weight gain doesn’t have to feel like an inevitable struggle.
By focusing on balanced nutrition, regular exercise, and the right support, we can protect our health, preserve our strength, and confidently embrace this new chapter of life.
Resources:
1. Gail Greendale, Barbara Sternfeld, MeiHua Huang, Weijuan Han, Carrie KarvonenGutierrez, Kristine Rupert, Jane Cauley, Joel Finkelstein, Sheng-Fang Jiang, and Arun Karlamangla. Changes in Body Composition and Weight During the Menopause Transition. Journal of Clinical Investigation 2019, Mar 7; 4(5):e124865.
2. Jane J Lee, Alison Pedley, Udo Hoffmann, Joseph M Massaro, and Caroline S Fox. Association of Changes in Abdominal Fat Quantity and Quality With Incident Cardiovascular Disease Risk Factors. American College of Cardiology 2016, 4;68(14):1509-21.
3. Connor A. Emdin, Amit V. Khera, MD, Pradeep Natarajan, et al. Genetic Association of Waist-to-Hip Ratio With Cardiometabolic Traits, Type 2 Diabetes, and Coronary Heart Disease. Journal of American Medical Association 2017, 317(6): 626-634.
4. Giuseppe Rinonapoli, Valerio Pace, Carmelinda Ruggiero, Paolo Ceccarini, Michele Bisaccia, Luigi Meccariello, and Auro Caraffa. Obesity and Bone: A Complex Relationship. International Journal of Molecular Science 2021, 22(24), 13662.
5. Vondal Wright, Jonathan Schwartzman, Rafael Itinoche, and Jocelyn Wittstein. The Musculoskeletal Syndrome of Menopause. Climacteric The Journal of Adult Women’s Health and Medicine 2024, Volume 27 – Issue 5.
6. Pangaja Paramsothy, Siobán D Harlow, Bin Nan, Gail A Greendale, Nanette Santoro, Sybil L Crawford, Ellen B Gold, Ping G Tepper, and John F Randolph Jr . Duration of the menopausal transition is longer in women with young age at onset: the multi-ethnic Study of Women’s Health Across the Nation. The Journal of The Menopause Society 2017, 24(2):p 142-149, February.
7. Nanette Santoro and Kim Sutton-Tyrrell. The SWAN Song: Study of Women’s Health Across the Nation’s Recurring Themes. Obstetrics and Gynecology Clinics of North America. 2011, Volume 38, Issue 3.
8. Andres V Ardisson Korat, M Kyla Shea, Paul F Jacques, Paola Sebastiani, Molin Wang, A Heather Eliassen, Walter C Willett, Qi Sun. Dietary protein intake in midlife in relation to healthy aging - results from the prospective Nurses' Health Study cohort. American Journal Clinical Nutrition 2024, Feb;119(2):271-282.
9. Madjd, A. et al. Effects of cognitive behavioral therapy on weight maintenance after successful weight loss in women; a randomized clinical trial. European Journal Clinical Nutrition. 2020, 74, 436–444.
10.Stahre, L. & Hällström, T. A short-term cognitive group treatment program gives substantial weight reduction up to 18 months from the end of treatment: A randomized controlled trial. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity. 2005, 10, 51–58.
11.Sallit, J., Ciccazzo, M. & Dixon, Z. A cognitive-behavioral weight control program improves eating and smoking behaviors in weight-concerned female smokers. Journal of the Academy of Nutrition and Dietetics. 2009, 109, 1398–1405.
12. Fernández-Ruiz, V. E. et al. Short-medium-long-term efficacy of interdisciplinary intervention against overweight and obesity: Randomized controlled clinical trial. International Journal of Nursing Practice. 2018, 24(6), e12690.
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