Menopause weight gain: why it happens and ways to manage

One day your favorite jeans fit perfectly; the next, they’re snug around the middle — despite your routine staying the same. Weight creeping up during menopause, especially around the belly (aka “meno-belly”), is a common experience during perimenopause and menopause. 

Menopause weight gain can feel frustrating, especially alongside hot flashes, mood swings, and sleep struggles. But learning what’s behind these changes can give you practical strategies to manage your weight during menopause. There’s no one-size-fits-all fix, but building simple, healthy habits — especially ones that get you moving — can help you manage body changes, maintain your health, and feel stronger during the menopause transition.

Here, learn more about what causes menopause weight gain, how it can affect your health, and the most effective ways to manage and prevent it — including movement tips from Hinge Health physical therapists.

What is menopause-related weight gain?

Menopause weight gain refers to extra weight that many women notice during the menopause transition, often around the midsection. (Menopause starts when you haven’t had a period for 12 months. The phase leading up to it, called perimenopause, usually begins in your 40s or 50s and can last several years.) Unlike general weight gain that can happen with aging, menopause-related weight gain has some unique factors.

Hormone changes during menopause change how your body stores fat. Many women see new weight build up around their belly and hips — even if their eating and exercise habits haven’t changed. This shift in body fat can make your clothes fit differently, even if the scale doesn’t move much. Weight gain can happen gradually throughout the menopause transition (typically ages 45–55). On average, women gain about 1.5 pounds per year during this time, though this amount varies from person to person.

This type of weight gain can feel deeply personal and affect your energy, confidence, and daily comfort. But once you know why it happens, it can be easier to take steps to manage it.

“I hear from so many women in perimenopause and menopause who feel frustrated when their bodies seem to change overnight, even when they're doing all the 'right' things,” says Brittney Sellers, PT, DPT, a physical therapist at Hinge Health. “That frustration is real and understandable. The good news is, there are lots of ways you can feel more in control and support your health, so you can feel your best during this transition,” says Dr. Sellers.

Causes of menopause weight gain

Menopause often brings multiple changes that can increase the likelihood of weight gain — from hormonal changes and a slower metabolism to increased hunger, reduced activity, and higher stress. Here’s a closer look at what’s driving these changes:

• Hormonal shifts. As estrogen drops, your body tends to store more fat, especially around your belly.

• Slower metabolism. Muscle mass naturally declines with age, which means your body burns fewer calories at rest.

• Changes in appetite and satiety. Menopause hormone changes can increase hunger and cravings, making it easier to overeat.

• Lifestyle shifts. Physical activity can decrease with age. At the same time, busy schedules, stress, and menopause-related fatigue can make it harder to prioritize movement and healthy meals.

• Stress and sleep disturbances. Menopause-related stress and poor sleep can raise cortisol (a stress hormone), which nudges your body to hold onto fat — particularly in the abdomen.

Recognizing these factors highlights that menopause weight gain is a multifaceted experience influenced by many things beyond your control — not simply about willpower or personal choices.

Health risks of menopause weight gain

Weight changes during menopause are common, and managing them can be frustrating. While some weight gain is a normal part of aging, carrying extra weight — especially around your midsection — can raise your risk for health problems like heart disease, diabetes, joint pain, cancer, and mental health issues. Being aware of these risks can help guide healthy choices that support your long-term well-being:

• Heart health. Extra weight, especially around the belly, can increase your risk of cardiovascular disease.

• Type 2 diabetes. Changes in fat distribution may make your body more resistant to insulin.

• Joint pain. Joint discomfort and other musculoskeletal symptoms are common during menopause due to hormonal shifts, muscle loss, and inflammation. Extra weight can strain your hips, knees, and lower back, making it harder to stay active.

• Cancer. Carrying extra weight after menopause can raise the risk of certain cancers, including breast and colon cancer.

• Mental health. Weight gain during menopause is linked to higher rates of depression and may contribute to memory and cognitive challenges later in life.

When to see a doctor

Menopause weight gain is common, but if you’re gaining a lot of weight rapidly or without explanation, talk to your provider to rule out underlying medical conditions. You can also ask about options like nutrition support, mental health care, or medically supervised weight management. Weight loss medications or other treatments may help if lifestyle changes alone aren’t enough — especially if weight gain is affecting your health or well-being.

How to manage weight during menopause

Managing weight during menopause is about supporting your health through balanced eating, regular movement, stress management, mindful habits, and good sleep. Changes in your body during this time can make losing weight more challenging than before, and you may find that your body settles at a different weight or size — and that’s normal. 

Not everyone needs to pursue weight loss during menopause. Focusing on healthy routines and habits that help you feel your best is more important than chasing a specific number or size. Approaching menopause with practical strategies — and a compassionate mindset — can support your health and well-being through these changes:

• Adopt a balanced diet. Fill half your plate with fruits and veggies (fresh, frozen, or canned), and aim for plenty of fiber, lean proteins (chicken, fish, tofu, beans), and healthy fats (nuts, olive oil, avocado). Whole grains like brown rice and oats help you feel full longer.

• Engage in regular physical activity. Try to move your body most days, aiming for at least 150 minutes of moderate-intensity exercise each week (that’s about 20 minutes a day). Strength training two to three times a week is especially valuable. It helps build lean muscle, which burns more calories and supports metabolism.

• Monitor portion sizes and eat mindfully. Sitting down for meals, savoring flavors, and listening to your body’s hunger and fullness signals can help prevent unintentional overeating.

• Manage stress. Mindfulness, meditation, deep breathing, or gentle yoga can lower stress hormones that contribute to weight gain.

• Prioritize sleep. Good sleep does more than boost energy. Quality rest helps balance hunger hormones, reduce cravings, and support healthy metabolism.

It might be tempting to drastically cut calories when you see the number on the scale creep up, but excessive restriction can actually work against you, says Dr. Sellers. “Your body needs steady fuel, especially during menopause to keep your energy up, support your metabolism, and help you feel your best.” Focus on nourishing your body, not depriving it, says Dr. Sellers.

How can menopause weight gain be prevented?

Healthy habits like regular movement, balanced eating, good sleep, stress management, and limiting processed foods can help prevent menopause weight gain. Weight gain during menopause isn’t inevitable. Many of the same habits for managing weight also help prevent menopause weight gain before it starts:

• Move your body regularly. Combine aerobic activity (walking, cycling, dancing) with strength training to build muscle and support your metabolism.

• Eat to nourish your body. Choose nutrient-dense foods that fill you up without excess sugar or processed carbs.

• Prioritize rest and recovery. Aim for 7–9 hours of quality sleep each night.

• Tame stress. Practice techniques that calm your mind and body, like guided meditation or mindful movement.

• Limit processed foods, sugar, and alcohol. These can sneak in extra calories without much nutrition.

Can hormone therapy help with menopause weight loss?

Menopause hormone therapy (MHT) is not used to help with weight loss during menopause. Studies show that women who use hormone therapy do not lose more weight or have less body fat than women who don’t use it, though there may be a very small reduction in belly fat for some. The main use of hormone therapy is to manage menopause symptoms like hot flashes, night sweats, bone health, and vaginal and urinary symptoms  — not weight control.

Exercise for menopause weight gain

Movement is one of the most powerful ways to manage menopause weight gain — and it goes far beyond just burning calories. Regular exercise supports your overall health during menopause by building and maintaining muscle, supporting joint health, boosting energy and mood, protecting your heart, and strengthening your bones. Here’s more about how exercise can support your health during menopause: 

• Builds and preserves muscle. During menopause, lower estrogen can lead to muscle loss and a slower metabolism. Strength training helps you maintain or rebuild muscle, so your body burns more calories even at rest.

• Supports joints and reduces pain. Changing hormones can make joint pain and stiffness more common during menopause. Staying active keeps your joints flexible and eases discomfort, making day-to-day activities easier and more enjoyable.

• Boosts energy and mood. Hormonal changes can leave you feeling tired or down. Exercise releases endorphins, helps manage stress, and can improve sleep — helping you feel more energized and resilient.

• Protects your heart. The risk of heart disease rises after menopause. Aerobic exercise and strength training both help lower blood pressure, improve cholesterol, and keep your heart strong.

• Boosts bone health. During menopause, lower estrogen can increase your risk of osteoporosis, a condition that makes your bones weak and more likely to break. Regular exercise—especially weight-bearing, resistance, and balance activities — helps keep bones strong and lowers the risk of fractures by improving bone density and reducing your risk of falls.

“When you think about exercise, it’s easy to focus just on burning calories,” says Dr. Sellers. “But movement is about so much more.” Regular physical activity can help with menopause symptoms like brain fog, anxiety, and low mood, she explains. “I see every day how even simple movement routines lift energy and support both physical and mental well-being. Exercise is one of the best gifts you can give yourself during this time.”

Managing menopause body changes with physical therapy

In addition to weight gain, menopause can also contribute to issues like joint pain, muscle aches, and pelvic changes such as bladder urgency or leakage. Many people don’t realize all of these symptoms are often linked to the hormone-related changes happening in your body during menopause.

Physical therapy can help you manage many of these common menopause symptoms, especially muscle and joint pain or pelvic floor issues. A physical therapist (PT) can assess your needs and create a personalized exercise plan, recommending strength training, low-impact movements, stretches, and weight-bearing exercises to reduce stiffness, build muscle, boost your metabolism, and protect your bones — even if you are new to exercise, have joint pain or pelvic issues, or are experiencing changes in your body. PTs are experts in helping you stay active and address barriers, so you can move and feel better during menopause. 

You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

Best types of exercise for menopause weight gain

A well-rounded routine — including strength training, aerobic exercise, balance and flexibility work, pelvic floor exercises, and relaxation techniques — can help manage menopause weight gain and support your overall health. These different types of exercise can help you maintain muscle, increase metabolism, reduce body fat, and make it easier to manage your weight and stay healthy through menopause (always consult with your healthcare provider before starting a new exercise program):

• Strength training. Lifting weights, using resistance bands, or doing bodyweight exercises two to three times per week helps build and maintain muscle. Having more muscle raises your metabolism, making it easier to burn calories and manage your weight during menopause. Strength training also supports bone health and can improve blood flow to the brain, which may help reduce menopause-related brain fog.

• Aerobic exercise. Activities like walking, jogging, swimming, and cycling help you burn calories, reduce body fat, and boost cardiovascular health. Mixing in short bursts of higher-intensity effort — like with HIIT — can help you lose more fat and improve your body composition.

• Balance and flexibility exercises. Movements that improve stability and flexibility — like yoga or targeted balance training—help prevent injuries and keep you moving comfortably, so it’s easier to stay active and stick with your routine. 

• Pelvic floor exercises. Strengthening these important muscles supports your core, which helps you move more efficiently during other exercises and can help manage menopause-related issues like leaks, urgency, painful sex, and pelvic discomfort.

• Relaxation exercises. Deep breathing, stretching, and yoga help lower stress hormones that can contribute to weight gain, while also supporting your overall well-being and helping you feel calmer and more balanced.

You don’t need to spend hours at the gym to see benefits. Simple movements like short walks, gentle stretches, or quick home routines all add up. 

Best types of exercise for menopause weight management

Regular physical activity and movement can help manage symptoms and effects of menopause, including supporting weight management. (Always consult with your healthcare provider before starting a new exercise program.) Some of the best types of exercise for menopause include:

1. Strength training

Resistance exercise (aka strength training) is the gold standard for improving muscle health, strength, and supporting weight management in menopause. This involves lifting or pushing against an external resistance like weights, resistance bands, weight machines, or your own body weight. Aim for two to three strength training sessions per week targeting major muscle groups (e.g., upper body, lower body, core, etc.). You don’t have to use heavy weights or buy expensive equipment to get the benefits of strength training. Everyday household items — like canned goods, water bottles, or even a jug of laundry detergent — work great as makeshift weights, especially when you’re just starting out.

“Compound movements, like doing a squat while pressing dumbbells overhead, let you work several muscle groups at once,” says Dr. Sellers. “It’s a great way to save time and get more benefit from each workout.”

Strength training helps build lean muscle, which burns more calories and boosts your metabolism. Bonus: Resistance exercise is also key for bone health in menopause. 

2. Aerobic exercise 

This type of physical activity — such as walking, jogging, swimming, and cycling — strengthens your heart and lungs to help improve cardiovascular health and support weight management. Aerobic exercise can also boost your metabolism, improve your mood, and enhance brain function, including mental sharpness and memory. Weight-bearing aerobic exercise, such as walking or jogging, can help promote bone growth. Physical activity guidelines suggest aiming for 30 minutes of aerobic exercise most days to maintain overall health and well-being.

High-intensity interval training (HIIT) is a type of aerobic activity that involves short bursts of intense effort (30 to 60 seconds) followed by one to two minutes of rest or low-intensity activity. Research shows that HIIT can help women in menopause lose fat and improve their body composition. You can incorporate HIIT into activities like walking, running, cycling, or bodyweight exercises. 

“It’s a common misconception that you need to go all-out with high-intensity workouts to see progress, especially during menopause,” says Dr. Sellers. While HIIT and other intense exercises can be great for some people, steady, brisk walks several times a week can be just as effective and put less strain on your body, says Dr. Sellers. “If high-intensity exercise isn’t right for you right now, know that brisk walking is a wonderful way to stay active, support your health, and feel your best.”

3. Balance and flexibility exercises

Both are important during menopause: Balance exercises help improve your stability and prevent falls, reducing fracture risk and making it easier to stay active. Flexibility movements work to lengthen and strengthen muscles and tendons to improve range of motion in your joints, so you can keep moving comfortably and stick with your exercise routine.   

4. Pelvic floor exercises

Your pelvic floor is a group of muscles and tissues that stretch like a hammock from your pubic bone in front to your tailbone in the back. These muscles support your bladder, bowel, and sexual organs. During menopause, many people deal with pelvic issues like leaks, urgency, and pelvic pain. Pelvic floor exercises can help treat and reduce these problems, and also help strengthen your core. A stronger core supports better movement and posture, making other activities easier and helping you stay active.

5. Relaxation exercises

Activities like deep breathing and yoga can help improve focus and mental clarity, improve pelvic floor muscle health and function, and help reduce stress and anxiety. Lower stress levels make it easier to maintain healthy habits and support weight management during menopause.

A note about overtraining

While regular physical activity is key to managing menopause symptoms and supporting your wellbeing, more isn’t always better. Overtraining — pushing your body too hard without adequate rest — can actually increase stress hormones, disrupt sleep, hinder recovery, and sometimes make it harder to reach your goals.

“During menopause, it’s important to listen to your body, honor your energy levels, and build in rest days,” says Dr. Sellers. Incorporating activities that support recovery, such as gentle movement, stretching, or mindful relaxation, can help you get the most benefit from exercise without overtaxing your system, she says.

“The best progress comes from consistency and balance — not from pushing yourself to the limit every day,” says Dr. Sellers. If you feel overly fatigued, notice new aches, or your workouts are leaving you feeling worse instead of better, it may be a sign to scale back and give your body more time to recover.

These exercises are designed to build strength, flexibility, and balance — all of which play a key role in managing weight during menopause. For example, movements like squats and lunges engage your largest muscle groups, helping to preserve muscle mass and boost metabolism as hormone levels shift. Bridges and planks work your core and glutes, improving stability and making daily activities easier. Upper body movements like straight arm pull downs improve posture and help you stay active with less discomfort; they also make everyday tasks — such as reaching for items on a high shelf, carrying groceries, or lifting laundry baskets — feel easier. Incorporating balance exercises like single-leg stance can further improve stability, enhance coordination, and reduce the risk of falls.

By practicing these exercises regularly, you can support your body’s natural ability to burn calories, move with more comfort, and stay resilient through the menopause transition. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT tip: Squeeze in movement throughout the day

“Every bit of movement counts — whether it’s taking the stairs, going for a short walk after a meal, or simply moving around your kitchen while washing dishes,” says Dr. Sellers. Even small choices, like parking farther away or standing up to stretch during the day, add up over time. “Give yourself credit for every way you keep your body moving. It all makes a difference for better health during menopause.”

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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