The menopausal transition promotes changes in body composition. We analyze the hormonal factors involved and the most effective nutritional strategies.

During menopause, many women experience weight gain, particularly in the abdominal area. Although this is often attributed exclusively to “hormones,” the phenomenon is more complex. The decline in estrogen levels, changes in muscle mass, and metabolic adaptations all play a significant role. We review what actually happens and how to intervene effectively.

Adriana Martín Peral – Neolife Nutrition Unit

Hormonal Changes in Menopause: What Really Happens?

Menopause is characterized by a progressive decline in estrogen levels, particularly estradiol. This hormonal shift impacts:

• Redistribution of body fat toward a more android (abdominal) pattern.
• Decreased basal energy expenditure.
• Increased insulin resistance.
• Higher cardiometabolic risk.

Estrogens play a protective role at the metabolic level. Their decline favors greater accumulation of visceral fat, which is metabolically active and associated with inflammation.

Is It Only a Hormonal Issue?

Not exclusively. In addition to hormonal changes, other factors are involved:

• Loss of Muscle Mass (Sarcopenia)

From the ages of 40–50 onward, there is a progressive decline in muscle mass if no strength stimulus is present. Since muscle is metabolically active tissue, its reduction decreases daily energy expenditure.

• Decreased Total Energy Expenditure

Lower levels of spontaneous physical activity, changes in sleep patterns, and increased stress contribute to a sustained positive energy balance.

• Changes in Appetite and Satiety

Some women report increased cravings for energy-dense foods, possibly related to hormonal fluctuations and sleep disturbances.

Evidence-Based Nutritional Strategies

• Prioritize Adequate Protein Intake: A sufficient protein intake (approximately 1.2–1.6 g/kg/day depending on individual profile) helps to:
  • Preserve muscle mass.
  • Improve satiety.
  • Support glycemic control.

Distributing protein evenly throughout the day optimizes muscle protein synthesis.

• Strength Training + Nutrition: Resistance training is key to counteracting age- and menopause-related muscle loss. When combined with adequate protein intake, it improves body composition beyond what is reflected on the scale.
• Control Energy Density: Reduce ultra-processed foods and prioritize:
  • Vegetables
  • Whole fruit
  • Legumes
  • Healthy fats (extra virgin olive oil, nuts)
  • Lean protein sources

This approach supports satiety while lowering overall caloric load.

• Fiber and Metabolic Health: A high fiber intake (25–35 g/day) improves:
  • Insulin sensitivity
  • Lipid profile
  • Gut health

The gut microbiota also appears to play a relevant role in weight regulation during this stage.

Sleep and Stress

Sleep deprivation is associated with greater insulin resistance and increased appetite. Therefore, intervention should be comprehensive and lifestyle-oriented.

What Does NOT Work

• Extremely restrictive diets maintained over time.
• Complete elimination of food groups without clinical indication.
• Focusing exclusively on weight without assessing body composition.

During menopause, the goal should be to improve body composition and metabolic health—not simply reduce body weight.

Conclusion

Weight gain during menopause is not inevitable, but it does require a different approach. The combination of appropriate nutrition, strength training, and a comprehensive lifestyle strategy can improve body composition and reduce cardiometabolic risk during this stage of life.

BIBLIOGRAPHY

(1) Lovejoy JC et al. Increased visceral fat and decreased energy expenditure during menopause.

(2) Lizcano F, Guzmán G. Estrogen deficiency and the origin of obesity during menopause.

(3) Stuenkel CA et al. Treatment of symptoms of menopause.

(4) Messier V et al. Menopause and sarcopenia: impact on metabolic health.