How to manage weight gain during perimenopause

Published on 04 December 2025

Do all women gain weight during perimenopause?

Weight gain is a common symptom of perimenopause, affecting at least half of all women. As oestrogen levels decline, fat that used to accumulate around the thighs and hips tends to accumulate around the abdomen and upper body.

At the same time, other perimenopause symptoms such as a slower metabolism and reduced muscle mass make it harder to maintain a healthy weight, and disrupted sleep and fluctuating hormones make it harder to exercise.

Do you gain more weight during perimenopause or menopause?

Perimenopause through to the first few years after the final menstrual period are when women tend to gain the most weight. After this, weight gain tends to slow down as hormones begin to stabilise, although post-menopausal women also struggle with maintaining a consistent weight.

Research from the Study of Women's Health Across the Nation (SWAN) shows that women typically gain around 1.5kg per year during the perimenopause phase, leading to an average total weight gain of 10kg by the time menopause occurs.

During the menopause transition, around 60% of women are over their ideal body mass index (BMI), so it’s important to have more compassion for your body during this already challenging time.

Tips for managing perimenopause weight gain

1. Diet

It’s very unlikely that the symptoms of menopause can be controlled by what you eat. When it comes to diet during menopause, the priority should be on foods that support bone and heart health.

Here are a few top changes you can implement to help to manage perimenopause weight gain:

• Eat more protein: Incorporating more protein-rich foods into a quarter of each meal is a valuable way to build muscle, in combination with exercise. Protein is also a valuable source of other nutrients such as omega-3 fatty acids (found in oily fish) and iron.
• Eat calcium-rich foods: To maintain good bone health throughout menopause, consuming foods like milk, yoghurt and kale is a great benefit.
• Delay your morning coffee: This is a difficult one, especially if you’re waking up tired after a night of disturbed sleep during menopause, but caffeine can lead to weight gain because it impacts our blood sugar levels. Starting your day with hot water and lemon or a de-caffeinated drink can also naturally support your cortisol levels which are at their peak first thing in the morning. Save your coffee for after breakfast instead!
• Notice if any foods trigger hot flushes: Some women experience an increase in hot flushes and sleep disturbances when they consume certain food and drink such as caffeine, alcohol and spicy hot foods.

2. Exercise

During menopause, your oestrogen levels decrease significantly, beginning during perimenopause. This increases your risk of osteoporosis (a condition causing weak, fragile bones that are more likely to break). Not only does regular exercise support you with weight loss, improve your energy and protect your heart health, it also helps you to maintain bone strength and density.

The recommended amount of exercise is to aim for at least 150 minutes of moderate-intensity exercise each week, which equates to 20 minutes a day. Doing a combination of cardiovascular and strength-training exercises will help to build lean muscle, increase fat burning and boost your metabolism.

Jogging, swimming, cycling or even a brisk walk around the block are great cardiovascular activities. Squats, box press ups, bicep curls and many more strength, resistance or weight-bearing exercises can be incorporated into your fitness routine at least once a week.

If you remain consistent with moving your body, you should see an improvement in the appearance of your abdominal area.

During perimenopause, women experience a reduction in the production of certain hormones that can weaken your pelvic structures. Explore the role of exercise in maintaining pelvic health.

3. Sleep and relaxation

Many people underestimate the role of sleep in weight loss. Getting enough good quality sleep helps to regulate the hormones leptin and ghrelin, that influence appetite, metabolism and storage of fat. Lack of sleep puts these hormones out of balance.

Insufficient sleep also leads to the following;

• Reduced physical activity: Feeling fatigued will affect your motivation to exercise, which is essential to support your weight loss journey.
• Insulin resistance: Lack of sleep can lead to insulin resistance, which makes it harder for your body to regulate blood sugar levels.
• More snacking: Awake at night but exhausted during the day? People who are awake for hours during the night will get hungry and be more likely to reach for a midnight snack!

A good place to start with improving your sleep is to practice more relaxation techniques, not just before bed, but throughout the day. Meditation, yoga or deep breathing exercises can help to control your stress levels. Even just taking five minutes out of your busy day to breathe deeply shouldn’t be underestimated in how it can regulate your nervous system.

If you’re struggling to get seven to nine hours of sleep a night consistently, it might be time to speak to a healthcare professional.

Seeking expert medical support

Gaining a lot of weight rapidly? Feeling exhausted by poor sleep? Struggling to exercise and eat healthy?

At Benenden Hospital, we understand how difficult it can be to be stuck in a vicious cycle with your health.

Weight loss

Our comprehensive non-surgical weight loss management service can support you with the following:

• Nutritional Therapy
• Physiotherapy and exercise support
• Medical support

It’s easy to book your appointment online.

Women's health support

We’re experts in women’s health and offer a range of private menopause treatments and gynaecology procedures in a discreet, supportive environment.
Our Private GP service can also help with advice and treatment for a wide range of women’s health concerns, including:

• Menopause and hormone replacement therapy (HRT)
• Contraception
• Incontinence
• Vulval health
• Osteoporosis
• Periods and menstrual health

You can also book an Advanced Female Health Assessment with Dr Fiona Warner, ideal for women navigating menopause or aged 50 and over.

Contact our Private Patient team via Livechat, complete our online enquiry form or call 01580 363158.