As she was prescribing HRT My doctor actually said to me “You can expect to gain a few kilos around the waistline.“
I’m nodding. But it in my head I’m thinking ‘not going to happen lady.’ Listen on to discover why weight loss is harder in peri-menopause and why I’d be very surprised if I do gain weight as I navigate this fascinating time of life.
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Video Version
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As she was prescribing my HRT, my doctor said something that made me sit up straight: “You can expect to gain a few kilos around the waistline as you’re going through this.”
I nodded politely, but in my head I was thinking, “Not gonna happen, lady.”
Now, before you think I’m being arrogant, let me explain.
My confidence doesn’t come from denial about the realities of menopause – it comes from understanding exactly why weight gain happens during this transition and knowing that we have more control than we’re often led to believe.
The Truth About Midlife Weight Changes
When you understand what’s actually happening in your body during perimenopause and menopause, the weight changes start to make sense. It’s not that you’re suddenly eating more or exercising less – your body is literally processing everything differently.
Your Metabolism Is Playing by New Rules
First, there’s the muscle mass issue. As we age, we naturally lose muscle tissue, and here’s the kicker: muscle burns more calories at rest than fat does. So even if you’re eating exactly the same amount as you always have, your body now needs fewer calories to maintain itself. It’s like your metabolic engine has shifted into a lower gear.
The Insulin Connection
Remember when you could eat a big plate of pasta and feel fine? As we age, our insulin sensitivity decreases. This means our bodies need more insulin to manage the same amount of carbohydrates, and higher insulin levels promote fat storage – particularly that stubborn belly fat that seems to appear out of nowhere.
The Protein Paradox
Here’s where it gets really interesting: while we need fewer overall calories, we actually need MORE protein as we age. Research suggests that in our 50s, we might need 10 to 35 times more of certain amino acids just to trigger muscle-building processes compared to when we were younger. So we actually need to eat less overall, but eat more protein. No wonder it feels complicated!
Your Digestion Is Slowing Down
This one surprised me: our gut motility naturally slows with age. Food stays in our digestive system longer, which means our bodies extract more calories from the same amount of food. We’re literally becoming more efficient at absorbing calories – great for survival on the savannah, challenging for maintaining our weight as modern humans.
The Hormone Hurricane
The decline in estrogen, progesterone, and testosterone creates a domino effect throughout your metabolism. These hormones interact with insulin and cortisol in complex ways, and when they’re out of balance, weight management becomes exponentially harder.
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Life Isn’t Making It Any Easier
Let’s be honest – this time of life isn’t exactly stress-free. Many of us are juggling:
- Peak career demands
- Teenagers or young adults who still need us
- Aging parents who increasingly need our help
- Sleep disturbances
- Our own health concerns
All this stress increases cortisol, which further complicates weight management and promotes fat storage around the midsection. It’s like our bodies are working against us at the exact time when life is most demanding.
Why I’m Not Worried (And You Don’t Need to Be Either)
So why did I have that confident reaction in my doctor’s office?
Because I’ve learned something crucial: while these biological changes are real, they’re not a life sentence.
I’ve spent the last five years developing the skill of truly listening to my body – not following external rules about what or how much to eat, but actually tuning in to what my body needs.
My mother, who sadly died at 63, navigated menopause without weight gain by doing exactly this. She never talked about dieting; she talked about having a “full tummy” and simply stopped eating when satisfied.
The key is adapting to your body’s changing needs rather than fighting against them. This means:
Adjusting portion sizes based on actual hunger and fullness
Prioritizing protein to maintain muscle mass
Being aware of how your body responds to different foods
Staying attuned to changes through regular weigh-ins (information, not judgment)
A Simple First Step
Want to start developing this body awareness? Try this simple practice: at your next meal, mentally divide your plate in half. When you’ve eaten the first half, pause. Actually pause. Check in with yourself. How does your stomach feel? Are you satisfied? Still wanting more?
This isn’t about restriction – it’s about awareness. Sometimes you’ll need the whole plate and more. Sometimes half will be plenty. The point is to start reconnecting with your body’s actual signals rather than eating on autopilot.
The Bottom Line
Weight gain during perimenopause and menopause isn’t inevitable, but preventing it does require a different approach than what worked in your 30s.
It’s not about willpower or discipline – it’s about understanding and working with your changing biology.
When my doctor made that comment about expecting weight gain, she was speaking from statistics, not destiny.
Yes, many women gain weight during this transition, but many don’t. The difference often comes down to knowledge and adaptation.
Your body is changing, but you’re not powerless. With understanding and the right strategies, you can navigate this transition on your own terms. And who knows? You might just surprise your doctor at your next visit.
In your corner,
Jules xx
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