As you approach middle age, you may notice that it’s getting harder to zip up your jeans and your clothes are feeling a little too tight, especially around your belly. Unfortunately, this is normal. Studies show that women gain an average of 1.5 pounds per year during the menopause transition, largely due to a decline in estrogen levels (1).
Decreasing estrogen levels changes how your body stores fat, typically moving away from the hips and thighs to accumulate around the abdomen, says Christine Maren, D.O., a board-certified physician who specializes in women’s health and hormones.
“Estrogen also plays a crucial role in blood sugar regulation, so as it declines, we often become more insulin-resistant. Changes in hormones can also impact thyroid function, which affects metabolism and can make it harder to lose or maintain weight.”
Lifestyle plays a big role too. “Women over the age of 40 tend to exercise less consistently, suffer from poor sleep, and have elevated stress levels—it’s a time in many women’s lives where they are prioritizing others,” says Marjorie Nolan Cohn, M.S., R.D., registered dietitian and clinical director of Berry Street.
While your changing reflection may be what’s motivating you to research weight loss for women over 40, there are health implications beyond aesthetics. Excess weight, especially in the belly, is an indicator of deeper metabolic issues and comes with health risks, like increased risk for heart disease, insulin resistance, type 2 diabetes, hormone-related cancers, arthritis, sleep apnea, and dementia, adds Maren (2, 3, 4).
Even though weight gain after 40 is common, it’s not inevitable, and experts say shedding pounds is possible with a few smart diet and lifestyle tweaks.
About the Experts
Marjorie Nolan Cohn, M.S., R.D., L.D.N., C.E.D.-S., Clinical Director of Berry Street.
Christine Maren, D.O., board-certified physician with a functional medicine practice specializing in a root cause approach to women’s health and hormones.
1. Cut Back Calories
Estrogen plays a significant role in regulating your basal metabolic rate (BMR), or the number of calories you burn at rest. As estrogen levels go down in your 40s (and beyond), your BMR goes down with it.
Because BMR accounts for about 50 to 65 percent of your daily calorie burn, as it drops you need fewer calories (5).Research shows that during perimenopause, your BMR goes down by up to 250 to 300 calories per day (6). Meaning: If you don’t cut back on calories, you gain a little under five pounds per year.
You don’t have to swear off all the foods you love. Reducing portion sizes and choosing low-calorie, nutrient-dense foods most of the time goes a long way.
One way to cut back? Intermittent fasting. In a 2022 study in Obesity, researchers found that an 8-week intermittent fasting plan helped obese pre- and post-menopausal women lose six to nine pounds (7).
2. Eat Well
You’ve likely heard the phrase “a calorie is a calorie,” which implies that it doesn’t matter where calories come from, as long as you’re staying within recommended ranges. But this is antiquated advice, and research shows calorie source matters since different types of foods are metabolized differently (8).
Protein is especially helpful for weight loss after 40, says Maren. “Many women I work with in their 40s and 50s are under-eating protein and restricting calories. Our body hears: Resources are scarce, hold onto fat for survival.” You also need protein to maintain lean muscle mass, which declines by 3 to 8 percent every decade after the age of 30 (9).
Aim for 0.8 to one gram of protein per pound of ideal body weight, spread across three substantial meals, says Maren.
As for other macros, it depends on your situation. “Active women with good muscle mass often need more healthy, complex carbs. If there’s insulin resistance (which is carbohydrate intolerance), you might rely more on healthy fats for energy,” she says.
Focus on whole, nutrient-dense foods like vegetables, lean meats, eggs, whole grains, legumes, nuts, and seeds, which fill you up with fewer calories.
Cook at home, where you can control ingredients and portions.
Avoid ultra-processed foods—they’re engineered to make you eat more, says Maren.
Eat regularly to keep your blood sugar stable.
3. Reduce Sugar and Alcohol
Sugar and alcohol are both calorie-dense but nutritionally void. This alone can lead to weight gain. But it’s not just about the calories. Sugar and alcohol can also disrupt sleep and exacerbate stress and anxiety, leading to a negative cycle that makes it difficult to lose weight.
In a 2024 study in JAMA, researchers also reported that a higher added sugar intake was associated with an older biological age in mid-life women (10). In other words, sugar may increase the rate at which your cells and organs age. Alcohol also contributes to metabolic issues.
The goal isn’t perfection—enjoying some sugar or alcohol is fine as long as you eat healthy, whole foods most of the time.
4. Get Enough Sleep
Poor sleep is a dealbreaker for weight loss, but women in perimenopause often struggle with insomnia due to declining hormone levels. To get as many hours of uninterrupted, restorative sleep as possible, Cohen recommends practicing good sleep hygiene:
Turn off electronic devices at least 30 minutes before bed (11)
Reduce caffeine and alcohol intake
Practice relaxing activities, like yoga or meditation, before bedtime
Get blackout curtains
Use earplugs or a white noise machine to block out ambient noise
Set a sleep schedule—wake up and go to bed at the same time every day, even on the weekends
Depending on the individual, Maren says supplements like melatonin or L-theanine might also help.
Instead of only prioritizing weight loss, Maren says your mid-life era is about focusing on body recomposition. “This means gaining muscle while losing fat, rather than just seeing the number on the scale go down,” she says.
Women start to lose lean muscle at the age of 30. This can contribute to weight gain since muscle tissue is metabolically active and helps burn calories even at rest. Muscle loss can significantly slow your metabolism, or BMR, according to Maren.
Strength training is crucial at this life stage, and Maren recommends three to five heavy strength training sessions per week. “While you burn fewer calories lifting weights than doing cardio, you’ll build muscle that makes your body more efficient at using calories and regulating blood sugar 24/7,” she says.
Complement resistance training with short bouts of cardio, which increases your calorie deficit. Aim for at least 150 minutes of moderate-intensity activity per week.
In addition to structured workouts, little changes like taking the stairs instead of the elevator or parking far from store entrances can have compounding effects that make a big difference in your weight.
6. Manage Stress
As you age, your body becomes less resilient to stress (12). That’s a problem because stress causes chronically high levels of cortisol, an adrenal hormone that can make it harder to lose weight. “High cortisol levels increase appetite and cravings, especially for high-calorie foods rich in sugar and fat. It also promotes fat storage, particularly around the abdomen, reduces insulin sensitivity, and disrupts sleep,” says Maren.
To control stress, Maren recommends focusing on stress-reduction techniques like meditation and deep breathing.
Keep in mind that stress comes in many forms. For example, intense exercise is also considered a stressor. If your body is already in a chronically stressed state, it may make more sense to try lower-intensity workouts like somatic exercise or steady-state cardio and resistance training over high-intensity cardio circuits.
Other stress-relieving techniques to try:
Listen to calming music
Engage in a fun hobby
Make an effort to spend time with family and friends
Avoid work and business communication outside of your working hours
Get regular massages
Practice progressive muscle relaxation
7. Hydrate
Hydration improve energy levels, enhances your workouts, and even helps with honoring your hunger and fullness cues, says Cohn. Sometimes, you may get what you think is a hunger signal, but it’s dehydration.
As you age, you might have to be a little more intentional with your fluid intake since hormonal changes can decrease your thirst, prompting you to drink less (13).
Maren recommends drinking the equivalent of half your body weight in ounces of water daily, ideally between meals. That means if you weigh 180 pounds, you’ll want to drink 90 ounces of water.
Drink clean, filtered water rather than tap. Endocrine-disrupting chemicals, like PFAS, found in tap water can further exacerbate hormone changes and even speed up the menopausal transition (14, 15).
While electrolytes can be helpful, Maren says they’re not essential. If you want to try an electrolyte powder, stick to one that doesn’t contain any sugar, artificial sweeteners, or flavors such as the unflavored LMNT.
8. Improve Gut Health
Gut health becomes especially important during perimenopause as hormone changes can negatively affect your microbiome. Recent research suggests your microbiome may play a role in your weight, including your ability to lose weight.
Focus on fiber-rich foods as a starting point, says Maren. Fiber is fermented by gut bacteria, creating byproducts called short-chain fatty acids (SCFAs) that positively alter your gut microbiome and can help with weight management and insulin control (16, 17).
Maren also suggests considering digestive enzymes, as enzyme production often declines with age. Digestive enzymes help break food down into smaller, absorbable compounds, which can lead to improved digestion and less gas and bloating. (Of course, any underlying digestive issues should be addressed with a practitioner.)
Fortunately, many lifestyle changes that help manage weight, like eating a better diet, managing stress, getting better sleep, and staying hydrated, also contribute to a balanced gut. You may also want to try:
Taking probiotics
Eating more prebiotic-rich foods, like garlic, leeks, onions, Jerusalem artichokes, and bananas, which feed the good bacteria in your gut
Lindsay Boyers is a functional nutritionist and writer who specializes in evidence-based health and wellness writing. Her bylines appear on Healthline, Verywell Health, mindbodygreen, and Livestrong, among others.
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