Weight Gain

Women often report that they gain weight during perimenopause and menopause.

Overall, the research does not necessarily show a straightforward link or correlation between menopause and weight gain.1

Ageing and menopause happen at the same time. Some studies have found that weight gain is linked to both menopause and ageing.

That said, studies suggest a stronger link between women in menopause and changes in the ways their bodies store fat. Many women may experience an increase in abdominal or visceral fat (which is deep abdominal fat that wraps around vital organs like the liver, intestines, stomach, heart and pancreas) during their menopause journey.2 The reason for this is yet not fully understood.3

Early and surgical menopause is also linked with weight gain.

Oestrogen has important functions related to muscle mass and strength.

Swinging or fluctuating oestrogen levels during perimenopause, with an overall decline at menopause, has a negative effect on muscle mass and strength. This may contribute to weight gain in women.

While research on weight gain amongst perimenopausal and menopausal South African women is limited, one study found that menopausal women had lower lean muscle mass. This study also found that there were fewer differences in fat mass between menopausal women and pre-menopausal women (that is, women still in their reproductive years).

Women may experience hot flushes, difficulties sleeping and fatigue as other symptoms of perimenopause and menopause, which may result in less physical activity (exercise) that in turn may contribute to weight gain.

Many women become less physically active in their midlife which plays a part in muscle loss – which is called sarcopenia. Muscle loss is linked to lower energy expenditure (think of this as burning fewer calories) and contributes to weight gain.

Weight gain is a complex matter for women during perimenopause and menopause.

Many of the factors that cause weight gain are interconnected.

Lifestyle and diet is very important not only for managing weight gain, but for the overall management of perimenopause and menopause symptoms, and the long term health consequences of your menopause journey.

My Menopause SA

Evidence-based menopause information for South African women.

Page last reviewed: 1 March 2026
Next review due: 1 March 2027

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Footnotes

1 Some studies in other country contexts show a link between menopause and an increase in fat mass (Greendale et la, 2019), while others do not.↩

2 We have stayed away from calling abdominal or visceral fat – belly fat or stomach fat which is commonly used – because these are not the same. ↩

3 However, there is new research which links daily energy expenditure (which reflects daily energy needs) with fat-free mass. ↩

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