As women age and approach menopause, one of their biggest complaints (aside from frustrating menopause symptoms) is that their waistline is growing. Many women believe that their weight gain and growing waistlines are side effects of menopause itself—just more bodily changes that occur as a result of hormonal fluctuations. However, what is really happening in the body is a little more complicated.

Menopause can have effects on body composition and the presence of fat, but it is now believed that menopause doesn’t cause literal weight gain. Instead, other lifestyle factors and aging may be to blame.

Menopause and your middle

A growing waistline tends to make women think that they are gaining weight, and this can cause a significant amount of stress. When this occurs during perimenopause and menopause, it’s easy to associate the weight gain with the other changes the body is undergoing.

Previously, menopause was believed to cause general weight gain. It was thought that changes in your hormone levels might make it more likely that your middle section gains weight. However, there is no scientific evidence to support that menopause causes weight gain in this way.

Instead, new research indicates that menopause may lead to the redistribution of body fat, particularly to the waistline. During this transitional period, body fat often shifts away from the hips, thighs and buttocks and up to the stomach area.

Perimenopause, in particular, has been associated with changes in body composition, resulting in increased fat around the abdomen. A lot of women experience a shift from a “pear-shaped” body, where more weight is carried below the waist, to an “apple-shaped” body, with more fat present above and around the waist. Along with this change, women may notice a decrease in fat around other parts of their bodies, notably their thighs and hips.

When this happens, the number on the scale may not be going up, but your tummy may be looking larger than before.

Metabolism and lifestyle factors

Although menopause itself may not be the cause of weight gain, that does not mean that women around menopausal age are exempt from weight gain entirely. Instead of blaming menopause for your weight gain, you may need to examine other aspects of your life, including your activity level, diet and age. Generally speaking, weight gain is more common as women age due to changes in metabolism.

Muscle mass tends to decline as you age. This loss of muscle mass can slow your body’s metabolism, or the rate at which your body burns calories. When this happens, more fat is likely to be stored, causing weight gain, unless you make dietary and/or activity level changes.

Women going through menopause also tend to be less active than they were when they were younger. Higher stress levels, busier schedules and even the symptoms of menopause can make working out more challenging or less appealing. With decreased activity can come an increase in weight gain because you’re burning fewer calories.

Because of these changes, women in their 40s and 50s may see an increase in total body fat as well as a shift in body fat accumulation away from the hips and thighs and toward the waistline. However, it’s important to remember that these changes are caused by different things.

Risks of fat accumulation and distribution

Although weight gain and redistribution are normal in menopausal women, they are not necessarily safe. An overall increase in body fat can be dangerous to your health, but an excess of fat around the central part of the body can come with its own set of risks.

Central weight distribution has been linked to serious health risks, such as cardiovascular issues. Glucose levels and blood pressure can also be altered by this central fat, potentially leading to other health problems. For these reasons, it’s important for women to pay attention to both their overall weight and the circumference of their abdomen to monitor fat accumulation around the waist. Major increases in either area could set you on a path to chronic disease.

Hope isn’t lost!

With a better understanding of the physical changes your body may experience related to weight and fat distribution, you have the opportunity to get ahead and combat it through healthy lifestyle choices. Weight gain and excess belly fat are not inevitable; it just might take a little extra work to keep it off.

One of the best things you can do during menopause is make healthy food choices. Fad dieting is not the answer! You may need to decrease your calorie count slightly, but eating healthier, more nutrient-dense foods and cutting out processed foods or excess sugars can make a world of a difference when it comes to reducing body fat during and after menopause.

Additionally, menopausal women should stay physically active throughout their transition and beyond. Aim to get at least 75 minutes of physical activity a week, including aerobic exercises like jogging or swimming as well as strength exercises to increase muscle mass.

Sleeping a healthy amount each night and taking steps to reduce stress can also have substantial impacts on weight gain and fat loss during these transitional years. Stress management is necessary for menopausal women because stress can make it more difficult to stick to a healthy diet. When you’re stressed, the body releases cortisol and triggers sugary cravings. Women who are stressed all the time tend to eat more desserts and processed foods. Without proper exercise, this can contribute to overall increased weight gain. Stress-relieving techniques like yoga, journaling and meditation can help you keep off the extra pounds and feel better mentally.

Making these changes during perimenopause or even earlier can help you establish healthy habits that last throughout your transitional years to make it easier to keep excess weight off and reduce the appearance of body fat around your waistline.

Editor’s note: This blog was originally published in January 2020. It has been updated to include more relevant and comprehensive information.