How Do You Lose Menopause Belly Fat? An Approach That Benefits Your Mind, Body, and Waistline

In some ways, menopause is like puberty, except that you’re older and it’s happening in reverse. Hormone swings are common, and your body may be changing in ways that surprise you. Weight gain, especially around your middle, is often a part of these body changes during menopause — even when you’re doing what you’ve always done to stay healthy.

Every body changes with age. And menopause, like aging itself, is a natural process. But there are health risks that come with extra weight, especially in the form of belly fat. While menopause can bring challenges, like a larger waistline, it’s also an opportunity to focus on your goals and prioritize your health.

What causes weight gain during menopause?

Not everyone gains weight during menopause. But if you find that it’s harder to lose weight or maintain your weight, you’re not alone. Up to 70% of women gain weight during menopause. On average, women gain about 1.5 pounds every year in their fifties and sixties. Often weight gain begins before that, during the years of perimenopause. Many women gain 20 pounds or more between the ages of 40 and 60.

Menopause weight gain tends to happen around the middle of your body. At the same time, you often lose muscle mass with age. So, even if your weight hasn’t changed much, the amount of fat in your belly and around your organs may have increased. 

Some of these changes occur with age. Both men and women tend to lose muscle and gain belly fat as they get older. But female hormones also play a role. Less estrogen means that body fat often shifts from your legs and hips to your middle. 

What are the risks of belly fat?

We all need fat in our bodies, including belly fat. But having too much of it can lead to inflammation. And that’s a risk for health conditions like:

• Heart disease

• Stroke

• High blood pressure

• Type 2 diabetes

• Joint pain

• Back pain

• Many forms of cancer

Because of lost muscle mass and shifts in body fat, after menopause you may need different measurements to assess your risk. Body mass index (BMI) alone won’t tell you everything you need to know. Postmenopausal women who have an average BMI and a larger waist may still be at greater risk for health problems. So, it helps to measure your waist as well as your weight.

To measure your waist accurately, try these tips: 

• Use a measuring tape that doesn’t stretch.

• Breathe out naturally.

• Wrap the measuring tape around your middle between your lowest rib and the top of your hips. That’s usually close to your belly button.

• Keep the measuring tape parallel with the floor.

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• Self-care in menopause: These self-care routines can help with the most bothersome menopause symptoms.

• Does protein powder help with weight loss? A high-protein diet can help you lose weight. But protein powder may not be the best way to increase your protein intake.

For many women, a waist size that’s 35 inches or more means a higher risk of inflammation and health problems. For Asian women, those risks may increase with a waist size of 31.5 inches. And for some other racial and ethnic groups, a waist-to-hip ratio may be a better predictor of risk.

What is the best diet for losing menopause belly fat?

When it comes to diet, there’s no one-size-fits-all approach. And although there aren’t any surefire ways to target only belly fat, there are some ways of eating that can lower your risk of chronic diseases. This can also help you feel better and more comfortable in your body in the process.

Lower calorie intake

Restricting your food intake too much isn’t healthy or sustainable. And, if you’re regularly losing more than 2 pounds a week, you may be losing muscle mass or water weight instead of fat.

It’s hard to be patient. But when it comes to losing body fat, taking it slow and steady gets the best results. No matter the specifics of your eating plan, decreasing your calorie intake by 500 to 750 calories a day seems to have the best long-term success. This leads to an average weight loss of around 1 lb to 1.5 lbs a week.

But, in general, people aren’t too accurate when it comes to estimating how many calories they eat. Even in lab studies calorie intake is often underreported. Using a nutrition app or keeping a food journal can help you keep track of the amount and kinds of foods you eat.

Mediterranean diet

The Mediterranean diet focuses on foods that are good for your body, rather than a strict eating plan. Besides helping people lose weight, it can also reduce the risk of chronic conditions like:

• Cardiovascular disease

• Alzheimer’s disease

• Parkinson’s disease

• Type 2 diabetes

• Some types of cancer

Foods in the Mediterranean diet are high in fiber, antioxidants, and lean protein. That helps to maintain muscle and decrease inflammation. And a Mediterranean diet with a lower calorie count can help with menopausal weight gain as well. 

The Mediterranean diet includes:

• Fruits, vegetables, nuts, beans, olive oil, and whole grains every day

• Fish and seafood a few times a week

• Dairy, eggs, and poultry once a day to once a week

• Red meat once or twice a month

• Limited sweets

• Red wine, if you choose to drink alcohol 

Choosing healthy carbs

In studies, women who ate fewer carbohydrates had a lower risk of weight gain in menopause. The most extreme form of low-carb eating is the keto diet. It might help you lose weight in the short term. But it can be hard to maintain over a longer period of time. And it may not be right for people with certain health conditions.

Your body needs carbohydrates, protein, and fat. But there are more and less healthy sources for each. For people who eat fewer carbs, it’s harder to lose weight if their protein and fat comes from animal sources rather than plants. 

There’s no magic number of carbs that will guarantee healthy weight loss. But, for steady weight loss over time, aiming for 50 g to 150 g of carbohydrates a day seems to work as well as very low carbohydrate diets, like keto. 

Quality matters, too. Carbohydrates in the form of whole grains, fruits, vegetables, and beans have added nutritional benefits that help with weight loss and overall health. Processed and sweetened foods and drinks add calories without the added health benefits.

The power of protein

To preserve muscle in menopause, you need to eat enough protein. Your healthcare team can help figure out the amount that’s right for you. But for most older adults, between 1.2 g and 2 g of protein per kg of body weight seems to be the right amount. So, for every 100 pounds of body weight, that would be between 55 g and 90 g of protein.

Strong muscles are great, but what does that have to do with belly fat? Maintaining the strength of your bones and muscles means you can be more active. And muscles use more energy than fat. So, even when you’re not moving around, your muscles are burning calories. 

Some good protein sources in menopause include:

• Poultry

• Fish and seafood

• Eggs

• Nuts and seeds

• Soy

• Lentils, peas, and beans

• Grains, like barley and quinoa

• Greek yogurt

Are there any exercises that target belly fat?

Exercise is vital for reducing fat and building muscle. But you can’t spot reduce fat in your belly or anywhere else in your body.

Exercise that gets your heart rate up is great for burning calories. Over time, that helps to reduce fat, including in your belly. You can do cardio in a gym or take a class, if that works best for you. But studies have shown that women in menopause who walk on a regular basis also lose body fat. Plus, walking is great for your muscles, balance, and bones.

Adding resistance training is another great strategy to lose fat and gain muscle during menopause. It may even help reduce hot flashes. Lifting weights at a gym is great, if you enjoy it. But you can also get the benefits of resistance training with hand weights, resistance bands, Pilates, and some types of yoga.

Is there anything else that helps with menopause belly fat?

In menopause, your whole body is changing. So, a whole-body approach is beneficial when you’re working on belly fat. 

Some other strategies that may help include:

• Weight loss medications: These aren’t right for everyone, and they come with risks. GLP-1 agonists — like Ozempic, Wegovy, and Zepbound — do help people lose weight and decrease waist size. But older adults in particular need to be careful about losing muscle as well. 

• Menopausal hormone therapy (MHT): Some studies have shown that women who used MHT (also known as hormone therapy, hormone replacement therapy, or HRT) had a little less belly fat than those who didn’t — but only when combined with healthy habits. And experts don’t recommend taking MHT just to prevent or treat weight gain.

• Better sleep: Sleep problems in menopause can affect your metabolism and your eating patterns. Sleeping fewer than 6 hours a night increases the risk of excess weight. Poor-quality sleep can do the same. Having a regular sleep routine can help. So can exercise, as well as limiting your caffeine and alcohol intake.

• Mindful eating: Planning meals, eating more slowly, and having a plan for when you eat out can all be helpful strategies.

• Stress management and self-care: The combination of stress and hormone changes can make weight loss in menopause even more of a challenge. Be sure to take care of your mental health as well as your physical health.

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Written by:

Anne Jacobson, MD, MPH

Anne Jacobson, MD, MPH has been a board-certified physician since 1999. She was a full-scope family physician (inpatient, outpatient, obstetrics, and office procedures) in the Cook County Ambulatory Health Network for 15 years.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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