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Navigating Perimenopausal Weight Gain

Updated: Apr 6

By Sejal Desai - MD Board Certified in Obesity Medicine of Tula Medical Weight Loss & Wellness


Dr. Sejal Desai - Shaping Women Naturally Magazine & Events
Navigating Perimenopausal Weight Gain

As you approach perimenopause, you may find yourself facing a myriad of changes, both physical and emotional. One of the most common concerns during this transitional phase is weight gain, especially around the midsection. While it’s true that hormonal shifts play a significant role, there are also other factors at play. In this blog post, we’ll delve into the causes of perimenopausal weight gain, discuss how to diagnose it, and explore various treatment options to help you navigate this journey with confidence and empowerment.


Causes of Perimenopausal Weight Gain:

1. Hormonal Changes: Fluctuations in estrogen and progesterone levels can lead to changes in metabolism, resulting in weight gain, particularly around the abdomen.

2. Decreased Muscle Mass: As we age, we tend to lose muscle mass, which can slow down metabolism and contribute to weight gain.

3. Lifestyle Factors: Poor dietary choices, sedentary lifestyle, stress, and lack of sleep can all contribute to weight gain during perimenopause.

4. Insulin Resistance: Changes in hormone levels can also affect insulin sensitivity, leading to weight gain and an increased risk of developing metabolic disorders like type 2 diabetes.


Diagnosing Perimenopausal Weight Gain:

This diagnosis involves a comprehensive evaluation which may include:

1. Medical History: Discussing symptoms, lifestyle factors, medications, and any underlying medical conditions.

2. Physical Examination: Assessing weight distribution, body composition, and other physical markers.

3. Bloodwork: Tests to measure blood sugar, insulin, cholesterol, thyroid and hormone levels.

4. Metabolic Assessment: Evaluating metabolic parameters and markers of inflammation.

5. Evaluation of Current Medications: Certain prescription medications or over the counter supplements you are taking may cause weight gain.


Treatment Options: Treatment should always be individualized because every woman’s experience during this phase of life is unique. In addition, treatment should be comprehensive, addressing all of the factors that may be contributing.

1. Lifestyle Modifications: Adopting a healthy lifestyle is key to managing perimenopausal weight gain.

This includes:

• Balanced Diet: Focus on whole, nutrient-dense foods such as fruits, vegetables, lean proteins, and whole grains. Limit processed foods, unhealthy fats, sugary beverages, and alcohol.

• Regular Exercise: Incorporate a combination of cardiovascular exercises, strength training and flexibility into your routine to improve metabolism, muscle tone, and overall well-being. • Stress Management: Practice relaxation techniques such as deep breathing, meditation, yoga or tai chi to reduce stress levels and promote hormonal balance.

• Adequate Sleep: Aim for 7-8 hours of quality sleep per night to support metabolism, hormone regulation, and overall health.


2. Medications: There are many medications and supplements that can help manage weight gain and other symptoms of menopause. These may include weight loss medications, hormone replacement therapy, or even medications to address insulin resistance, thyroid dysfunction, or other underlying medical conditions.


3. Behavior Therapy: Cognitive behavioral therapy or counseling may be beneficial for addressing emotional and behavioral factors contributing to weight gain, such as depression, stress eating or body image issues.


If you are struggling with perimenopausal weight gain, it’s essential to see a healthcare provider trained in obesity medicine. These doctors have pursued additional training beyond their primary specialty to gain expertise in the management of weight-related conditions. They will take a comprehensive approach to diagnosis and treatment, by finding the root cause of your weight gain and then developing a personalized plan for treatment. By taking control of your health now, you can navigate perimenopausal weight gain and emerge stronger, healthier, and more empowered than ever before. Remember to prioritize self-care, listen to your body, and seek support along the way. You’ve got this!



Dr. Sejal Desai

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