How to Balance Hormones for Weight Loss

Among their many functions, hormones regulate metabolism, appetite, and fat distribution in the body.⁽¹⁾ Body weight is influenced by genetics, age, diet, environment, and socioeconomic factors. However, hormonal fluctuations during perimenopause and menopause are believed to be the predominant factors in menopausal, or hormonal, weight gain. Weight gain is common during midlife, with one study showing that women between the ages of 36 and 79 in the United States experienced an average increase of 11.9 pounds over the past 10 years. The greatest weight gain occurred among women aged 36 to 39.⁽²⁾⁽³⁾

Excess body fat may increase the risk of certain health conditions, but adopting effective weight management strategies can help prevent or reverse menopausal weight gain, reducing associated health risks during this phase of life.

What is hormonal weight gain?

Hormone levels fluctuate continuously in response to different physical and emotional stimuli. During perimenopause and menopause, women experience significant hormonal shifts, including changes in estrogen, progesterone, and testosterone levels. Perimenopause encompasses the years from a woman’s first irregular period up to 12 months after their final period.⁽⁴⁾ Most women enter the menopause transition between the ages of 45 and 55, and the transition can last anywhere from seven to 14 years.⁽⁵⁾ Hormonal changes during this time are common, but restoring hormone balance may offer relief from menopausal symptoms like hot flashes, dizziness, night sweats, and weight gain.

The endocrine system facilitates the release of hormones and plays a significant role in regulating hunger and how the body stores and uses nutrients.⁽¹⁾ When certain hormones are imbalanced, it can lead to weight gain. These natural hormonal fluctuations can make weight management more challenging as women move through different stages of life.

The Relationship Between Hormones and Weight Gain

Menopausal weight gain is associated with a decline in hormone production, and even small shifts in hormone levels can have significant effects. Several hormones may contribute to menopausal weight gain, including the following:

• Estrogen: Estrogen is a sex steroid hormone that influences metabolism and the accumulation and distribution of body fat.⁽⁶⁾ The decrease in estrogen levels during menopause has been linked to increased abdominal fat. Among its many functions, estrogen affects the area of the brain that signals hunger and fullness. Therefore, fluctuations in estrogen levels during menopause may disrupt the body’s ability to regulate appetite.

• Progesterone: Like estrogen, progesterone is also a sex steroid hormone. These hormones are known to influence appetite, eating habits, and the breakdown of food into energy.⁽⁷⁾

• Cortisol: Commonly known as the “stress hormone” or the “fight or flight hormone,” cortisol is released into the bloodstream when the body detects a potential threat. Research shows that cortisol levels may increase during certain stages of menopause.⁽⁸⁾⁽⁹⁾ Having high levels of cortisol in the body may contribute to increased fat accumulation in the midsection.^(10)(11) Elevated cortisol levels have also been associated with a greater tendency to reach for foods that are high in fat and sugar.⁽¹²⁾ Cortisol also interacts with other hormones that affect weight, sleep, and mood.

• Insulin: Insulin is a hormone that regulates blood sugar levels. Estrogen helps protect against insulin resistance, but as estrogen levels decline during menopause, women become more susceptible to high blood sugar and potential weight gain.⁽¹³⁾ Chronic lack of sleep can also increase susceptibility to insulin resistance, particularly in postmenopausal women.⁽¹⁴⁾ Many women experience sleep disorders during the menopause transition, with insomnia being one of the most commonly reported.⁽¹⁵⁾

• Leptin: Leptin belongs to a category of hormones known as energy homeostasis peptides, which help regulate the body’s use of energy.⁽¹⁶⁾ This hormone suppresses appetite by signaling the brain when a person is full and when the body has enough energy stores (body fat). Along with decreased estrogen levels, changes in leptin and other peptides during menopause may contribute to increased food intake and potential weight gain.

• Ghrelin: This hormone also belongs to the energy homeostasis peptide family. Ghrelin is sometimes called the “hunger hormone” because it increases appetite and influences body weight.^(16)(17) It’s released when the stomach is empty, signaling the brain that it’s time to eat, and its levels decrease after eating. Fluctuations in ghrelin levels and other hormones during menopause may contribute to menopausal weight gain and make weight management more difficult.

• Thyroid Hormone: Produced by the thyroid gland, thyroid hormone regulates heart rate, the menstrual cycle, and the speed at which the body burns calories.⁽¹⁸⁾ Women are more prone to thyroid disorders than men, especially after menopause. If the body generates too little thyroid hormone (hypothyroidism) or too much (hyperthyroidism), it can impact metabolism.

Signs of Hormonal Weight Gain

Prior to the menopause transition, weight gain typically occurs around the hips, buttocks, and thighs. This is due to elevated estrogen levels from puberty that persist throughout a woman’s reproductive years.⁽¹⁹⁾ During perimenopause and menopause, however, weight gain often shifts to the abdomen, resulting in the formation of visceral fat. These changes in fat distribution are influenced by fluctuations in estrogen, progesterone, and testosterone levels during menopause. For some women, signs of hormonal weight gain may include the following:^{(2)(20)(21)(22)}

• Increased abdominal fat

• Unexplained weight gain starting in the mid-30s to early 40s

• Increased appetite

• Cravings for sugary foods

• Elevated stress levels

The Importance of Managing Hormonal Weight Gain
While hormonal weight gain may be a natural physiological response to hormone fluctuations associated with menopause — as well as dips in energy, increased stress, or reduced physical activity — menopausal weight gain can raise the risk of certain health conditions. Visceral fat can promote inflammation and increase the risk of developing insulin resistance.⁽²³⁾ The risks associated with the accumulation of visceral fat can worsen due to stress, lack of sleep, smoking, and poor diet. Menopausal weight gain and obesity may increase the risk of the following health conditions:

• Cardiovascular Disease: Cardiovascular disease (CVD) is the number one cause of death among women.⁽²⁴⁾ Research suggests that the natural changes the body undergoes during the menopause transition significantly increase the risk of CVD. The menopause transition has been linked to increases in cholesterol levels, weight gain, and other indicators of vascular health. While studies have produced mixed results, some research shows that women who enter menopause at an earlier age may be at greater risk for coronary heart disease.⁽²⁴⁾

• High Blood Pressure: Blood pressure is measured in two parts: systolic and diastolic. Systolic blood pressure refers to the pressure exerted on artery walls when the heart beats, while diastolic blood pressure measures the pressure in the arteries when the heart is at rest.⁽²⁵⁾ Many women experience increases in blood pressure as they age, which may be tied to hormonal fluctuations during menopause. Additionally, the increased risk of insulin resistance associated with menopause can also affect blood pressure and body weight.⁽²⁶⁾

• Cancer: Excess body fat can increase susceptibility to cancer. Studies from around the world have shown that increases in body mass index (BMI) during postmenopause may raise the risk of breast cancer.⁽²⁷⁾ Hormonal fluctuations, associated weight gain, and an increased likelihood of developing insulin resistance during menopause are all thought to potentially contribute to this relationship. In addition, the continuous loss and regaining of weight, known as weight cycling, has been linked to a higher risk of endometrial cancer in postmenopausal women.⁽²⁸⁾

• Stroke: Adopting effective weight management strategies during reproductive years can help prevent health issues that may develop during the menopause transition. Research from the American Heart Association/American Stroke Foundation found that moderate weight gain during premenopausal years increases the risk of stroke in late adulthood.⁽²⁹⁾

• Arthritis: Hormonal weight gain can make women more vulnerable to arthritis, characterized by inflammation of the joints. Excess body weight adds strain to the joints, potentially causing pain and swelling. Hormones such as estrogen, leptin, and cortisol, which fluctuate during the different stages of menopause, undergo changes in response to obesity.⁽³⁰⁾ These chemical messengers influence inflammation, the deterioration of cartilage, and more.

• Respiratory Diseases: Obesity may increase susceptibility to respiratory infections, asthma, obstructive sleep apnea (OSA), and obesity hypoventilation syndrome (OHS).⁽³¹⁾ This is because the accumulation of abdominal fat adds pressure to the surrounding area, making it harder for the lungs, diaphragm, and chest wall to move and expand during inhalation and exhalation. Individuals with respiratory problems may experience wheezing, labored breathing, tiredness, and more.

• Type 2 Diabetes: Aging and obesity are the two main contributors to the rising rates of type 2 diabetes around the world. Type 2 diabetes is a metabolic disorder, and women go through many metabolic changes during menopause. Along with increases in abdominal fat and total body fat mass, menopause also changes how the body metabolizes glucose. People with diabetes have high blood sugar levels, and research suggests that women who enter menopause at a younger age may be more vulnerable to the condition.⁽³²⁾

In addition to increasing the risk of various health conditions, decreased hormone levels and excess weight gain associated with menopause may also affect libido, energy levels, and self-image.

4 Ways to Balance Hormones to Prevent and Manage Menopause Weight Gain

Given the relationship between hormone imbalances and menopausal weight gain, implementing strategies to replenish reduced hormone levels during the menopause transition may help prevent or reverse weight gain. Here are a few methods for balancing hormones to manage menopausal weight gain: 

• Maintaining Adequate Protein Intake: While everyone’s dietary needs are different, eating high-quality protein during the menopause transition may support weight management by helping to balance hormone levels. Inadequate dietary protein can negatively impact hormone production.⁽³³⁾ Some research suggests that as women enter perimenopause, the body experiences changes in skeletal muscle protein balance.⁽³⁴⁾ Adequate protein intake may help protect against lean muscle loss, curb cravings, and aid in the prevention and treatment of obesity.⁽³⁵⁾ Sources of high-quality protein include fish, poultry, eggs, tofu, beans, lentils, and nuts.

• Decreasing Sugar Intake: A diet high in sugar can disrupt insulin, leptin, and ghrelin levels in the body.⁽³⁶⁾ Insulin regulates blood sugar, while leptin and ghrelin influence hunger and satiety. Reducing sugar intake may help regulate hormone fluctuations and prevent weight gain. 

• Getting Enough Sleep: Most Americans aren’t getting the sleep they need. Sleep deprivation can lead to hormonal imbalances, including increased ghrelin and cortisol levels and decreased leptin levels.⁽³⁷⁾ Sleep deprivation has also been linked to an increased risk of obesity. Getting 7 to 9 hours of sleep each night can help mitigate stress, restore hormonal balance, and support weight management.⁽³⁸⁾

• Exercising on a Regular Basis: Lack of exercise can contribute to menopausal weight gain. Some research has demonstrated that exercise may help increase the levels of certain hormones in individuals aged 40 and older.⁽³⁹⁾ Regular physical activity may help regulate hormones like testosterone, sex hormone-binding globulin (SHBG), and insulin-like growth factor-1 (IGF-1). Adults are recommended to get 150 minutes of moderate-intensity exercise every week, along with two days of muscle-strengthening activities.⁽⁴⁰⁾ This can be split up into 30 minutes of physical activity daily for five days each week.

Supplements to Balance Hormones and Support Weight Management

Some over-the-counter (OTC) supplements may help stabilize fluctuating hormone levels and prevent weight gain. Before starting any new medications or supplements, individuals should first speak with a doctor. The following supplements may benefit women during the menopause transition:

• Green Tea Extract: Green tea contains compounds called catechins that may play a role in balancing hormones associated with body weight and fat loss.⁽⁴¹⁾ However, research findings have been inconsistent regarding the effects of green tea supplementation on weight management. Although green tea is generally considered safe for consumption as a beverage, oral green tea supplements may impact liver function.⁽⁴²⁾ Green tea also contains caffeine, which may pose health risks for some individuals if consumed in excess.

• Isoflavones: Naturally found in soybeans, isoflavones are believed to act similarly to estrogen.⁽⁴³⁾ These compounds may help prevent obesity by regulating blood sugar levels and promoting weight loss. However, more research is needed to understand the effects of isoflavone supplementation on weight management in menopausal women with obesity.

• A Combination of Supplements and Exercise: Some supplements may be effective in relieving certain menopause symptoms when combined with a regular exercise routine. For example, research suggests that calcium and vitamin D, when paired with aerobic exercise and strength training, may help improve bone mineral density lost during menopause.⁽⁴⁴⁾

Hormone Replacement Therapy for Weight Loss

Hormone replacement therapy (HRT) can help restore balance to declining levels of estrogen, testosterone, and progesterone during menopause, all of which influence appetite and body weight. Although HRT is not specifically designed for weight management, it has been linked to reductions in abdominal fat, waist circumference, and body mass index in postmenopausal women.⁽⁴⁵⁾ HRT has also been shown to prevent increases in body fat as women age. Alternatively, dehydroepiandrosterone (DHEA) is a hormone precursor naturally produced in the body that gets converted into estrogen, testosterone, and other hormones. In one study, DHEA replacement therapy was found to decrease abdominal fat and boost insulin action in older adults.⁽⁴⁶⁾

A variety of factors influences menopausal weight gain and effective weight management. There are natural ways to lose weight, and addressing the hormonal changes that occur during menopause can be one of them.