You haven’t dramatically changed what you eat. You may even be exercising as much as you always have or maybe more. Yet suddenly your jeans feel tighter around your waist, your stomach feels softer, and weight seems to be settling in a place it never used to. 

Sound familiar? 

For many women, this is one of the most frustrating changes of perimenopause and menopause. It can feel as though your body has suddenly decided to play by completely different rules and it didn’t warn us that it was going to do so. 

And while it’s tempting to think, “I just need to eat less and exercise more,” the reality is more complicated. 

As we move through the menopause transition, hormones change, body composition changes, muscle mass can decline, sleep can become more difficult and the way the body stores fat can shift. There can also be changes in glucose metabolism and insulin sensitivity. (1,2) 

So if your middle suddenly seems to be getting more attention than it used to, your physiology may have changed. 

Perimenopause changes the metabolic landscape 

Perimenopause is about much more than periods becoming irregular or hot flushes appearing out of nowhere. 

As ovarian function changes, oestrogen levels become more variable and eventually decline. Oestrogen interacts with many tissues throughout the body, so these hormonal changes can have effects far beyond reproductive health. 

One of the changes we see around the menopause transition is a shift in body composition and fat distribution. Research suggests that menopause is associated particularly with an increase in central fat accumulation, alongside changes in lean mass and other aspects of metabolic health. (1,2) 

At the same time, some women experience: 

It is important to say that menopause doesn't magically cause weight gain. 

Ageing, genetics, lifestyle, diet, activity, sleep and energy balance all matter too. In fact, the increase in overall body weight seen during midlife appears to be influenced strongly by ageing, while the shift towards a more central pattern of fat distribution appears to be more closely linked with the menopause transition itself. (2,3) 

Why does weight go to the middle in menopause? 

Not all body fat is the same. Some fat sits underneath the skin. This is called subcutaneous fat. 

Other fat is stored deeper inside the abdomen, around the internal organs. This is called visceral fat. 

During and after the menopause transition, there can be a shift towards storing more fat around the abdomen and less in the traditional pattern around the hips and thighs. (2,3) 

One reason for this appears to be the changing hormonal environment. 

Oestrogen influences fat storage and distribution. As oestrogen declines, the body's preferred pattern of fat storage can change too. (3,4) 

This doesn't necessarily mean you've suddenly gained a huge amount of body fat. 

Your waistline can change because of a combination of: 

This is why body weight and body composition are not the same thing. 

Two women can weigh exactly the same but have very different proportions of muscle and fat, and that ratio can change considerably during midlife. 

What does insulin have to do with weight around the middle? 

Insulin is a normal and essential hormone. One of its jobs is to help move glucose from your bloodstream into your cells, where it can be used for energy or stored. 

But insulin sensitivity can change with age and during the menopause transition. Some women become less sensitive to insulin, meaning the body may need to produce more insulin to achieve the same effect. Changes in oestrogen, body fat, muscle mass, physical activity and sleep can all be relevant to this picture. (4,5) 

And this matters because muscle is one of the body's major tissues for taking up glucose. 

Pair protein, fibre and healthy fats. Aim for 1.4g per kg of bodyweight in protein, 8 handfuls of vegetables a day for your fibre and 1-1.5g of quality fats per kg of bodyweight.  

This can help create a more balanced glucose response and, importantly, gives your body the nutrients it needs to support muscle, gut health and overall metabolic health. 

4. Keep moving outside the gym 

Your daily movement matters too. 

Walking, cycling, gardening, taking the stairs, doing the housework or simply getting up regularly throughout the day all contribute to your overall activity. 

5. Don't ignore your sleep 

Sleep is part of metabolic health. 

If you're experiencing significant night sweats, insomnia, anxiety, hot flushes or other menopausal symptoms, it's worth getting support rather than accepting that poor sleep is simply something you have to put up with. 

6. Targeted supplements  

Core Metabolic - The formula has been designed to support healthy glucose metabolism, helping the body better regulate blood sugar during a time when hormonal changes can make this much more challenging. Supporting blood sugar isn't just about weight management either - it can also help maintain more consistent energy levels and reduce those afternoon energy crashes and cravings that so many women experience.  

Creatine - Creatine helps support muscle strength, power and recovery, making resistance training more effective. But the benefits don't stop there. Emerging research is also highlighting creatine's role in supporting brain function, cognitive performance and overall energy production, making it particularly relevant during perimenopause when both physical and mental energy can feel depleted.  

The weight around the middle can be frustrating. Especially when it feels as though your body has changed without asking permission. 

It's about supporting the body you have now, build strength, protect muscle and give your metabolism the best environment to thrive. 

References