I have to confess that the last year has been more sedentary for me, with hours of full on research and report-writing, and If you’re like me, then you will most likely have noticed how much harder it is to keep weight off during the menopausal years. And if not, then you probably know someone else who has this challenge. The things that worked in our 20s or 30s and maybe even early 40s no longer have the same effect.

Why do so many women at menopausal age struggle?

It’s not just about “calories in, calories out” or “eat less, exercise more”. If it were, we would all be sorted. Here are seven reasons why it can feel so hard to lose weight at menopause.

(1) Dieting or not eating enough

This is the most common issue I see with many clients. They may not “be” on a diet and they may not think they are undereating, but they are, which ironically, is stopping them from losing weight. This is especially pertinent for those of us who have consistently been on and off diets or yo-yo dieted in the past.

Consistently undereating reduces your resting metabolic rate or RMR. Your resting metabolism is what your body does when you are doing absolutely nothing – like beating your heart, growing your nails and hair, digesting your food, replacing cells, processing your pee and so on. When you don’t eat enough over a period of time, your body lowers your RMR. Basically, it powers down, just as your mobile phone does when running low on battery, going onto low power mode. The trouble is, it isn’t so quick to bring it back up again, which means that when you return to the same intake of calories as you did before, the pounds pile back on, and more.

Quite simply, your body now needs less to function, so it stores the rest away. I know, that’s really annoying. But all is not lost, because it’s possible to work with your body, to raise its RMR again, but it’s not just about the calories.

(2) Prolonged stress

When our bodies experience stress, it releases a stress hormone, known as cortisol. Cortisol has a few functions in our body and one of them is raise blood sugar levels, to help to handle the stressor. Your body does this because it thinks that you need the energy to either fight or flee. This kicks insulin, another hormone, into action, because your body doesn’t like to have too much sugar in the blood.

So to keep it in a narrow range, insulin tells the cells in your muscles to take up the sugar and use it for the energy you need to fight or flee. But, if you’re under prolonged and chronic stress, resulting in elevated cortisol and insulin at the same time for an extended period of time, the muscle cells can’t take up any more sugar as you’re not using up that energy by fighting or running, but simply sitting at your desk… so fat cells come to the rescue.

Yes, the body makes new fat cells if it has to, so it can store all that excess energy. Worse still, cortisol breaks down muscle, so over time, you can end up with less muscle and more fat.

Now here’s the thing. It’s not just mental and emotional stress that does this. It’s also physiological stress – things that cause your body to be stressed – like skipping meals or under-eating, or not getting enough sleep. What’s more, during menopause, fluctuating hormones add to the load. That’s why it’s even more important at this time to reduce stress levels as much as possible, and reduce your cortisol levels.

(3) Eating the wrong foods

You possibly know about this one and may even have tried to address it already – high sugar foods and highly refined carbohydrates. These are converted very quickly into sugar, which can sharply spike your blood sugar levels, which cues insulin to bring the blood sugar levels back down again.

We’ve already seen that insulin tells cells in the muscles to take up the blood sugar, and any excess gets turned into fat. This is even more significant during menopause, when oestrogen levels start to drop. The process is not well understood, but it is known that oestrogen plays a role in helping to regulate blood sugar and the sensitivity of the cells to insulin messaging, known as insulin sensitivity.

So, less oestrogen means reduced insulin sensitivity, means cells not taking up the sugar, and hence, the making of fat cells to store that excess energy. In other words, once we hit the menopause, our bodies become more susceptible to the effect of eating food high in sugar and/or highly refined carbohydrates.

Instead of high-sugar and highly refined carbohydrates, eat unprocessed “smart carbs” such as sweet potato, lentils, chick peas, or butternut squash, as examples, which provide a slower and steadier conversion to blood sugar.

(4) Under- or over-exercising

Along with the under-eating, this is also a common issue. Exercising is important, we all know that, and the idea of under-exercising is not likely to be a surprise to you. But did you know that over-exercising could sabotage weight loss?

Exercise improves insulin sensitivity, and as we have seen, less oestrogen means reduced insulin sensitivity. That’s why exercise becomes even more important during the menopausal years. But there is a fine balance in terms of how much exercise is needed and at what levels of intensity. Exactly where this balance is, is individual.

Exercising for too long or at too high an intensity, increases cortisol, which can lead to less muscle and more fat (see Prolonged stress at 2 above). Ouch, that’s just the opposite of what one might expect. The key then, is to start off with a moderate intensity aerobic or cardio-exercise for at least half an hour, five days a week. Examples of this include brisk walking or walking uphill, or cycling, and you can gauge if you are at moderate intensity by the “talk test”, which means that you can comfortably chat while doing the exercise. If you can’t, you’re going too hard. To preserve muscle mass, you need to also include some resistance training twice a week. This doesn’t necessarily have to mean using weights, as you can do bodyweight exercises, using the weight of your body as resistance.

(5) Overloading your liver

The liver is an incredible organ which we cannot live without. It lives just under our ribcage on the right hand side, and it plays a key role in processing fat, which makes it a crucial organ in the context of weight loss. Another of its key jobs is neutralising chemicals and toxins and getting them ready for excretion.

The truth is, our livers really have their work cut out for them, because the world that we live in today, is filled with toxins – from pesticides and plastics, to chemicals in our foods, cleaning materials and personal toiletries and cosmetics. To give you an idea as to how much our liver potentially has to contend with, consider that there are over 80,000 chemicals in commerce that are registered for use with the U.S. Environmental Protection Agency.

Further, excess oestrogen is a bodily chemical that the liver is also responsible for detoxifying and getting ready for excretion. But if the liver is overloaded, it can’t do this its job as effectively, and this may result in excess oestrogen, which may contribute to oestrogen dominance and related menopausal symptoms. What’s more, oestrogen itself plays a role in supporting liver health and its ability to process fats. With reduced oestrogen levels as a result of menopause, looking after your liver health becomes even more important.

With all that to contend with, perhaps it’s no wonder that our liver may deprioritise processing fat loss! To support the liver, eat plenty of vegetables of all colours of the rainbow, including dark leafy greens, steer clear of high-sugar foods and refined carbohydrates as already mentioned, and hydrate well.

Also reduce and limit your exposure to toxins from cleaning products, plastics and personal products.Yes, alcohol too. Limit your intake or quit completely, saving it for special occasions, as it places a burden on your liver, because the body sees it as a toxin which the liver has to handle first, above all else. Some people like kombucha as a replacement.

(6) Ignoring your gut microbiome

Research in the gut microbiome and its role in health has been burgeoning over recent years. It is now known that gut bacteria play multiple roles, including supporting our immune system, and turning carbohydrates into short-chain fatty acids which are used by the intestinal cells as a source of nutrients and energy for repair and maintenance. An imbalance between friendly and unfriendly bacteria can therefore have a significant impact on our health.

While this is important, no matter what stage of our lives we are at, it can become more noticeable at menopause, because the gut microbiome can also impact oestrogen levels. These gut bacteria are referred to as the estrobolome. These bacteria produce an enzyme called β-glucuronidase, which frees up oestrogen that the liver has already bound up ready for excretion, allowing it to recirculate. This translates to increased circulating oestrogen levels which may contribute to oestrogen dominance, and… weight loss resistance.

The good news is that the food that we eat greatly influences the composition of our gut bacteria. Eat foods that are rich in fibre (such as beans and legumes), polyphenols (deeply coloured fruits and vegetables) and prebiotics (which are foods that the bacteria love, and include Jerusalem artichokes, asparagus, oats and apples. Eat fermented foods to help maintain your gut bacteria also, such as kefir, sauerkraut and kimchi. Finally, ditch any intake of artificial sweeteners which can encourage the growth of unfriendly bacteria.

(7) Inflammation

Inflammation is part of our immune or defense system, and is our body’s response to stress or injury. Inflammation can be a good thing. For example, when you sprain your ankle, you feel pain, there is swelling, redness and heat, which are signs of inflammation and your body attempting to protect and heal the area. After doing its job, inflammation should then subside, but if it doesn’t and carries on to become chronic, it can contribute to health issues, such as hormone imbalances (e.g. insulin resistance), cardiovascular disease, diabetes or obesity. While fat itself contributes to inflammation, inflammation itself can also contribute to belly fat and weight gain. It then becomes a vicious circle.

But what else can cause inflammation? In short, our modern lifestyle. We’ve already covered a number of these – such as eating the wrong things (sugar, unhealthy oils and fats, hidden food sensitivities), nutrient deficiencies, stress, poor sleep, imbalance in the gut microbiome, hidden infections and environmental toxins.

The role of oestrogen in the body is wide-reaching and complex. It has both pro-inflammatory and anti-inflammatory roles. In menopause, oestrogen levels fall, and this may have an impact on how inflammation persists in the body at this time. Start tackling inflammation by eating an anti-inflammatory diet and anti-inflammatory foods, and implementing the other tips mentioned earlier.

If you’re suffering from fat loss resistance, there may be different reasons for it, and this can be different for different people. It isn’t just about “eat less, exercise more” or just about calories or low fat, as you may have been led to believe. Fat or weight loss resistance is multi-factorial. But it is possible to address, steadily and step by step.

You can be trimmer and healthier.

Let’s get you feeling better.

Much love.


Brady, C.W. (2015) Liver disease in menopause. World Journal of Gastroenterology, 21(25), pp. 7613–7620.

Morello-Frosch, R., Cushing, L.J., Jesdale, B.M., Schwartz, JM., Guo, W., Guo, T., Wang, M., Harwani, S., Petropoulou, S.-S.E., Duong, W., Park, J.-S., Petreas, M., Gajek, R., Alvaran, J., She, J., Dobraca, D., Das, R., and Woodruff, T.J. (2016) Environmental Chemicals in an Urban Population of Pregnant Women and Their Newborns from San Francisco, Environmental Science and Technology, 50 (22), pp 12464–12472

Palmisano,B.T., Zhu, L. and Stafford, J.M. (2017) Estrogens in the Regulation of Liver Lipid Metabolism, Advances in Experimental Medicine and Biology, 1043, pp. 227–256.

Rock, K.D. and Patisau, H.B. (2018) Environmental Mechanisms of Neurodevelopmental Toxicity. Current Environmental Health Reports.5(1), pp. 145-157

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