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Why perimenopause causes belly fat and how to stay healthy

A closer look at how hormonal changes impact your body and what you can do to feel your best.
Updated
October 8, 2024
Written by
Dora Jambor

Introduction

One of the most frustrating changes women face during perimenopause is the weight gain that seems to settle stubbornly around the belly. You’re not imagining it—those hormonal shifts happening in your body during perimenopause are real, and they’re affecting your metabolism. But this isn’t just about feeling uncomfortable in your favorite jeans. Belly fat during perimenopause can have deeper implications for your overall health, especially when it comes to your heart and metabolic health. In this post, we’ll break down why this happens, what risks are involved, and what actionable steps you can take to manage it and stay healthy.

What causes belly fat during perimenopause?

During perimenopause, your hormone levels—especially estrogen—begin to fluctuate, and this affects where your body stores fat. In younger years, women tend to store fat more evenly around the hips, thighs, and other areas. However, as estrogen decreases, testosterone levels can play a larger role in shifting fat storage to the abdomen. This is why many women notice an increase in visceral fat, which wraps around the internal organs, particularly in the belly area.

But there’s more to it than just hormones. Other factors, like slower metabolism, changes in muscle mass, and even lifestyle factors like stress and sleep, can contribute to this stubborn belly fat.

Why is belly fat during perimenopause dangerous?

While weight gain in general is something many women are concerned about, belly fat—specifically visceral fat—is particularly dangerous for your health. This kind of fat isn’t just sitting under your skin; it’s stored around your internal organs, including your liver and intestines, and is linked to serious health risks. These include:

  • Increased risk of heart disease: Visceral fat contributes to inflammation and raises your risk of developing cardiovascular disease.
  • Higher chance of insulin resistance: Belly fat can lead to insulin resistance, a precursor to type 2 diabetes.
  • Potential links to cognitive decline: Studies suggest a connection between visceral fat and an increased risk of dementia.
  • Higher risk of certain cancers: Excess visceral fat has been associated with a higher risk of developing breast cancer.

The risks aren’t limited to these conditions. Researchers have found that visceral fat may even increase the likelihood of early death, as it’s closely tied to metabolic dysfunction.

How does stress contribute to belly fat during perimenopause?

Hormonal changes aren’t the only factor at play when it comes to belly fat. One major contributor is stress. Perimenopause can be a stressful time—whether it’s due to changes in your body, juggling family responsibilities, or managing your career. And when you’re stressed, your body releases cortisol, a hormone that helps you cope with stressful situations but also promotes fat storage, particularly in the belly area.

Managing stress through techniques like meditation, deep breathing, or even short, mindful walks can help keep cortisol levels in check, reducing its impact on your waistline. Sleep, too, is crucial—poor sleep quality during perimenopause can raise cortisol levels and disrupt your metabolism, leading to more belly fat.

What role does diet play in managing belly fat during perimenopause?

There’s no single magic diet to prevent weight gain during perimenopause, but making a few targeted adjustments to your eating habits can help reduce belly fat. Here’s how:

  1. Focus on whole foods: A diet rich in fruits, vegetables, lean proteins, and healthy fats (like those found in avocados, nuts, and fatty fish) helps balance blood sugar levels and supports hormone production.
  2. Cut down on sugar and refined carbs: Excess sugar and refined carbohydrates cause spikes in insulin, contributing to fat storage. Try to limit added sugar to no more than 25 grams a day.
  3. Increase fiber intake: Eating at least 25 grams of fiber daily has been shown to help reduce belly fat and improve overall metabolic health.
  4. Don’t fear fat: Healthy fats are essential for hormone balance and overall health. Opt for sources like olive oil, avocados, and omega-3-rich foods like salmon.

These changes won’t just help manage your weight—they’ll also lower your risk of heart disease, diabetes, and other metabolic disorders.

Why is muscle mass important for managing weight during perimenopause?

Another key factor in managing weight during perimenopause is maintaining muscle mass. As we age, muscle mass naturally declines, and this can slow your metabolism even further. Muscle burns more calories than fat, even when you’re at rest, so preserving muscle is crucial for keeping your metabolism functioning efficiently.

Strength training—whether through bodyweight exercises, resistance bands, or weights—can help you maintain and even build muscle during perimenopause. Incorporating at least two strength-training sessions per week, along with cardiovascular exercise, can significantly help with weight management and reducing belly fat.

How can you monitor your health during perimenopause?

One of the most practical ways to keep an eye on your health during perimenopause is by tracking your waist-to-hip ratio. This simple measurement helps you gauge how much fat is stored around your abdomen and can indicate whether you’re at risk for health issues.

To measure:

  • Wrap a tape measure around the smallest part of your waist.
  • Then, measure the widest part of your hips.
  • Divide the waist measurement by the hip measurement.

A waist-to-hip ratio of 0.85 or lower is considered healthy for women. This ratio provides valuable insight into whether you’re storing more fat in your abdomen, which can signal an increased risk of cardiovascular disease and other conditions.

What else can you do to manage belly fat and stay healthy?

In addition to diet, exercise, and stress management, there are other proactive steps you can take during perimenopause to support your health:

  • Get regular checkups: Monitoring your cholesterol, blood pressure, and blood sugar levels can help you stay on top of your cardiovascular and metabolic health.
  • Talk to your doctor about hormone replacement therapy (HRT): While not for everyone, HRT can help balance estrogen levels and manage some of the symptoms of perimenopause, including weight gain. Always consult with your healthcare provider to determine if HRT is right for you.
  • Quit smoking: If you smoke, quitting is one of the most impactful things you can do for your health. Smoking increases your risk of visceral fat, along with many other health problems like heart disease and stroke.

Conclusion

Weight gain during perimenopause, especially around the belly, is common but can have serious health implications. Understanding the reasons behind it—from hormonal changes to lifestyle factors—can empower you to take control. By making key adjustments to your diet, incorporating strength training, managing stress, and staying proactive about your health, you can manage belly fat and reduce your risk of cardiovascular disease and other metabolic disorders.

Perimenopause may bring challenges, but with the right tools, you can navigate this transition feeling healthier and more confident.