Belly Fat Post-Menopause
Why Belly Fat Increases During Menopause
Many women between the ages of 45 and 60 come to me with the same concern: “My stomach has become very big.” They often describe having a curvy figure when they were younger, but once menopause begins, their body shape changes, and their belly starts to grow. The question is, why does this happen?
To understand this, we need to look at hormones. Hormones are the body’s chemical messengers. From puberty through adulthood, they help shape the body and prepare women for pregnancy. During the teenage years, hormones guide fat to the hips and breasts, creating the familiar “hourglass” shape.
There are different types of body fat. Subcutaneous fat sits just under the skin. It is less harmful to health. Visceral fat is different. It collects deep inside the belly, around the organs. This type of fat is dangerous because it raises the risk for heart disease, diabetes, and inflammation in the body.
When menopause begins, estrogen levels drop. This shift has several effects. First, women lose muscle, and their metabolism slows down. That means the body burns fewer calories each day, even if activity levels stay the same. At the same time, fat starts moving away from the hips and thighs and begins to build up in the belly. Even if a woman gains only a small amount of weight overall, the change in where the fat is stored can make the stomach look much larger.
It’s important to understand that this belly fat is not the woman’s fault. It is not simply the result of eating too much or not exercising enough. The main driver is hormone changes. Vigorous exercise and dieting alone may not fully reverse it.
There are treatment options. Hormone replacement therapy can help reduce the buildup of belly fat and may also lower the risk of heart disease. However, it is not right for everyone, since it can raise the risk of breast cancer.
The most important takeaway is that women should not blame themselves. A growing belly during menopause is a natural process linked to hormones, not a personal failure. Managing it often requires the support of medical professionals who can help guide safe and effective strategies for long-term health.
Lancet Diabetes Endocrinol. 2016 March ; 4(3): 254–264. doi:10.1016/S2213-8587(15)00418-0.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5192018/
Fenton A. Weight, shape, and body composition changes at menopause. J Mid-life Health 2021;12:187-92. https://journals.lww.com/jomh/fulltext/2021/12030/weight,_shape,_and_body_composition_changes_at.2.aspx
