Why Belly Fat Is Harder to Lose After Menopause

Medically Reviewed By William C. Lloyd III, MD, FACS
Unseen Caucasian woman holding belly fat

It’s not your imagination: Most women’s bellies get bigger as they get older, even if the women continue to exercise regularly and eat a healthy diet. Here’s what causes belly fat in women and why changing hormones make belly fat harder to lose.

Blame low estrogen levels.

As women go through perimenopause—the multi-year period that precedes the total cessation of menstrual cycles—their ovaries gradually produce fewer female hormones, particularly estrogen. By the time a woman’s menstrual cycles have stopped, her body produces almost no estrogen.

It’s this lack of estrogen that seems to trigger a shift in fat. Almost all women (and men, for that matter) gain weight as they get older, but studies have found that women who have entered menopause have significantly more visceral fat, or fat located deep in the abdomen, than similar-aged women who have not yet experienced menopause. Some women remain the same weight before and after menopause but notice a significant challenge in their silhouette. In almost every case, women add inches to their waist after menopause.

Women who use hormone therapy to treat menopausal symptoms tend to have less visceral or belly fat than other menopausal women, which lends support to the theory that lack of estrogen drives the accumulation of belly fat. Unfortunately, when women stop hormone therapy, they gain belly fat.

Age, genetics and overall health also affect belly fat.

As humans age, muscle mass declines. People who have a lot of muscle mass burn more calories per hour than people with less muscle mass. So losing muscle mass can slow your metabolism and make it easier for you to put on weight.

Some people are also genetically predisposed to hold more weight in the belly. Studies have also shown that people who were small at birth more readily gain belly fat later in life, compared to people who were of average weight at birth.

Your overall health affects belly fat too. If you have arthritis or joint problems that make it difficult to exercise, for instance, you are probably more likely to gain belly fat than women who are able to move without pain.

There are ways to manage belly fat.

Belly fat is not just a cosmetic issue—it has real health consequences. Excess visceral fat increases your risk of cancer, and a waist size of larger than 35 inches (for women) is associated with an increased risk of developing diabetes, high cholesterol, high blood pressure, and heart disease. You may not be able to completely prevent or halt the accumulation of belly fat, but you can keep it in check.

Exercise is the most effective way to lose belly fat. Eating a healthy diet (and eating sweets and drinking alcohol only in moderation) is beneficial, but diet alone cannot reduce belly fat. So, incorporate physical activity into each day. Studies have found walking 50 minutes a day three times a week or 30 minutes a day six days a week can prevent (or help you lose) belly fat.

Taking estrogen can keep belly fat under control, but because estrogen may also increase the risk of developing endometrial or breast cancer as well as the risk of stroke, heart attack, and dementia, estrogen therapy is not recommended solely to control weight or belly fat. There are risks and benefits to hormone therapy after menopause; your healthcare provider can help you understand these factors in the context of your personal health history.

You may not be able to eliminate belly fat after menopause, but you can remain healthy and active. Your healthcare provider can help you manage your health risks and stay vibrant.

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  1. What Does Your Waistline Say About Your Health? Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/belly-fat/art-20045809?p=1
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 May 8
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