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Adding a couple of kilos and shape-shifting is common during perimenopause, even if you haven’t changed what you eat or how much you exercise.


On average, females gain around 2 kg of weight and add 2.5 centimetres around their waist in the years leading up to their last period. While 2kg may not sound like a lot, the how, the why and the where matter.

Weight gain is not always simply a matter of ‘adding fat’ to your body. During perimenopause, hormonal changes mean you become more resistant to the effect of insulin – you don’t metabolise your energy as efficiently. The result is that you store more fat tissue about your belly and trunk. This is also associated with health risks – high blood pressure, diabetes, high cholesterol, heart disease, diabetes, dementia and an increased risk of some cancers. 

Increased insulin resistance is responsible for the weight gain and shape-shifting of perimenopause and menopause.

Here are a few ways to improve your insulin sensitivity:


Your top strategy is to reduce the load of “easy energy supply” your body has to deal with by doing these things-

  • switch out sugary foods and drinks
  • reduce breads, pasta, rice and other grains
  • eat more vegetables, fruit and protein
  • use healthy fats – olive oil, avocado
  • reduce alcohol
  • try slightly smaller portion sizes (just a bit!).

Intermittent fasting

Another helpful tactic to improve insulin sensitivity is intermittent fasting or time-restricted eating. This allows your body stretches of time where it can switch from metabolising your food to burning your fat tissue for fuel, training your body to be metabolically ‘flexible’. It also tends to reduce your overall calorie intake.

Intermittent fasting is complex – it’s not just starving yourself – do some more research or get professional help.

Moving more

Did you know that regular physical activity can be used to improve your insulin sensitivity? 30 minutes of moderate intensity activity (mild huff and puff) improves your metabolism (that’s right, not high intensity activity!).

Your muscles, particularly your larger ones, are great metabolic power houses. Using them in movements such as lunges, squats, lifting weights and yoga are especially helpful as it improves muscle strength and size, resulting in a higher metabolism. It also had the side benefit of keeping your bones and joints healthy.

Stress and sleep

Too much stress and not enough sleep increases cortisol levels (a ‘fight and flight’ hormone), which in turn increases your fat storage. Find ways to manage your stress!


Metformin is commonly used to improve insulin sensitivity although there are many other medications your doctor might also prescribe.

Most women also notice their boobs get bigger during perimenopause.

Top Tip on “measurements”

The most important sign of insulin resistance is the distribution of your weight – not the actual weight itself. Poorer health is linked to weight gathering around your middle compared to distributed elsewhere, such as your thighs and your backside. A waist circumference of more than 80 cm might mean you need to pay attention to your metabolism. Waist circumference is, of course, only one number in a broader set of measurements that can be used to monitor your metabolic health.

The number on the scales is also something we can easily measure but it is much less meaningful than your waist circumference. It also does not take into consideration your body “composition”. This is how much of your weight is due to muscles vs fat. As we age we want to maintain or increase our muscle, so the number on the scales can deceive us! 

Many woman have spent a lifetime struggling with their weight, often feeling dissatisfied with their bodies. Perhaps the rounding out of your reproductive years can be a time where you start to view your body differently – for what it can do for you, for how it feels rather than what it looks like. It is a time for letting go of society’s preferences for youthfulness and thinness. They should no longer be important enough to dictate to you how you feel about yourself.

Now is a time for change.

Focus on your health, on your vitality, on how you feel x

This information is for general educational purposes only and does not constitute medical advice. Please see your health professional for advice that is personalised to you.
Key Take Aways

Weight gain during perimenopause is due to increase insulin resistance

Paying attention to your diet and exercise now will have longterm benefits

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