The role of stress in weight gain during menopause

Why does stress matter more during menopause?

Many women still gain weight during menopause despite following a healthy diet. With menopause causing a great hormonal shift in the body, stress on top of this can cause more disruption to fat loss efforts (1). The physiology of stress plays a major role in weight gain during menopause (1). This blog will aim to address how stress hormones can influence weight during the menopause transition and provide strategies to help manage this.

Why can women feel stressed during menopause?

Biological factors

During menopause, there is a decline of oestrogen in the body, which affects mood, quality of sleep and fluctuating emotions (1). If women are experiencing low mood and poor sleep quality, the body struggles to cope with everyday pressures, making stress feel more intense and difficult to manage (3). This creates a vicious cycle, where stress levels increase over time, and further disrupts sleep and emotional stability (3).

Lifestyle factors

Many women during the menopause transition carry responsibilities such as caring for children, elderly parents and work pressures, which can increase stress levels and impact sleep quality, leading to insomnia and night sweats (2). Additionally, women during menopause can have increased anxiety surrounding health and changes in the body, such as weight gain (1).

What are the stress hormones that link to weight gain?

Cortisol is a stress hormone which can be linked to weight gain. Cortisol is released in response to stress, and it helps to regulate blood sugar levels, energy levels and inflammation in the body (2). However, when the body is in a state of chronic stress, cortisol levels are constantly heightened, disrupting the two key hormones involved in hunger, ghrelin and leptin. This leads to strong sugar cravings and an overall increase in appetite, further contributing to weight gain (2).

How does cortisol link to weight gain?

During menopause, the decline in oestrogen removes the protective effect against cortisol, and stress responses increase during menopause (3). Chronic stress causes the body to be in a state of threat, prioritising fat storage over fat loss (1,2). Cortisol promotes fat storage around the abdomen, a particularly sensitive area to cortisol where visceral fat is stored (2). Visceral fat can be harmful to health because it surrounds vital organs such as the pancreas and the liver. Fat stored in these areas interferes with normal organ function, particularly insulin regulation and increases inflammation, which contributes to metabolic dysfunction. Therefore, excess visceral fat can result in increased risks for type 2 diabetes, high blood pressure and cardiovascular diseases (2).

How does the relationship between stress and sleep cause weight gain?

During menopause, women can experience disrupted sleep, causing night sweats, difficulty falling asleep and waking up early (1). Poor quality sleep raises cortisol levels, in turn, increasing hunger during the day (1). In addition, frequent sleep disruption reduces insulin sensitivity, which causes the body to be less efficient at managing blood sugar levels (2). This means that there are increased amounts of insulin and sugar circulating in the blood, promoting fat storage rather than burning energy (2).

Improving sleep may better support cortisol levels and help manage weight and metabolic health during menopause.

Can stress cause emotional eating during menopause?

High cortisol levels can increase cravings for certain foods such as refined carbohydrates and sugar, leading to weight gain due to excess calories (2). This is due to the hormonal shift during menopause, with the decline in oestrogen being associated with lower mood and stress, creating a coping response of eating to feel better (4).

Practical dietary and lifestyle guidance

Although supplements can play a supportive role during menopause, for long-term health, it is crucial to follow practical dietary and lifestyle strategies that help regulate blood sugar, manage stress and support emotional well-being.

Dietary advice

• Aim to choose wholegrain foods such as brown rice, wholemeal bread and wholewheat pasta instead of refined carbs such as white rice, white bread and white pasta, to decrease spikes in insulin (5).

• Include foods high in magnesium, such as leafy green vegetables and nuts, to help with stress levels and support sleep (6).

• Talking to a therapist alongside a registered nutritionist or dietitian can help support emotional well-being through addressing underlying stressors and providing evidence-based, tailored advice.

Lifestyle advice

• Take part in regular physical activity such as yoga classes, walking and swimming to calm the mind and reduce stress levels (6).

• HRT- certain hormone replacement therapy is shown to increase oestrogen levels and support hormones during menopause, which can improve negative symptoms and reduce stress levels (6).

Conclusion

Changes in weight during menopause aren’t just down to the amount of exercise you do or eating a balanced diet alone. Chronic stress can also play a major role in weight gain during menopause, and ongoing stress can make it difficult to manage weight. Also, hormonal shifts, such as the decline in oestrogen, can cause the body to become sensitive to insulin, which encourages fat storage.

It’s important to focus on reducing stress through regular exercise, a well-balanced diet and a good sleep pattern. Managing stress alongside diet will help to keep cortisol levels regulated better, in turn supporting weight loss and management during menopause.

References

1. James, D.L., Larkey, L.K., Evans, B., Sebren, A., Goldsmith, K., Ahlich, E., Hawley, N.A., Kechter, A. and Sears, D.D. (2023). Mechanisms of improved body composition among perimenopausal women practicing Meditative Movement: a proposed biobehavioral model. Menopause, 30(11), pp.1114–1123. doi:https://doi.org/10.1097/gme.0000000000002262.

2. Singh Balvinder and Maurya Neelesh Kumar (2024). The Cortisol Connection: Weight Gain and Stress Hormones. Archives of pharmacy and pharmaceutical sciences, 8(1), pp.009-013. doi:https://doi.org/10.29328/journal.apps.1001050.

3. Albert, K.M. and Newhouse, P.A. (2019). Estrogen, Stress, and Depression: Cognitive and Biological Interactions. Annual Review of Clinical Psychology, 15(1), pp.399–423. doi:https://doi.org/10.1146/annurev-clinpsy-050718-095557.

4. Schreiber, D.R. and Dautovich, N.D. (2017). Depressive symptoms and weight in midlife women. Menopause, 24(10), pp.1190–1199. doi:https://doi.org/10.1097/gme.0000000000000897.

5. Lm, S., Y, Z., Ml, W., K, K. and Kc, M. (2021). Whole grain intake, compared to refined grain, improves postprandial glycemia and insulinemia: a systematic review and meta-analysis of randomized controlled trials. Critical reviews in food science and nutrition. [online] doi:https://doi.org/10.1080/10408398.2021.2017838

6. Nilima Bhore (2015). Coping strategies in menopause women: A comprehensive review. Innovational: Journal of Nursing and Healthcare, [online] pp.244–253. Available at: https://innovationaljournals.com/index.php/ijnh/article/view/652.