Why So Many Women Struggle to Lose Weight Around Menopause
Rupali is a holistic health practitioner who knows there are no magic pills or 'one-size-fits-all' solutions in healthcare. A registered New Zealand pharmacist, she runs her virtual clinic, Pause.Breathe.Live, focusing on Functional Nutritional Therapy. Specializing in gut health, she offers functional testing to guide clients toward true healing.
Many women reach perimenopause or menopause only to find that no matter how much they exercise or how well they “eat,” their bodies seem to resist weight loss, especially around the belly. What’s more frustrating is being told it’s simply about “eating less and moving more.” I often see women working tirelessly at the gym, only to end up injured or burnt out, as their bodies are already in an inflammatory state, with minimal results to show for it.
1. The hormonal shift no one told you about
As women approach menopause, the ovaries gradually slow down their production of estrogen, progesterone, and other sex hormones. What many women don’t realise is that the body begins to rely more on another system, the adrenal gland, and the brain-to-gland communication pathway known as the HPA axis to help pick up some of the hormonal slack, especially by producing a weaker form of estrogen called estrone.
Here’s where it gets tricky: this same system is also responsible for responding to stress. So if your body has constantly been in fight-or-flight mode, pumping out stress hormones like cortisol, it may struggle to shift gears and support hormone balance. That’s not because your adrenal glands are “tired”, but because the entire stress-response system becomes dysregulated, like a thermostat that no longer knows how to adjust the temperature.
When this happens, many women find themselves stuck in a hormonal tug-of-war, too much of one thing, not enough of another, which can contribute to weight gain, energy crashes, sleep issues, and feeling “off” despite doing all the right things.
2. Blood sugar rollercoasters worsen the problem
Many women in their 30s and 40s are unknowingly on a blood sugar rollercoaster, relying on caffeine, refined carbs, or skipped meals to power through the day. But this pattern leads to insulin spikes, blood sugar crashes, and increased cortisol release, which worsens adrenal dysregulation and promotes fat storage, especially around the midsection [1].
Insulin is a fat-storage hormone, and as we become more insulin-resistant with age (which often happens during perimenopause), our bodies become even more efficient at holding onto fat, particularly visceral fat, which surrounds our organs and is hormonally active [2].
3. The role of adipose tissue in estrogen production
Another missing piece: Fat cells make estrogen, too. Specifically, adipose tissue converts androgens to estrogen via the enzyme aromatase [3]. This becomes especially important as ovarian estrogen levels decline during menopause.
From a functional perspective, this may help explain why the body resists weight loss during this phase; it could be holding onto fat to preserve hormonal balance. If estrogen levels have plummeted and the stress response is dysregulated, the body may not feel metabolically "safe" enough to release that stored fat. Instead of shaming the body, we can view this as an adaptive survival response, one that can be supported and rebalanced through foundational health strategies.
4. Liver and gut health matter too
Hormonal balance isn’t just about how much hormone you make; it’s also about how well you metabolise and eliminate them.
The liver plays a crucial role in breaking down and preparing estrogen for excretion. But when it’s overburdened with toxins, medications, or a poor diet, estrogen clearance may slow down. This can lead to recirculation of estrogens and symptoms of estrogen dominance, like stubborn weight gain, water retention, and bloating.
The gut microbiome also regulates hormone metabolism. A specific group of gut bacteria, known as the estrobolome, produces an enzyme called beta-glucuronidase, which can reactivate estrogen that’s meant to be excreted, sending it back into circulation [4]. This is another reason why gut health is critical to hormonal balance and weight regulation.
5. It’s not just willpower – it’s biochemistry
We need to stop reducing menopause-related weight gain to a matter of willpower or discipline. The body is not broken; it’s adapting. But when the root causes are not addressed, chronic stress, poor blood sugar balance, inflammatory diets, overburdened detox pathways, and gut dysbiosis, the body stays in a state of dysregulation.
Functional nutrition supports the body by:
Stabilising blood sugar with balanced meals
Supporting the adrenal axis through lifestyle and targeted nutrients
Nourishing the liver and gut to optimise detox and hormone clearance
Prioritising rest, stress reduction, and breathwork to signal safety to the body
Healing isn’t always fast, but when we work with the body rather than against it, weight loss becomes a byproduct of restored balance.
Curious how this applies to your own journey?
You can explore working together through my virtual clinic. Learn more here.
Read more from Rupali Lal
Rupali Lal, Functional Nutritionist Specialising in Gut Health
Rupali is a holistic health practitioner dedicated to empowering individuals on their journey to optimal well-being. Her health journey began in pharmacy school with digestive dysfunction. Despite using fiber supplements and probiotics, lasting relief eluded her. A decade later, studying Functional Nutritional Therapy, she realized she had 'normalized her symptoms' and learned 'just because it is common, doesn’t mean it is normal.' Respecting both conventional pharmacy and functional nutrition, Rupali works holistically with clients facing similar challenges. Specializing in functional gut and hormone testing, she meets clients where they are, creating personalized plans to address their unique needs.
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