Women’s bodies go through countless transitions over the years, yet few are as confusing and overlooked as perimenopause. It’s a time of profound change—physically, emotionally, and hormonally. Among the many concerns women in midlife express, weight gain is one of the most frustrating. It’s confusing, often feels out of our control, and can lead to cycles of dieting, restriction, and self-criticism. You’re exercising more, eating less… but nothing is working.
I work with clients navigating perimenopause and menopause. I also support people who are dealing with disordered eating and eating disorders. I have found that weight is an interesting and tricky topic. I get it—when nothing seems to be working, the temptation is to seek out the fastest solution possible. That’s why medications like Ozempic are skyrocketing in popularity and why dieting culture remains so persistent.
But what if we shifted the conversation? What if there was a different approach—one that didn’t require fighting against your body but instead worked with it? Instead of restriction, frustration, and quick fixes, what if we focused on nourishment, balance, and self-compassion to support your body through this transition in a way that actually lasts?
The Reality of Perimenopausal Weight Changes
As estrogen and progesterone levels fluctuate, our bodies respond in ways that can feel unpredictable. Changes in metabolism, shifts in fat distribution, increased insulin resistance, and stress-related cortisol production can all contribute to weight gain. However, viewing this solely as a problem to be “solved” through extreme measures often leads to disordered patterns of eating and an unhealthy relationship with food.
Research shows that disordered eating behaviors, like chronic dieting, binge eating, and obsessive food tracking, increase during midlife. A study published in the International Journal of Eating Disorders found that perimenopausal women reported a significantly greater prevalence of eating disorders than premenopausal women, often driven by a desire to control weight during this uncertain time.
Research from STRIPED (the Strategic Training Initiative for the Prevention of Eating Disorders) found that 34% of females struggling with an eating disorder were over the age of 40, encompassing the perimenopausal years, emphasizing the need for awareness and appropriate interventions during this transition.
Disordered eating behaviors, such as binge eating, restrictive dieting, or an obsession with healthy eating (orthorexia nervosa), can lead to nutrient deficiencies, decreased bone density, and mental health challenges. Addressing these patterns with a compassionate, evidence-based approach is essential for long-term well-being during midlife.
The Cost of Weight-Centric Approaches
Many of the popular weight loss methods today—whether it’s restrictive diets, excessive exercise, or even the use of weight-loss medications—come with unintended consequences. Rapid weight loss can lead to muscle loss, metabolic slowdown, and nutritional deficiencies. Restriction often fuels cycles of deprivation and overeating, exacerbating feelings of frustration and failure.
Perhaps most importantly, focusing on weight as the primary measure of health can overshadow deeper issues like energy levels, digestive health, hormonal balance, and mental well-being. When weight loss becomes the main goal, sustainable habits take a back seat to quick fixes that often do more harm than good.
Shifting the Focus: Supporting Your Body, Not Fighting It
Instead of waging war against your body, consider a different approach—one that prioritizes nourishment, balance, and long-term well-being. Here’s what that might look like:
- Support Your Changing Metabolism – Rather than restricting calories, focus on nutrient-dense meals that stabilize blood sugar, support digestion, and provide the protein and healthy fats your body needs.
- Prioritize Muscle Health – Strength training and movement that feels good can help preserve muscle mass and maintain metabolic health.
- Address Stress and Cortisol – Chronic stress contributes to weight changes and overall health challenges. Practices like mindfulness, breathwork, and quality sleep can make a significant impact.
- Build a Healthy Relationship with Food – Ditch the dieting mindset. Intuitive eating, mindful eating, and self-compassionate nutrition strategies can help you reconnect with your body’s signals and needs.
- Seek Sustainable Support – You don’t have to navigate this alone. Working with a practitioner who understands the complexities of perimenopause can help you create a personalized, sustainable approach to feeling your best.
You Deserve More Than a Number on the Scale
Your worth is not defined by your weight. Midlife wellness isn’t just about your body size —it’s about caring for your whole self in a way that helps you feel strong, vibrant, and healthy. By stepping away from weight-centric approaches and embracing a more balanced, nourishing path, you can find true health and confidence in this season of life.
I want every woman going through this transition to know that there’s light and hope on the other side. This isn’t the end of anything—it’s the start of a new chapter full of possibilities.
If you’re struggling with these changes and unsure of the best next steps, I’d love to support you. Let’s shift the focus from weight loss to well-being—because you deserve to feel strong, vibrant, and empowered at every stage of life.
Let’s Continue the Conversation
I’d love to hear your thoughts on these issues, or, if this is something you are struggling with, reach out to me directly through the link to my calendar here: BOOK NOW
References:
Vincent C, Bodnaruc AM, Prud’homme D, Guenette J, Giroux I. Disordered eating behaviours during the menopausal transition: a systematic review. Appl Physiol Nutr Metab. 2024;49(10):1286-1308. doi:10.1139/apnm-2023-0623
Mangweth-Matzek B, Hoek HW, Rupp CI, et al. The menopausal transition—A possible window of vulnerability for eating pathology. Int J Eat Disord. 2023;56(6):1274-1284. doi:10.1002/eat.22345.
Deloitte Access Economics. The social and economic cost of eating disorders in the United States of America: A report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders. Published June 2020. Accessed February 4, 2025. https://www.hsph.harvard.edu/striped/report-economic-costs-of-eating-disorders/.
