“Why am I gaining weight around my middle, and why can’t I lose it?”
If you’re a woman in your late 30s, 40s, or 50s, you might be asking yourself this question - and you’re not alone.
There’s nothing more frustrating than feeling like your body is no longer your own, like the skin you’ve lived in your entire life no longer fits or responds to the same switches you’ve always used to to make yourself feel better. Perimenopause can often feel like a journey through uncharted waters - one where you really wish you had a map.
Well, here I am with the map! Yes, your body is going through a lot: hormonal changes, metabolic shifts, fluctuating energy levels. But with the right understanding and some proactive steps, you can manage these changes and still feel strong, healthy, and confident - and absolutely find balance again with your weight.
Let’s dive in.
What is Perimenopause?
Perimenopause is the transitional phase leading up to menopause, characterised by fluctuating levels of oestrogen and progesterone. But it’s not just these two hormones that change; others, including testosterone, insulin, cortisol, and your neurotransmitters (serotonin, dopamine, and GABA), also undergo significant shifts. Neurotransmitters, by the way, are the chemical messengers of your nervous system, controlling mood, reward, sleep, and emotional balance.
Perimenopause can last anywhere from 4 to 10 years, with the average being about 7 years. This period marks the hormonal evolution from premenopausal (the whole span of time from puberty to perimenopause) to postmenopausal (12 months when you haven’t had a period). Not all women will feel the same during this time, but it’s common to experience shifts that can feel overwhelming - even if you’ve been looking after yourself better than ever.
Let’s take a look at what’s happening with your hormones and how it impacts your metabolism, appetite, body mass distribution, and weight.
What’s really going on with your hormones?
- Oestrogen and Fat Storage
As oestrogen levels drop, the body starts to store fat differently, often shifting it towards the abdomen. This type of fat is more visceral (around the organs) than subcutaneous (under the skin), which can make you feel like your shape is changing to more of an apple shape. Visceral fat is metabolically active, meaning it produces and interferes with other hormones, increasing your risk for cardiovascular disease. - Insulin Resistance
As oestrogen declines, your body becomes less responsive to insulin, the hormone responsible for controlling blood sugar levels. This results in increased insulin resistance, meaning more of the energy you consume can be stored as fat. If blood sugar stability isn’t managed, this can also cause anxiety-related symptoms which are often dismissed as ‘oh you're just hormonal’. This infuriates me, as these can be easily supported so women don’t need to suffer unnecessarily! - Cortisol + Stress
Cortisol (the stress hormone) levels will rise during perimenopause. Increased cortisol can make you feel more emotional, overwhelmed, crave quick energy from sweet foods, and disrupt sleep. It becomes a bit of a vicious cycle: as progesterone (our natural sedative) is also falling, so sleep is further impacted, which results in higher blood sugar and insulin the following day. The body can’t discern that this internal stress is not a lack of food or risk to our survival, so it starts making a rainy day energy fund… in one central tyre around our middle, just in case! Cortisol also makes the body need three times more insulin to control blood sugar. So, you can see how these factors layer together to make fat storage more likely! But not a given, remember we are going through to understand why we need to change our habits, not falling into a pit of doom and gloom! - Muscle Mass Decline
As we age muscle mass naturally declines, and this is exacerbated during perimenopause as oestrogen dropping will accelerate the process. Muscle is crucial for maintaining metabolism because it helps to burn energy, even when you’re at rest. If muscle mass isn’t maintained, metabolism slows, which is often blamed on “getting older.” But this decline isn’t inevitable if we actively work to preserve muscle mass. - Appetite Regulation
Low oestrogen can also increase levels of ghrelin, the hormone that makes you feel hungry, while decreasing leptin, which signals fullness. This means you may feel hungrier, especially if your progesterone is also low. This can lead to emotional eating, further complicating weight management. The solution to this lies in using the food matrix to hack your food satisfaction - you can find a simple, clear explanation of how to do this in my blog, or on the Liebling Health Youtube channel if you prefer to watch!
So what can I do?
If you’re now thinking, ‘Christ, this is sounding pretty hopeless’ - don’t worry, there are actually several ways we can address these challenges.
First and foremost, we need to create a sense of stability for the body. Your body is undergoing a lot of internal changes, and a high-stress environment only makes things worse, as your body will remain stuck in that constant state of cortisol and insulin production. Small disruptions that might have been fine in the past may now be working against you - so it’s these we need to tackle.
- Stimulants
Coffee can exacerbate stress and disrupt sleep. I recommend switching to matcha or ceremonial cacao and drinking them after a meal (read more on why here). Hydrate with optimal functional water – aim for 0.04 litres per kilogram of body weight, adding a pure electrolyte concentrate like Oshun to support your adrenal system. - Alcohol
Alcohol can distort hunger signals, increase cravings for unhealthy foods, and interfere with blood sugar levels. It also prevents proper melatonin production, which disrupts sleep further. If you want to enjoy alcohol, avoid drinking on an empty stomach, swap sweet mixers like tonic water to sparkling/soda water, and try to stop drinking at least 2-3 hours before bed. - Limit Screen Time
Tech overload raises stress hormone levels. Aim to avoid phones, tablets, and laptops at least 2 hours before bed to ensure a restful sleep. During the day, take short 5-10 minute breaks every 1-2 hours to reduce stress levels. Pair this with gentle movement like walking to activate muscle tissue for that metabolic enhancement. - Exercise
Consistency is more important than intensity. Think of your body like a nervous deer (hear me out) - you can calmly walk towards it, hands outstretched and find it doesn’t run away. But bound towards it and it’s going to think it’s being attacked and run a mile. Avoid high-intensity activities like running, spinning, or HIIT during perimenopause. Instead, focus on 20-30 minutes of walking with a weighted vest, yoga, pilates, or light resistance training to maintain muscle mass without overloading your system.
- Sleep
Prioritise a consistent sleep routine. Aim for a set bedtime and wake time. Women actually need around 1 to 1 ½ hours more sleep than our male equivalents! The average ideal bed time for a woman is 9.30pm, whereas for a man it’s 10.30-10.45pm. If sleep is difficult, try a magnesium bath or supplements like magnesium bisglycinate, 5HTP, or CBD oil to improve sleep quality.
Alright - but what about food?
Instead of focusing solely on calories, aim for foods that provide lasting satisfaction. Low-carb diets can exacerbate cravings for sweets and fats. Instead, include whole food carbohydrates at meals to manage hunger and avoid grazing. Fasting is also counterproductive, as it adds additional stress to your system.
Breakfasts - always savoury. Opt for root vegetables as your carbs and what we call high anabolic proteins. So meat, fish and poultry as these are high satiety and will stabilise blood sugar, paired with fibrous vegetables.
- Breakfast hash - 100g grilled chicken breast, 80g boiled new potatoes, steamed kale and tenderstem broccoli. Warm in a pain, add lemon juice then drizzle a tablespoon of tahini over the top
- Turkey bowl - 100g Turkey mince sautéed with garlic and onions, 100g roasted parsnips, wilted spinach, ½ avocado, lemon & a drizzle of olive oil
- Steak + root veggies - 50g Grilled steak strips, 1 egg, 100g roasted butternut squash and beetroot, sauteed cabbage + green beans, pesto or chimichurri over the top
Lunches - follow a similar theme to breakfast. I like options that are easy to prep for a few days, like sandwich or potato fillers - or making all in one style options that use a grain, lots of lovely vegetables, a protein and a yummy sauce that actually get better being in the fridge for a few days.
- Grilled salmon bowl - grilled salmon with roasted beetroot, carrots and cumin, grilled courgettes and hummus. All prepped at the weekend then just assembled or packed up
- Protein-packed dip/filling - a tin of salmon or mackerel, mashed with 1 tbsp yoghurt or cottage cheese, olives, chopped up steamed spinach, broccoli & parsley. Make a few portions and have in a sandwich, baked potato or use crunchy whole grain crackers to eat like a dip
- Stir fry - make with cooked and cooled rice, prawns, tofu, mixed vegetables and topped with chopped nuts
Snacks - its about planning these in and picking savoury whole food choices rather than mindlessly picking.
- Yoghurt with cooked fruit and seeds or cacao nibs
- A boiled egg with a handful of almonds or edamame beans
- Crackers with cottage cheese or tzatziki and radishes
- You could also experiment with a baked good that is made with vegetables, protein powder and raw cacao if you are getting cravings for sweets
Dinners - here we go for lighter proteins with grains to support sleep.
- Scrambled eggs with smoked trout - 2 eggs + 50g trout, paired with cooked quinoa tossed with roasted aubergine, peppers and olives
- Grilled prawns or chicken breast, whole grain pasta, kale, mushrooms, peppers and pesto
- Lentil and lean beef bolognese - made with lots of vegetables like squash, mushrooms, cabbage, celery and fennel served in a baked potato
By implementing these lifestyle changes, you can manage your hormones more effectively, maintain a healthy weight, and feel like yourself again during perimenopause.
If you’d like more personalised advice, feel free to reach out! Let’s work together to create a plan that works for you. You can book a confidential quick consult with me here for an immediate discussion, or opt for the Liebling Health Hormones Package (call or email based), for personalised nutritional and lifestyle guidance over four sessions, in addition to any targeted supplements.
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