“What’s the Best Diet in Perimenopause?”

Weight Gain

I’m often asked, “What’s the best diet for women in perimenopause and menopause?” And while I’d love to give an answer, the truth is there is not one specific diet that works for everyone. And in fact, I would go a step further and suggest that anything related to Diet Culture needs to be erased entirely from the perimenopause conversation.

Perimenopause and weight gain seem to go hand in hand for many women. And the problem is more complex than “calories in, calories out.” It usually starts because of hormone imbalances that show up in your early 40’s (or even earlier for some) but gets compounded by habit changes that seem like the right thing to do, but ultimately backfire. 

Perimenopause and weight gain seem to go hand in hand for many women. #dietculture #weightgain #losingweight #perimenopause #menopause #hormoneimbalance #foodsensitivity #mindfulness #DrAnnaGarrett #AnnaGarrettAsheville Click To Tweet

Fortunately, weight gain doesn’t have to be a rite of passage in midlife. Staying at a healthy weight is totally doable…once you recognize the potential landmines in your approach to managing it. Unfortunately, many of us start doing exactly the WRONG things when we want to lose weight. Here are my top 6 hidden causes of stubborn weight gain.

  1. You’re Deficient in Vitamin P

Show me a woman who’s gained weight and I am willing to bet she is not intentionally injecting pleasure into her life. Because the diet industry and our culture tell us that the battle of weight loss necessarily includes a fun-free diet, grueling workouts, and white-knuckle willpower. However, this doesn’t work over the long-haul. As humans, we are not wired to live this way.

When we separate pleasure from food, we alter the biochemical responses in our brains. This results in carb-cravings, decreased absorption of nutrients, and slowed fat burning.

  1. You’re Not Eating Enough

When women gain weight, their first instinct is to cut calories. Often dramatically! This approach can quickly backfire.

A significant calorie deficit will result in weight loss initially, but if you skimp on protein, you lose muscle mass. If you skimp on good carbs, you can lose both body fat and muscle. If you skimp on calories overall, cortisol levels rise and this encourages your body to hang to all the calories it can get (and deposit them around your middle).

  1. You’re Eating on Autopilot

Mindful eating is a powerful strategy when it comes to weight loss. But if you’re eating with anything that has an on/off switch, there is almost no chance you’re being mindful. Same with standing at the kitchen counter wolfing something down. When you are not in your body and present with your food, you can’t pay attention to your hunger signals. Especially the one that says, “I’m full.”

Put your food on a pretty plate. Sit down at a table. Eat slowly and stop before you are full. “Satisfied” is what you’re after! You should feel energized after a meal…not like you need to take a nap.

  1. You and Exercise Need a New Relationship

Most of us have a transactional relationship with exercise. “I’ll run 5 miles if I lose 5 pounds by Friday.” Sound familiar?

Here’s the deal. Our bodies were meant to move. The cavemen did not sit around all day at a desk. They were on the move if they wanted to eat! What if you moved just because it felt good or just because you could? What kind of movement would feel like LOVE to your body? You don’t have to go grind it out in a gym. You can go for a hike. Or row a boat. Or do qi-gong. Whatever feels good.

And as an FYI…exercise only contributes about 15% to weight loss results. And if you ramp it up and overexercise you will gain more weight. Too much exercise raises cortisol levels.

  1. Your Hormones Are Out of Balance

As we age, chances are high that some sort of hormone imbalance will occur. This happens because of stress (cortisol), exposure to toxins in the environment (estrogen dominance), and the aging process itself (thyroid). Until you uncover and correct these imbalances, achieving a healthy weight can feel like swimming upstream. Fortunately, these imbalances are fixable! A knowledgeable provider can help you identify what they are and create a plan to turn things around.

  1. You’ve Got Food Sensitivities

New food sensitivities can crop up in mid-life. This causes inflammation, which then results in fluid retention and weight gain. The most common food sensitivities are gluten (even if you don’t have celiac disease), dairy, and corn. You can try an elimination diet or do a food sensitivity test.

  1. You’re Insulin Resistant

Insulin is released from your pancreas in response to food intake which raises your blood sugar. Insulin’s job is to help your cells use that glucose for energy. Insulin resistance is when cells in your muscles, fat, and liver don’t respond well to insulin and can’t use glucose from your blood for energy. The extra glucose gets stored as fat. Your pancreas makes more insulin as a result of your chronically elevated blood sugar and ultimately produces less. This can result in Type 2 diabetes. 

There are many ways to maintain your weight in perimenopause. The answers are very individual and depend on your habits and genetics. If you’ve addressed these hidden causes of weight gain and you’re stuck, let’s talk


Dr. Anna Garrett is a menopause expert and Doctor of Pharmacy. She helps women who are struggling with symptoms of perimenopause and menopause find natural hormone balancing solutions so they can rock their mojo through midlife and beyond. Dr. Anna is the author of Perimenopause: The Savvy Sister’s Guide to Hormone Harmony. Order your copy at www.perimenopausebook.com.

Dr. Anna is available for 1-1 consultations. Find out more at www.drannagarrett.com/lets-talk. 

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