Menopause Muffin Top? Here’s What to Do About It

Stuck in the Middle with Menopause Belly

For a chosen few over age 45, the ability to keep a svelte figure before, during, and after menopause seems effortless. But for the rest of us, our menopausal years typically usher in a growing girth that won’t go away, in spite of diet and exercise. If you’re seeing a muffin top and letting out your belt a notch or three, here’s why and what you can do about it.

“Waisting” away? Nope.

Pants fit tighter, belts need to be let out, and your diet hasn’t changed in years. What’s going on? The waistline of a woman in menopause is where fat seems to accumulate with ease. Both subcutaneous (fat just below the skin surface) and visceral (deep within and around the organs) abdominal fat increase during menopause.1-3 This is due to shifts in your hormones that change your fat storage patterns.

A season of change

Understanding which hormones are changing as you go through menopause can help you know the how and why of that muffin top, as well as how to effectively manage it.


The process of perimenopause—the time between fertility and menopause—is like a road with ups and downs that includes loss of estrogen and, surprisingly, estrogen dominance. It is estrogen dominance that has been clinically shown to increase abdominal fat.2,3 What is estrogen dominance exactly? It is when estrogen, while reduced during perimenopause, is disproportionally higher than the other female hormone, progesterone.4,5 This imbalance can cause estrogen to run wild and, along with local estrogen production that comes from fat cells, dominate the hormone kingdom.6


Cortisol is the “fight or flight” hormone that is triggered during times of perceived danger or threat.7 This important hormone is partly regulated by—you guessed it—estrogen. And when estrogen declines during menopause, it can cause a rise in cortisol and throw your metabolism off track.1,8,9


An accumulation of abdominal fat cells is linked to insulin resistance,10 which is when the body’s response to insulin is lost. This creates a cycle where the body increases insulin production in order to manage blood glucose levels. And because insulin is considered a gatekeeper for metabolism, it can create a cycle of weight and abdominal fat gain. Additionally, insulin can lower production of sex hormone binding globulin (which binds estrogen and other sex hormones together and carries them through the blood), which is linked to visceral fat and insulin resistance in menopausal women.11,12


Leptin is the hormone that signals you’re full.13 And elevated insulin levels usually result in elevated leptin. While this sounds like a good thing, it can lead to dysfunction of the leptin receptors (leptin resistance) that signal the brain to stop eating.14 High intake of refined carbohydrates has been linked with the development of leptin resistance.15


Thyroid hormones can become unbalanced with age and affect the regulation of your metabolism (including how quickly you burn calories). An underactive thyroid can lead to symptoms of weakness, fatigue, and weight gain.16

What can you do about menopause belly?

Now that you know about all these stakeholders in your expanding waistline, you can take action to keep them at bay. Your usual diet and exercise routine may not be enough to accomplish this, so you must think “outside the belly” to make effective changes that last. And remember that this is about more than your figure—it’s for your overall health.

Stop eating muffins

If you want to diminish the muffin top, consider the muffins (and other refined carbohydrates) you’re eating. High intake of refined carbs is linked to greater insulin production and spikes in glucose. Also look for inflammatory foods that can contribute to insulin resistance.17 This may include foods that contain gluten, or grains in general, as well as dairy products; you may also consider eliminating alcohol. Consume antioxidant-rich foods instead.

You may also consider implementing an intermittent fasting program, where food is eaten within a limited set of hours. Intermittent fasting has been shown to reduce body weight and abdominal fat,18 as well as improve insulin sensitivity even if there is no weight loss.19

Move the muffin!

It’s easy to sit all day, especially during the work week. However, living a sedentary lifestyle that sees you from desk jockey by day to couch potato at night makes you more prone to gaining body fat.20 Menopausal women may consider high-intensity interval training (HIIT) to effectively reduce abdominal and visceral fat, as well as improve insulin sensitivity and build muscle.21,22 Additionally, yoga is recommended for menopausal women as a way to reduce menopausal symptoms.23

Give the muffin a break

Sleep is an often overlooked factor when it comes to belly fat. Studies have shown a link between how long you sleep and the risk of obesity and fat around the middle.24 Not getting enough sleep can lead to changes in leptin or other hormones related to satiety, increased feelings of hunger, making poor food choices, reduced physical activity, and insulin resistance.24

Whittle your middle

You can reduce your menopause belly. Start by talking with your healthcare practitioner about the best steps for you. And remember to be kind to yourself at this time—your body is changing, and it just needs your help to keep things in good shape.

This information is for educational purposes only. This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues.


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