Menopause's Effect on Your Body Shape

Menopause is a powerful life transition that can feel like your body has a mind of its own. One of the most common frustrations I hear from my female patients is how fat seems to suddenly accumulate around the belly. It’s not just a cosmetic issue—this shift in fat storage can have deeper implications for your health.

Over the years, I’ve had the privilege of learning from my patients, who share their challenges and insights with honesty and vulnerability. The advice I’m about to give is shaped by the collective wisdom of the women I’ve worked with over the years and is rooted in science as well. So, let’s explore the “why” of belly fat in menopausal women and what you can do to take control.

Before menopause, estrogen helps your body store fat in places like your hips, thighs, and buttocks. Although sometimes frustrating, extra weight in these areas isn’t strongly linked to chronic disease risks. But when estrogen levels drop post-menopause, the body begins to store fat in the abdomen, a type of fat called visceral fat.

Unlike the fat you can pinch under your skin, visceral fat wraps around vital organs like your liver and pancreas. It’s metabolically active, meaning it releases chemicals that can increase inflammation, disrupt hormones, and raise the risk for conditions like heart disease, Type 2 diabetes, and metabolic syndrome.

Many women tell me they feel betrayed by this change. “I’m doing everything the same,” they say, “but my body isn’t responding like it used to.” If you’ve felt this way, know that you’re not alone—and you’re not powerless.

For many of my patients, simple lifestyle changes make a big difference. Here’s what has worked for them:

Make movement non-negotiable

Exercise is one of the most effective ways to manage visceral fat and overall health post-menopause. Strength training is particularly powerful—it helps you preserve muscle mass, which naturally declines with age, and boosts your metabolism. Add in cardiovascular exercise, like walking, swimming, or dancing, to further target visceral fat and support your heart. Not only that, but exercise also helps with mood and energy, making it a win for both physical and mental health.

Rethink what’s on your plate

Nutrition is where the real magic happens. Here are two approaches that have stood out in the research and in my clinical experience:

• Mediterranean diet: Center your meals around whole foods—fruits, vegetables, whole grains, nuts, seeds, and olive oil.
• High-fiber, low-processed diet: Incorporate legumes, beans, whole grains, and starchy vegetables. These foods help stabilize blood sugar and reduce visceral fat over time.

If there’s one thing to avoid, it’s ultra-processed foods. They’re engineered to be addictive and have a knack for encouraging belly fat.

Seek medical support when needed

For some women, lifestyle changes alone aren’t enough. New medications, like GLP-1 receptor agonists (such as Ozempic or Wegovy), are safe and effective for many patients. These medications can reduce appetite and help your body manage weight more effectively. But remember, this is in addition to healthy lifestyle changes, not in lieu of them.

Get emotional support

Navigating menopause is easier when you have a support system. Many women I work with say that having a partner, friend, or even an online community on board makes a huge difference. One patient shared how cooking meals with her family became a bonding activity, making healthier eating a shared effort rather than a solo struggle.

While menopause may change your body, it doesn’t define your health. The path to feeling your best starts with small steps, whether it’s moving your body more or choosing whole foods. With healthy habits, you can fortify your changing body and, even better, embrace it.

• Weight isn’t the only signifier of good health.
• What to expect when going through menopause.
• Read up on Northwell’s OB/GYN services.