
Menopause, Belly Fat, and Insulin Resistance – Stop the 1 Pound-a-Year Weight Gain
Video | Why Weight Gain? | IR and Belly Fat | Improving? | Carbohydrates | Fasting | Exercise
As women reach middle age, many will gain about 1 pound (0.5kg) a year (1).
This steady increase in weight is attributed to age rather than menopause itself. However, the transition into menopause has an unwelcome effect on body composition, with accelerated gains in fat mass (often showing up in the belly) and losses of lean mass (2).
So, even if the scale is not changing, your body composition and fat distribution may be.
Improving insulin sensitivity, while not a cure-all, gives you a way to mitigate these changes, and you can achieve that by making insulin’s job easier. I will show you how in this blog.
Menopause, Belly Fat, and Insulin Resistance – At-A-Glance
- As a woman transitions to menopause, hormonal advantages that enhance insulin sensitivity go away.
- Insulin resistance increases the risk of developing visceral fat and vice versa.
- Lowering your carb intake lowers blood sugar levels, reducing insulin’s workload.
- Intermittent fasting is an effective way to reduce belly fat and improve insulin sensitivity.
- Exercise improves how well your muscles take in glucose, making insulin’s job easier.
Menopause, Belly Fat, and Insulin Resistance – Stop the 1 Pound-a-Year Weight Gain [Video]
In this video, you’ll learn…
- How hormones contribute to women gaining weight as they age.
- The role insulin resistance plays in these changes.
- Three ways to improve insulin resistance.
Why Weight Gain?
During our younger reproductive years, women have hormonal advantages that enhance insulin sensitivity. These advantages are due, in part, to higher estrogen levels and a related increase in sex hormone-binding globulin (SHBG), which is a protein that keeps androgens, like testosterone, low. As a woman moves into perimenopause and menopause, those hormonal advantages go away (3)(4).
That is a problem because when your cells become less sensitive to insulin, in other words, they become insulin resistant, your blood sugar and insulin levels remain elevated. High insulin promotes the storage of fat, much of which ends up as visceral or belly fat over the menopause transition (5).

Insulin Resistance & Belly Fat
Visceral fat is not the fat that you can pinch. That is called subcutaneous fat. Visceral fat builds behind the abdominal muscles, pushing out as it accumulates.
It is not uncommon to have both types of fat stored in your midsection. However, the deep visceral fat is more “metabolically active” than the outer fat, increasing inflammation and the risk of health conditions like insulin resistance (6).
So, if nothing changes, we see that reaching menopause drops us into a back-and-forth cycle where insulin resistance leads to visceral fat and vice versa.

How Do You Know If You’re Improving?
You cannot naturally turn back the hands of times, hormonally speaking, but you can improve insulin sensitivity by making insulin’s job easier.
Insulin’s job is to move excess sugar out of the blood and into the cells. It is released into the bloodstream in response to rising blood sugar levels. Therefore, if insulin is having an easy time performing its task, the levels in the blood will mimic the rise and fall of blood sugar.
You cannot test insulin levels at home, but you can test your blood sugar levels. What you want to see is a controlled blood sugar rise after eating that returns to the pre-meal level within 2 hours after eating.
To test, you can use a monitor from your local pharmacy called a glucometer. These monitors test a finger prick of blood to estimate your blood glucose or blood sugar level. You can test before a meal and then in one-hour increments following the meal.
Another option is to wear a continuous glucose monitor or CGM from Levels. Levels is a company that makes it possible for people without diabetes to monitor their blood sugar. See the video above for more information about Levels.
What to Do?
Whether you use a monitoring device or not, there are three things you can do to make insulin’s job easier. You can give insulin less to do. Give it more time off and give it more places to go. Let’s go through some numbers, so you have clear goals to hit.
Lower Your Carb Intake (aka Give Insulin Less To Do)
When insulin resistance is present, insulin cannot efficiently move sugar out of your blood and into your cells. Because carbohydrates break down into sugar, eat fewer of them, and you make insulin’s job easier because it has less to do.
If you are new to low-carb eating, start by aiming for no more than 125 grams of carbs per day.
If you are already eating a low-carb diet but experiencing the fat gain consequences of menopause, aim for 50 grams or fewer a day.

Add Fasting Periods (aka Give Insulin More Time Off)
When there is no food coming in, insulin gets a break. So, if counting carbs does not thrill you, count hours instead. Intermittent fasting has been found to be a safe practice for post-menopausal women of normal health, and it has also been found to be an effective way to reduce belly fat (7)(8).
If you are new to intermittent fasting, make it your goal to stop eating three hours before bed. In the evening hours, your circadian clock influences the production of hormones that prepare you for sleep. Eating too close to bedtime can work against this hormonal shift, keeping your blood sugar and insulin elevated and blocking fat burning overnight.
If you already practice intermittent fasting, try shifting your eating window to earlier in the day so you eat your last meal by 4 or 5 pm. This early time-restricted eating (eTRE) schedule has been shown to improve insulin sensitivity (9).

Add Exercise (aka Give Insulin More Places to Go)
Getting regular exercise makes insulin’s job easier because it improves how well your muscles take in glucose (10).
The good news is that you can choose the type of exercise you do because both aerobic and resistance exercises have been shown to be beneficial.
If you are not currently exercising, get moving in a way that you enjoy, whether that be walking, swimming, jogging, or going to the gym.
If you’ve already established an exercise routine, work on combining resistance exercises, like weight lifting, with aerobic exercises like biking, swimming, or using a treadmill. That combination has been shown to enhance insulin sensitivity (11).

Takeaway
Menopause sets the stage for weight gain, but you can take action to prevent that from happening. By focusing on making insulin’s job easier, you encourage fat loss and improve insulin sensitivity. You reduce insulin’s workload when you reduce your carb intake, stop eating before bed, and exercise.
These tasks take some focus and may require you to shift a few routines, but I’ve found that they add so much quality to life. They can do the same for you.
Thank you for reading and have a wonderful week!
References:
(1) Davis, Susan Ruth, et al. “Understanding weight gain at menopause.” Climacteric 15.5 (2012): 419-429.
(2) Greendale, Gail A., et al. “Changes in body composition and weight during the menopause transition.” JCI Insights 2019;4(5):e124865.
(3) Yan, Hui, et al. “Estrogen improves insulin sensitivity and suppresses gluconeogenesis via the transcription factor Foxo1.” Diabetes 68.2 (2019): 291-304.
(4) Patel, Shrita M., et al. “Higher serum testosterone concentration in older women is associated with insulin resistance, metabolic syndrome, and cardiovascular disease.” The Journal of Clinical Endocrinology & Metabolism 94.12 (2009): 4776-4784.
(5) Samargandy, Saad, et al. “Abdominal visceral adipose tissue over the menopause transition and carotid atherosclerosis: the SWAN heart study.” Menopause 28.6 (2021): 626-633.
(6) Hardy, Olga T., Michael P. Czech, and Silvia Corvera. “What causes the insulin resistance underlying obesity?.” Current Opinion in Endocrinology, Diabetes and Obesity 19.2 (2012): 81-87.
(7) Nair, Pradeep MK, and Pranav G. Khawale. “Role of therapeutic fasting in women’s health: An overview.” Journal of mid-life health 7.2 (2016): 61-64.
(8) Wilkinson, Michael J., et al. “Ten-hour time-restricted eating reduces weight, blood pressure, and atherogenic lipids in patients with metabolic syndrome.” Cell metabolism 31.1 (2020): 92-104.
(9) Sutton, Elizabeth F., et al. “Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes.” Cell Metabolism 27.6 (2018): 1212-1221.
(10) Borghouts, L. B., and H. A. Keizer. “Exercise and insulin sensitivity: a review.” International journal of sports medicine 21.01 (2000): 1-12.
(11) AbouAssi, Hiba, et al. “The effects of aerobic, resistance, and combination training on insulin sensitivity and secretion in overweight adults from STRRIDE AT/RT: a randomized trial.” Journal of Applied Physiology 118.12 (2015): 1474-1482.
About the Author
Becky Gillaspy, DC, is the author of The Intermittent Fasting Guide and Cookbook and Zero Sugar / One Month. She graduated Summa Cum Laude with research honors from Palmer College of Chiropractic in 1991.