Stop Blaming Yourself: Why ‘Eat Less, Move More’ Fails in Midlife - a new path forward that works.

During the menopause transition, many women notice their body changing — weight settles around the middle and feels stubborn to shift. The old advice of “eat less, move more” doesn’t just fail here, it can make things worse. In this post, I’ll explain what’s really happening in menopause and give you the facts you need to feel strong, supported, and confident in your body again.

As a menopause dietitian, I see this every day. And research confirms it: menopause causes significant changes in body composition.

How menopause affects body composition

During the menopausal transition and into post-menopause, declining oestrogen drives several physiological changes:

• Increased total body fat

• Greater accumulation of visceral (abdominal) fat

• Loss of lean muscle mass

• Declining bone density

• Redistribution of fat from hips and thighs to the waist

What research shows about postmenopausal body composition

Studies consistently show that postmenopausal women have:

✔️ higher total and visceral fat✔️ increased waist circumference and waist-to-hip ratio✔️ lower skeletal muscle mass✔️ reduced bone mass and total body water.

Importantly, for some women body weight may remain stable, while muscle and bone decline and fat increases.

This is why relying on the scale alone during menopause is misleading.

Why muscle loss during menopause matters

Loss of muscle during menopause is not just about appearance — it has health implications.

Reduced muscle mass is associated with:

• increased insulin resistance

• higher cardiometabolic risk

• reduced strength, balance and functional capacity

• increased risk of falls and fractures

When muscle loss occurs alongside fat gain, this pattern is known as sarcopenic obesity, a common but under-recognised issue after menopause.

Visceral fat and menopause-related health risks

Visceral fat — the fat stored deep in the abdomen — is particularly concerning.

It is:

• metabolically active

• pro-inflammatory

• strongly linked to heart disease, type 2 diabetes and metabolic syndrome

The gut–muscle–fat–bone connection in menopause

Menopause affects multiple systems simultaneously.

Hormonal changes:

• increase inflammation

• accelerate muscle protein breakdown

• impair bone remodelling

• alter gut health and insulin sensitivity

This interconnected process explains why outdated advice like “eat less and move more” often worsens outcomes in midlife women.

Can you improve body composition after menopause?

Yes — diet and lifestyle interventions make a meaningful difference.

Research consistently shows that the following strategies help preserve muscle, protect bone and limit visceral fat gain from peri to post menopause:

• Targeted resistance training (2–4 times per week)including weight-bearing exercise for bone health

• Adequate (not excessive) protein intake to support muscle maintenance

• Sufficient energy intake to prevent muscle breakdown

• A nutrition approach that supports gut, bone and metabolic health

This phase of life requires more nourishment and smarter movement, not restriction.

Menopause nutrition: what matters most

During menopause, your body needs more of the nutrients that support structural and metabolic health, including:

• Protein (muscle preservation)

• Calcium and vitamin D (bone health)

• Fiber diversity (gut and metabolic health)

• Complex slow-release carbohydrates (energy and cortisol regulation)

• Healthy fats and polyphenols (cardiovascular and inflammatory support)

The bottom line

Menopause isn’t just about weight gain. It’s is a metabolic transition that accelerates muscle loss, visceral fat gain and increases metabolic risk. This can occur without changes in the number on the scale.

Early, targeted nutrition and exercise strategies are key to protecting strength, bone density, metabolic health and long-term quality of life.

My advice? Educate yourself - get a DEXA body composition scan and know your lean body mass. Get a bone density scan and know your risk for osteoporosis.

If you’re navigating perimenopause or post-menopause and feel like your body has changed despite “doing all the right things,” working with a menopause-specialist dietitian can help you understand what’s happening — and what to do next. Book and appointment and let's work to getting you feeling like yourself again!

Reference: J. Clin. Med. 2026, 15, 740. The Impact of the Menopausal Transition on Body Composition and Abdominal Fat Redistribution Anna Szeliga , Peter Chedrauiand Blazej Meczekalski.