Perimenopause/Menopause Belly Fat: Why It Happens & How to Beat It

If you are a woman in your 40s or 50s gaining belly fat despite doing the same things you always have, this video explains why midlife body changes happen and what most women are never told about them.

In this video, I explain what is actually happening inside your body during perimenopause and menopause, why belly fat feels different in midlife, and why traditional advice often stops working. This is not about shrinking yourself. It is about understanding your physiology so you can stop fighting your body and start working with it.

If you are navigating perimenopause and want guidance, education, and support from women who truly get it, you can join the Perimenopause Coaching Waitlist below (EMBR Midlife Method Link)

Like, subscribe, and share this with a friend who might be blaming herself for changes that are not her fault.

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Kimberly Hoyt is a physician assistant with two decades of clinical experience who helps women navigate perimenopause and menopause with clarity and confidence. Her work focuses on midlife health and education, helping women understand what is happening in their bodies so they feel prepared, informed, supported and empowered.

Medical Disclaimer: The information shared on this channel is for educational and informational purposes only and is not intended as medical advice. Kimberly Hoyt, PA-C, and associated content are not a substitute for professional medical care, diagnosis, or treatment. Viewing/Listening to this content does not establish a patient-provider relationship. Always consult your own healthcare provider before making changes to your health plan, starting supplements, or addressing medical concerns.

General Disclaimer: I am not a CPA, attorney, insurance/real estate agent, contractor, l...

Transcript

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If you're a woman in your forties or fifties and feel like belly fat showed up out of nowhere, even though you're doing the same things you've always done, I want you to hear this clearly. This is not a discipline problem. This is not, you're not doing enough problem and it's not fixed by just eating less and moving more. There's a real biological shift in midlife that changes how your body stores fat. And once you understand it, you can stop fighting your body. And start making choices that actually help. I am Kimberly Hoyt. I'm a physician assistant and I help women in midlife who are trying to make sense of changes that feel confusing and honestly unfair. In this video, I'm going to explain why belly fat becomes so common in perimenopause and menopause, what visceral fat really is, why old advice often backfires and what actually makes a difference, in a realistic, non extreme way. One quick note before we start. This is for educational and entertainment purposes only. It is not medical advice. If you have concerns or questions, please seek the advice of your medical provider. And we're not here talking about getting a beach body back. This is about health, stability and feeling like you recognize your body, again. When women say I'm gaining belly fat, they're often describing something very specific, not just weight gain, a shift in body composition. There are two different types of fat I want you to understand. First is subcutaneous fat. That's the fat under your skin. It's the kind you can pinch. And it's what gives curves. It can be cosmetically distressing for sure, but metabolically, it's not the biggest problem. The second type is visceral fat. This is deeper. It sits under the muscle wall and wraps around your internal organs, it's inside the abdomen. This is the kind that often makes your belly feel harder, like it pushes outward, and a lot of women describe it as feeling like they look pregnant, or My jeans fit everywhere except around my waist. And here's a key point that surprises most people. You can be a normal weight with a normal BMI and still gain visceral fat. So if you've been telling yourself, I shouldn't be struggling because my weight isn't getting higher. Stop. That's not how this works. Visceral fat is metabolically active. It's strongly associated with insulin resistance and cardiometabolic risk. That's why it matters. It's not just cosmetic frustration. Now the big question, why does this shift happen in perimenopause and menopause? There's a hormonal and metabolic story here. In perimenopause your hormones don't gently glide downhill like a plane landing. They fluctuate. A lot. For many women, it feels like the body changes before you ever miss a period. As estrogen fluctuates and declines over time, it affects a bunch of downstream systems. One of them involves how hormones are carried in the bloodstream. There's a protein in the body that binds to sex hormones and keeps them less active. When estrogen trends lower, that binding can decrease and that can in increase the activity of androgens in the body. That matters because higher androgen activity is linked with more central fat storage, meaning more preference for storing fat in the abdomen. At the same time, midlife often brings an increase of inflammation, decrease in sleep quality, higher stress load, and changes in muscle mass, and insulin sensitivity. Here's the part that really clicks for women. This can become a feedback loop. Visceral fat promotes inflammation, inflammation worsens insulin resistance. Higher insulin levels promote fat storage, especially in the abdomen. And then the cycle reinforces itself. So if you felt like you're stuck in a loop, you're not imagining it. Let's talk about the most common advice women get in midlife. And why it backfires. Just eat less and move more. That sounds logical, but it's incomplete because hunger, satiety, cravings, sleep, stress response, and fat storage are all influenced by hormones. Not just estrogen and progesterone, but insulin, cortisol, leptin, and ghrelin. And when women respond to midlife changes by restricting harder, skipping meals and white knuckling it, what often happens, they get more stressed, they sleep worse, their cravings increase, their workouts feel harder, and their bodies can hold onto fat more stubbornly. I say this with zero judgment. This is what we see clinically and personally in women's lived experiences. Trying harder is not the answer. Trying smarter is. So what actually helps, let's shift into solutions, not extremes, not perfection, just levers to interrupt that cycle. I want you to think we are not chasing a smaller body. We are chasing a healthier metabolism, lower inflammation, better insulin sensitivity, and a body that feels steady again. So lever number one, fiber. Fiber is one of the most underused tools in metabolic health. Diets higher in fiber are associated with better insulin sensitivity and lower visceral fat, likely through the effects on blood sugar regulation. Gut microbiome and inflammation. The practical goal here is to aim for at least 25 grams per day as a baseline and build gradually so your gut adjusts. Easy fiber wins, berries, beans, lentils, chia seeds, flax seeds, oats, vegetables, and nuts. Lever number two, cut out added sugars, especially liquid sugar. This one matters. Added sugars, especially in beverages, is uniquely problematic because it's easy to over consume and doesn't create the same fullness that solid or whole foods do. Fructose heavy sweeteners are processed primarily in the liver and high intake is associated with fat accumulation in the liver and metabolic dysfunction. This is not about never eating sugar again, it's about being picky and intentional. If you want one high impact step, it's this reduce sugar sweetened beverages. I want to be crystal clear because diet culture loves to twist this. Whole fruit is not the enemy. Whole fruit comes packaged with fiber and nutrients and it behaves differently then just added sugar. Okay. Lever three, protein. Spread protein throughout the day. Most women undereat protein earlier in the day and then stack it at dinner, but protein supports muscle, stabilizes blood sugar, and influences hunger hormones. Instead of making this a math problem, here's a simple version. Try to include a protein source at breakfast, lunch, and dinner, plus one or two protein forward snacks if you need it throughout the day. Examples, eggs, Greek yogurt, cottage cheese, chicken, fish, tofu, tempe, lentils, beans, protein shakes, if that's what works for you. The goal is not perfection. The goal is steady input so your body doesn't feel like it's in a scarcity loop.

Kimberly Hoyt: 8:23

Your goal is to get one gram of protein per pound of ideal body weight. So if your ideal body weight is 130 pounds, you want 130 grams of protein per day spread out across the day. Okay, lever number four, movement for insulin sensitivity. I want to reframe exercise in midlife. This isn't about burning calories as punishment. Movement improves insulin sensitivity, it helps decrease inflammation. It supports mood and sleep and preserves your muscle mass. Two categories matter most. Number one, aerobic movement that you can sustain. Think walking, cycling, incline treadmill, or swimming. And then number two, resistance training. And this can include body weight work, bands, definitely weights and Pilates that challenge your muscles. We want to build muscle. If you can't do everything, choose consistency. A daily walk and two days of strength training beats a perfect plan that you only do for two weeks. Now let's talk about intermittent fasting, because this is where women get the most conflicting advice. First, the honest overview. Intermittent fasting, including time-restricted eating, can improve metabolic markers in many adults, and some studies show benefits for weight loss and insulin sensitivity. So why do some menopausal women find it helpful? A shorter eating window can reduce late night snacking. It can reduce overall calorie intake without constant tracking and it can improve fasting insulin and glucose regulation for some people. There's also menopause specific interest in time restricted eating and combining lifestyle approaches. But data in postmenopausal women is still developing and researchers are actively studying it. Now the key question that has been asked, why might it be less beneficial or even problematic in early perimenopause? Here's the truth. We have far less direct research specifically in early menopause, and that matters. Perimenopause is the phase where the hormones are fluctuating dramatically. Many women may also have more sleep disruption, more anxiety, higher stress load, and less resilience to under fueling. Intermittent fasting is a stressor, now it's not always a bad one, but it is a stressor and we know that changing meal timing can influence your circadian rhythms and hormonal patterns. Some reviews caution that intermittent fastings effect on hormone circadian rhythms are not fully understood and that hormone dysregulation is a legitimate concern to consider, especially in populations already dealing with hormonal instability. So if you are in early perimenopause and you're already dealing with poor sleep, increased stress, anxiety, or intense cravings. Aggressive, fasting can actually backfire. It can raise cortisol in some women. It can worsen sleep. It can lead to undereating during the day and then overeating later at night. It can also increase that wired but tired feeling. And if fasting makes you feel shaky, irritable, obsessive about food, or like your sleep gets worse, that is not your body being weak. That is your physiology giving you feedback. Also, a critical safety point to discuss. Fasting is not appropriate for everyone, including people with certain medical conditions, a history of disordered eating and those on certain glucose lowering medications. Now I also want to add something responsible and current. There has been debate about long-term safety of very short feeding windows based on large observational data. The American Heart Association has highlighted preliminary conference findings suggesting an association between eating in less than an eight hour window and increased cardiovascular mortality risk. This was observational. Not a randomized trial, and so it cannot prove the cause and effect. That doesn't mean time restricted feeding is dangerous for everyone, nor is it something that we should prescribe to everyone universally, especially not midlife, women whose sleep and stress systems are already under strain. If you want to experiment with fasting in menopause or late perimenopause, start gentle. A 12 hour overnight fast is a good baseline to start with. Focus first on food quality, protein, fiber added sugar reduction, decreasing or eliminating processed foods as best you can. If you extend the window, do it slowly and make sure your sleep improves and not worsens. And if you feel worse, stop. That is not failure, it's data. Listen to your body. The best plan is the one that your body tolerates and you can sustain. Hormone therapy can be a helpful option for some women. Especially estrogen-based therapy and it may support body composition and metabolic health for some individuals as part of a broader plan. It is not a magic fix. It is not a moral choice. It is one tool in our toolbox, and it's something that you can discuss with a provider who understands midlife hormone care, your personal risk profile, and your goals. If your body feels unfamiliar right now, I want you to hear this. You are not broken, you are not lazy, you are not failing. This is a life transition that deserves better information so you can find better solutions. Feel free to start with one lever. You don't have to do it all at once. Maybe it's fiber, maybe it's protein. Maybe it's taking out that added sugar. Maybe it's walking or strength training twice a week. Make sure you're supporting your sleep and your stress because your hormones are listening. If you found this helpful, please like and subscribe and tell me in the comments what surprised you most or what have you been struggling with. And share this with a friend who maybe has been blaming herself for a body that's just doing midlife things.