The Hidden Link Between Hormones and Belly Fat in Perimenopause

If you have noticed your waistline expanding despite eating well and staying active, you are not imagining it. One of the most common complaints I hear from women in their 40s and 50s is, "Why am I gaining weight around my middle all of a sudden?" The answer lies in your hormones – and more specifically, in the complex relationship between hormonal shifts and fat storage during perimenopause.

As a dietitian and somatic psychotherapist, I want to give you more than just surface-level advice. I want to help you understand what your body is doing, why it is doing it, and how you can work with it – not against it.

What Happens to Hormones in Perimenopause?

Perimenopause is the transitional phase before menopause where your reproductive hormones – particularly oestrogen and progesterone – begin to fluctuate and decline. This process can start as early as your late 30s and continue well into your 50s.

During this time:

• Oestrogen becomes erratic, often dipping lower than your body is used to causing mood changes and weight gain
• Progesterone drops steadily, contributing to sleep disturbances and mood changes
• Cortisol levels may rise, especially if you are experiencing chronic stress causing weight gain, belly fat, mood changes and poor sleep
• Insulin sensitivity often declines, making it harder for your body to process sugars and carbohydrates efficiently

All of these shifts work together to signal your body to store fat – particularly around the abdomen.

Why Belly Fat?

So why does the fat seem to migrate directly to your belly? There are several key reasons:

1. Oestrogen's Role in Fat Distribution

Oestrogen helps regulate where fat is stored. In younger years, women tend to store fat more around the hips and thighs. But as oestrogen levels decline, this distribution shifts toward the abdominal area. The body holds onto belly fat because fat cells produce oestrogen, and in the absence of enough circulating oestrogen, your body sees this as a backup plan.

2. Cortisol and Stress Fat

Chronic stress, which is incredibly common in midlife, drives up cortisol – your primary stress hormone. Cortisol increases appetite, drives cravings (especially for sugar and processed carbs), and tells your body to store fat centrally around your organs. This is known as visceral fat, and it is not only stubborn but also inflammatory.

3. Insulin Resistance

As you age, your cells become less responsive to insulin, the hormone that helps regulate blood sugar. This means more sugar is stored as fat – and most often, it shows up around your middle. This cycle can also make you feel tired, hungry and moody, increasing the likelihood of overeating or emotional eating.

The Somatic Side of Belly Fat

Let’s talk about the emotional and energetic layer that often gets ignored. Belly fat can also represent protection. As women navigate the demands of midlife – caregiving, career pressure, shifting identity, unresolved trauma – the body can respond by holding onto weight as a form of safety.

As a somatic psychotherapist, I witness time and again how stored emotional tension, shame and stress patterns settle in the body. The belly is often where we feel our intuition, our emotions and our vulnerability. Learning to listen to your body, to feel rather than fix, and to regulate your nervous system can be a powerful piece of the weight loss journey.

What You Can Do About Belly Fat in Perimenopause

As oestrogen and progesterone levels shift during perimenopause, so does the way your body stores fat — often favouring the belly area. This isn’t about vanity; it’s a metabolic, hormonal and nervous system issue that deserves a compassionate, holistic response.

Here are five foundational strategies to help your body feel more balanced, energised and supported through perimenopause and beyond:

1. Balance Your Blood Sugar

Blood sugar imbalances are one of the most overlooked drivers of hormonal weight gain — especially around the midsection. When blood sugar spikes and crashes (from skipping meals or eating high-sugar, high-carb foods), your body responds by releasing more insulin — the hormone responsible for storing fat.

Frequent spikes in insulin not only promote fat storage, but also contribute to inflammation, cravings, energy dips and mood swings. For women in perimenopause, this process becomes even more pronounced as oestrogen — a natural insulin sensitiser — declines, making the body more sensitive to sugar and stress.

What helps:

• Eating protein, fibre and healthy fats at every meal slows the absorption of glucose into the bloodstream and reduces insulin spikes.
• Minimising refined carbs and sugars helps regulate hunger and energy.
• Eating regularly, rather than skipping meals, supports cortisol balance and keeps your metabolism stable.

2. Reduce Stress and Cortisol

Chronic low-level stress is one of the biggest drivers of belly fat during perimenopause. When you’re under ongoing stress — from work, relationships, poor sleep, or even internal pressure — your body releases cortisol, a stress hormone designed to help you survive threats.

The problem? Chronic cortisol tells your body to store fat in the abdominal area, even if you're eating well. Cortisol also raises blood sugar, disrupts digestion, interferes with sleep, and leads to cravings for sugar and carbs — a perfect storm for weight gain and hormonal chaos.

What helps:

• Breathwork and nervous system regulation practices like vagal toning, meditation or somatic body scans calm your stress response.
• Gentle movement like walking, stretching, yoga or somatic dance lowers cortisol and supports lymphatic flow.
• Quality sleep is crucial for cortisol regulation, appetite hormones (ghrelin and leptin) and overall metabolic health.

3. Build Muscle with Resistance Training

As oestrogen declines, muscle mass naturally decreases, which slows down your metabolism. Less muscle means your body burns fewer calories at rest, and is less efficient at handling carbohydrates — which increases the risk of insulin resistance and fat storage around the midsection.

Resistance training not only boosts your metabolic rate, but also improves insulin sensitivity, helping your body process glucose more efficiently. It also supports bone health, mental clarity, and mood regulation, all of which are essential during this transitional phase.

What helps:

• Start with bodyweight exercises, resistance bands or light weights 2–3 times per week.
• Focus on compound movements that target multiple muscle groups (e.g. squats, lunges, push-ups).
• Don't be afraid of lifting heavier over time — muscle is your best metabolic ally.

4. Support Your Hormones Naturally

As oestrogen and progesterone fluctuate and eventually decline, your liver, gut and adrenal glands have to work harder to keep the body balanced. Without support, this can lead to symptoms like weight gain, bloating, anxiety, mood swings, and disrupted sleep.

Supporting natural hormone balance involves supporting detox pathways, replenishing nutrients, and incorporating foods that gently support oestrogen levels or modulate excess.

What helps:

• Phytoestrogens (found in flaxseeds, tofu, lentils and chickpeas) mimic the effects of oestrogen in the body and can help buffer the drop in hormone levels.
• Cruciferous vegetables (like broccoli, kale and cabbage) contain compounds like DIM that support liver detoxification of excess or “dirty” oestrogen.
• Professional guidance on supplements like magnesium, B vitamins, adaptogens and omega-3s can offer targeted support based on your symptoms and bloodwork.

5. Reconnect to Your Body

During perimenopause, many women feel disconnected from their bodies — especially when the body doesn’t look or feel the way it used to. This disconnection fuels stress, emotional eating, self-criticism and avoidance — which perpetuates the cycle of dysregulation and weight gain.

Reconnection means shifting from “fixing” your body to listening to it — noticing how you feel, what you need, and what supports you emotionally, physically and energetically.

What helps:

• Daily body check-ins — pausing to feel your breath, your tension patterns, your emotions
• Practices that build body trust, like somatic therapy, movement, intuitive eating and journaling
• Speaking kindly to yourself — shifting the internal narrative from criticism to compassion

The more you feel safe and grounded in your body, the more your nervous system relaxes — allowing digestion, metabolism, and hormone balance to naturally recalibrate.

Final Thoughts

There is no quick fix for perimenopausal weight gain — and that’s okay. The goal isn’t to shrink your body, but to support it back into balance. When you focus on nervous system health, hormonal alignment, muscle strength, and body reconnection, you begin to feel more like yourself again — calm, clear, confident and alive.

You don’t have to do it alone. If you’d like support through nutrition, somatic therapy, and lifestyle coaching, I’m here to help.

📧 anca@ancavereen.com
🌐 www.ancavereen.com/bookings