Menopause and Visceral Fat: What Research Suggests
Estimated reading time: about 3 minutes
Why Fat Distribution Changes During Menopause
Changes in weight distribution during the menopausal transition are well documented. These changes are often attributed to diet or physical activity alone.
However, research suggests that hormonal changes, particularly declining oestrogen, may also be associated with how fat is stored in the body.
For women who have used GLP-1 treatment during this period and observed variable responses to treatment, this provides helpful context. You can learn more about how these treatments support weight management and overall health at Beyondbmi.
What Research Says About Visceral Fat After Menopause
A clinical study published in Scientific Reports (2021) suggests that menopause may be associated with a shift in where fat is stored, with a greater proportion stored around internal organs rather than under the skin.
Visceral fat refers to fat stored around internal organs. It is associated with increased metabolic and cardiovascular risk.
The study also observed higher HbA1c (a marker of average blood sugar levels) and lower insulin sensitivity in postmenopausal women.
How Hormonal Changes Influence Metabolic Health
Research suggests that declining oestrogen during menopause is linked to changes in how the body processes energy and manages blood sugar, although this is influenced by a range of factors.
A 2025 review by Vecchiatto et al. (2025) Healthy adipose tissue after menopause describes how hormonal changes during menopause are linked with:
A shift in fat storage from subcutaneous (beneath the skin) to visceral (around organs).
Increased inflammatory signalling.
Reduced insulin sensitivity.
These changes are linked to a higher risk of conditions such as heart disease and diabetes, and are not just due to diet or lifestyle.
Why Treatment Outcomes May Differ During Menopause
During menopause, several biological changes occur:
Resting metabolic rate (the energy the body uses at rest) may decrease.
Muscle mass and function may change over time.
Prescription treatments that can support weight management and help regulate appetite when used under medical supervision.
Fat distribution shifts towards the abdominal area.
GLP-1 medications are prescription treatments that can support weight management and help regulate appetite when used under medical supervision.
However, the broader metabolic environment during menopause is different from earlier life stages. This means treatment outcomes may vary and should be interpreted within this context.
Can HRT Influence Fat Distribution?
Hormone replacement therapy (HRT) may, for some women, help influence how fat is stored in the body during menopause.
Some evidence suggests it may reduce abdominal fat accumulation during menopause. However, HRT may not be suitable for everyone and decisions about HRT are made on an individual basis with a doctor.
A Clinical Perspective from Beyondbmi
At Beyondbmi, weight management is approached within the full hormonal and metabolic context.
Treatment decisions are based on individual clinical assessment, with a focus on long-term health outcomes rather than short-term expectations.
Learn more about our clinically led obesity care approach.
Frequently Asked Questions
Does menopause cause weight gain?
Menopause is associated with changes in fat distribution and metabolism. These changes are influenced by hormonal shifts, as well as lifestyle and natural ageing, rather than lifestyle alone.
Why does fat increase around the abdomen after menopause?
Research suggests declining oestrogen may influence where fat is stored, with a greater proportion stored around abdominal organs.
Do GLP-1 medications work differently after menopause?
They continue to support satiety signalling, but outcomes may vary due to changes in metabolism, muscle and fat distribution.
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Vecchiatto, B., Santos, B.N., Costa, T.O., Rodrigues-Silva, S.M., Betz, M.J., Nallet-Khosrofian, E. and Ferreira, F.F. (2025) 'Healthy adipose tissue after menopause: contribution of balanced diet and physical exercise', Explor Endocr Metab Dis. 2025;2:101424. DOI: https://doi.org/10.37349/eemd.2025.101424
Abildgaard, J., Ploug, T., Al-Saoudi, E. et al. “Changes in abdominal subcutaneous adipose tissue phenotype following menopause is associated with increased visceral fat mass”. Sci Rep 11, 14750 (2021). DOI: https://doi.org/10.1038/s41598-021-94189-2
