It’s so frustrating: You’re doing everything you used to do to lose weight, but now, the scale just won’t budge. And the way you tracked macros successfully in the past isn’t working anymore either. If you are struggling with hormonal weight gain, that frustration you’re feeling is very real, my friends.

When you hit the perimenopause years, it’s time to shift from tracking for weight loss—which can bring temporary relief—to tracking for hormonal stability. Shifting your focus can result in permanent repair and long-term success with the health goals you’re trying to achieve.

Why Standard “Calories In, Calories Out” Fails in Your 40s

The basic science dictates that if you burn more calories than you eat (calories in, calories out—CICO), you will lose weight. But…once you hit perimenopause, that simple weight loss formula might not work anymore. Why?

• The Cortisol Factor: Cortisol is an essential hormone that plays a critical role in how your body manages stress, including blood pressure, inflammation, and some cognitive functions (fear, motivation, mood, and so on). Cortisol also plays a huge role in regulating your metabolism—how your body turns fats, proteins, and carbohydrates into energy. When it comes to weight loss, higher stress levels = higher cortisol levels, which can affect your ability to lose weight. If you’re eating at an extreme calorie deficit (anything below 1200 calories/day), which can be a tempting thing to do when that scale just won’t move, you’re adding even more stress to your body, which can trigger your body to store more fat, especially abdominal fat.
• The Estrogen Drop: When you’re in perimenopause, your estrogen levels are naturally lower. These lower estrogen levels reduce your sensitivity to insulin, which can affect how your body manages fat—whether or not fat is released (resulting in fat loss) or stored (resulting in fat gain). Makes sense that what worked in the past isn’t working now, right? It sometimes feels like your body is fighting against you!
• Metabolic Intelligence: In your younger, higher metabolism years before you hit perimenopause, you could lose weight by burning more calories than you ate—that CICO formula. But, once you hit perimenopause, the weight loss game changes. Now, weight loss is more about managing your hormones—especially cortisol, insulin, and estrogen, which can definitely be trickier. It’s about learning what to eat instead of how much to eat.

Click here for my Ultimate Perimenopause Guide where I dive deep into all-things perimenopause. It’s a must-read!

The 3 Macro Pillars of Perimenopause Repair

While relief (muting the symptoms) can happen more quickly, when it comes to working to alleviate as many perimenopause symptoms as possible, I’ll go for repair (healing the source) every single time. One powerful thing you can do to make your perimenopause season of life easier to navigate is through what you eat—those macronutrients.

1. Protein: Your Metabolic Anchor

For years, the Recommended Dietary Allowance (RDA) for protein has been between .8 g of protein per kilogram of body weight (or .36 g per pound), a recommendation that is meant for sedentary people and to protect your body from protein deficiency. I think we’d all like to go beyond the “protect my body from protein deficiency” space and aim for more of an “I want to be able to do all the activities I want to do AND protect my bones and my muscles as I age AND be as healthy as possible” space, especially as we enter perimenopause and beyond.

That RDA recommendation for protein just won’t work for us anymore, no matter our age.

Here’s the deal: Because your estrogen levels naturally decline as you get older, your body becomes less efficient at using protein, and when you’re not eating enough of this crucial macronutrient, you can experience the muscle and bone loss we’d all like to avoid and so many other negative side effects too. Plus, since protein has the highest satiety of any macronutrient (i.e. you feel fuller faster) AND your body burns 30% of those protein calories you eat through simply digesting that protein, eating enough protein can also help you lose weight if that’s your goal.

Click here to learn more about how to build muscle after 40 (it’s totally possible!).

Protein can also help to silence that food noise—that never-ending mental chatter you cannot turn off, which is often caused by eating high-sugar, ultra-processed foods that cause dopamine spikes and blood sugar crashes. Any guesses as to what can help with food noise? Protein! Eating enough protein can help prevent those spikes and crashes and go a long way towards silencing any food noise you might be experiencing.

Click here to learn how to silence food noise.

So, how much protein should you be eating? Aim for 80-100% of your body weight (or goal body weight) in grams every single day. So, if your goal body weight is 120 lbs, aim for 96-120g/day, always striving to hit the higher number when possible. Sounds like a Power Promise in the making, right?!?!

2. Carbohydrates: Fiber is Your Best Friend

Blood sugar crashes are not your friend, no matter how old you are. But in perimenopause, those crashes can be even more problematic. The key to avoiding blood sugar crashes is to shift from eating simple to more complex carbohydrates as often as possible. Why? Complex carbohydrates contain more nutrients, are higher in fiber, and take longer to digest, which means glucose is released into your blood stream more slowly. Plus, that fiber and the slower digestion process mean you’ll feel fuller longer—a bonus if you’re trying to lose weight!

Pro tip: Eat carbs before and after your workouts to help better control blood sugar crashes, manage insulin levels, AND prevent muscle loss.

Fiber can help with those fluctuating estrogen levels in perimenopause too. Estrogen detoxification is the body’s natural way of eliminating excess estrogen through your digestive system and liver, which keeps estrogen levels as balanced as possible. A diet low in fiber can cause this process to stall, meaning estrogen can actually be reabsorbed back into your system, which is not good with the estrogen-related issues you might already be experiencing.

Click here to learn more about the benefits of fiber + how it can help you achieve your health goals!

And I guess it goes without saying that a low-carb diet might not be your best friend either when you’re in perimenopause. Carbs are your body’s preferred fuel source, and when you cut that fuel source too much, it can cause a famine response in the brain, which can then increase your cortisol levels. And that triple threat to your metabolism (estrogen drop → cortisol spike → insulin surge = fat storage) that I’ve talked about before can happen over and over again.

3. Fats: The Foundation of Hormone Production

While fats have been considered the “bad guys” of nutrition in the past, they play a crucial role in hormone production in your body. And fat is not the enemy of your weight loss goals either. Fat can be both a satiety tool and a hormone regulation tool for your perimenopause tool kit. But, the type of fats you eat can either increase or decrease your hormone health, especially in your 40s and beyond. When choosing the fats to include in your diet, aim for monounsaturated fats + oils (peanut, canola, sunflower, safflower, olive, avocado, and canola oils, and most nuts and nut butters, avocados, and pumpkin and sesame seeds) and polyunsaturated fats + oils (corn, soybean, cottonseed, and sunflower oils, and walnuts, pine nuts, and flaxseed, as well as sesame, pumpkin, and sunflower seeds). And don’t forget the heart-and-hormone-healthy fish like salmon, herring, mackerel, sardines, trout, and tuna, which are loaded with those healthy fats.

Eating healthy fats can also contribute to your brain health, which can help alleviate that brain fog—a not-so-fun side effect of all of those hormone shifts as you get older. A healthy brain can also help you experience that “Quiet Luxury” for your nervous system where you’re feeding your body the fats it needs to reduce inflammation and stress and promote that calmness you’re searching for.

From “Macro Obsessed” to “CEO of Your Own Health”

I’ve tracked macros in the past, and this way of eating has helped me reach some important goals. But…I’ve learned over the years that macro tracking is not the be-all, end-all for weight loss and healthy living in general. Some people can become obsessed with hitting every macro number every day, and that’s not healthy either. When it comes to any nutrition plan, aim for repair over relief every single time. Yes, cutting calories drastically or following any diet plan that restricts anything can work in the short-term, but that’s only giving you temporary relief, and to be honest, those results will most likely be temporary also. Instead, opt to be the CEO of Your Own Health and do what’s best for your body long-term—the repair. I’ve been an intuitive eater for a while now, and I’ve learned over the years what combination of macros I need to feel good and to give my body the fuel it needs for optimal health. When you can trust your body and the signals it’s giving you, you’re taking drastic steps towards taking control of your own health, no matter what any online and totally unqualified “experts” might be telling you.

Another thing I’ve learned over the years is the 80/20 Rule, which can apply to sticking to your workout plan, your nutrition plan, or anything you want to accomplish. For nutrition, aim to eat on plan 80% of the time, and the other 20% of the time, eat those foods you love that might not be quite “on plan.” This way of eating allows space for real life while also keeping those Power Promises you’ve made to yourself.

How to Start: A Step-by-Step Transition Guide

I know, I know. You’ve read to this point and might’ve thought, “Wow. I need to eat more protein and fiber!” I get you, and you’re not alone. Here are some tips to get you started on making the most of your perimenopause eating plan, and if you’re already nailing any one of these steps, feel free to skip it!

• Step 1: Focus on protein first at every meal and snack. Try to include a serving of protein in every meal and even in your snacks. And no matter what, try and eat your protein first. It will make you feel fuller faster, which can go a long way towards curbing your overeating if that’s something you’re dealing with. Some good sources of protein are dairy, lean meats, seafood, and protein powders. Try this tip for 2 weeks, and then move on to step 2.
• Step 2: Increase your fiber to 25g+ daily. If this one is hard for you, it’s hard for around 95% of American adults and children too. Increase your fiber intake by eating more fruits and vegetables, adding vegetables to sandwiches, enjoying more salads (don’t forget to add protein!), eating more nuts and beans, and adding some high fiber cereals (with fruit!) to your plan. Try this tip for 2 weeks, and then move on to step 3.
• Step 3: Audit your sleep and stress—the “Silent Macros.” While we don’t often include sleep and stress in our daily macro tracking, these two things are crucial to metabolic, emotional, cognitive, and overall health. Aim for 7-9 hours of sleep every night and brainstorm ways to lower your stress levels.

Frequently Asked Questions

Should I do Keto in perimenopause? (Spoiler alert: Usually not, due to cortisol).

• For most of us, Keto or any low-carb diet can negatively affect your cortisol levels, making issues with anxiety, sleep, and losing fat more difficult. If you have any concerns about any nutrition plan + perimenopause, please chat with your healthcare team.

How many grams of protein do I really need?

• What you “really need” depends on your health goals. For optimal health, I recommend aiming for 80-100% of your body weight (or goal body weight) in grams every day.

Can I track macros and still do intuitive eating?

• Yes. Tracking macros for a bit can educate you about portion sizes and help you learn to listen to and understand the signals your body is sending you, which is the basis for intuitive eating.

Here’s the bottom line for successfully tracking macros in perimenopause: You aren’t broken, you’re just evolving. One of the only constants in life is change, and as you grow older and wiser, your body and its needs will naturally change too. With any of these changes, you have a powerful opportunity to rebuild a foundation of respect for your evolving body and all it has to offer you now and for decades to come.

Xo,
Heidi

Related reading:

Forget the Scale! Celebrate Non-Scale Victories
Sleep and Hormones: Why It’s Important for Weight Loss + Health
Macro Tracking for the Win! All of Your Questions Answered
The Ultimate Guide to Peptides: For Weight Loss, Anti-Aging, and Metabolic Health