Belly fat in perimenopause and menopause can feel impossible to lose, even when you’re eating well and exercising. So what actually works?
Tamsen brings together the best advice from The Tamsen Show’s top experts on midlife weight gain, visceral fat, metabolism, hormones, insulin resistance and GLP-1 medications.
Featuring endocrinologist Dr. Rocio Salas-Whalen (Weightless), physical therapist Dr. Shannon Ritchey (Evlo Fitness), nutrition expert Dr. Amy Shah (Hormone Havoc) and obesity medicine physician Dr. Alexandra Sowa (The Ozempic Revolution). From the best exercises for building muscle and losing fat to how much protein and fiber you really need, they explain what’s happening to your body in midlife and the changes that actually make a difference.
IN THIS EPISODE
■ Why belly fat increases in perimenopause and menopause, and why visceral fat is the dangerous kind
■ The best exercises for changing your body composition, and why under-eating can work against you
■ How protein, fiber, sleep, stress and insulin resistance affect weight, and what to know about GLP-1s
CHAPTERS
0:00 Intro
01:34 Why Belly Fat Suddenly Appears in Midlife
04:49 Why “Normal” Hormone Tests Can Miss Perimenopause
06:17 Visceral Fat vs. Belly Fat and What’s Actually Dangerous?
07:37 The 2 Things That Help Reduce Belly Fat Without Medication
09:55 Why Under-Eating Can Make Midlife Weight Gain Worse
13:40 The 30-30-3 Nutrition Framework for Midlife
15:23 Why You Can’t Spot Treat Belly Fat
18:28 The REPS Formula for Building Muscle After 40
28:09 Can GLP-1s Help With Menopause Belly Fat?
32:39 How Stress and Poor Sleep Cause Weight Gain in Midlife
If you liked this episode, you’re going to love this one:
Belly Fat 101: The 5 Simple Habits That Changed Everything:
FOLLOW THE EXPERTS
Dr. Rocio Salas-Whalen on Instagram:
Get Dr. Salas-Whalen’s book, Weightless:
Dr. Shannon Ritchey on Instagram:
Evlo Fitness:
Dr. Amy Shah on Instagram:
Get Dr. Shah’s book, Hormone Havoc:
Dr. Alexandra Sowa on Instagram:
Get Dr. Sowa’s book, The Ozempic Revolution:
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Medical Disclaimer: The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional regarding any medical concerns or treatment options. The views expressed by guests are their own and do not necessarily reflect those of The Tamsen Show.
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Want to put what you learned in this episode into action? 💛 Download my FREE Belly Fat Reset Guide here:
https://www.tamsenfadal.com/menopause-education-hub/the-belly-fat-reset-guide
Visceral fat melted away both my hubby and myself by going carnivore. Tons of issues reversed too. Carnivore was the absolute EASIEST way I have EVER melted fat effortlessly and have kept it off 2 years s running. Switched at yr 1 to keto-vore permitting myself a few carbs within limits.
Sad to read all the women in GLP1 or Hormonal replacement therapy. . The chances of getting Cancer due to these treatments are definitely NOT worth it. .
Omg I felt so seen watching this 😩 I was exercising daily, eating clean, and my belly just kept growing. I was so frustrated and cried so many times. Then a coworker told me about the Menopause Transition Playbook by (Lisa.Grant). I followed it and everything clicked—29 lbs gone, my stomach flattened, and I finally sleep through the night. This book explains exactly what's going on.
The stubborn belly fat made me feel so hopeless 😔 I literally tried everything and nothing worked. I was so embarrassed of my body. Then in a health group someone mentioned the Menopause Transition Playbook author (Lisa.Grant). I gave it a chance and within weeks my body started changing—lost 27 lbs, bloating gone, and I actually see my waist again. Still can't believe this isn't more well known.
"It's not your fault, it was never your fault" is such an important message for women to hear. So many women respond to a changing body by trying harder, eating less, and exercising more, then blame themselves when that still doesn't work. I also loved the emphasis on muscle and protein instead of more restriction. That is such a big shift for women who have spent decades being told the answer is always to eat less.
Ok so I’m one of those who’s very lean but gained 5 lbs of fat ( Im 5’2” 110 now), I’m trying everything but haven’t been able to get back to how I looked up till a year ago. just saw my doctor today for a 4 months HRT follow up check, she told me I look good , I’m doing so much better than others but she told me I would never be as lean as I used to be😢 and I’m not a good candidate for GLP-1…
Хорошее интервью мне понравилось
I cried over my belly fat so many times 😔 it was the first place weight went and the last place it left. Nothing I did made a difference. A friend who'd struggled too recommended the Hormonal Reset Protocol author is (Emma Wells) and promised it would target the middle. She was so right. 29 lbs down and my stomach is flat again. My confidence is back and I don't hide my body anymore. This is the answer women need honestly.
Great episode! Make an episode that highlights how to build a home gym on a budget. Milk jugs full of water for your farmer carry. Shopping thrift stores and marketplace for weights. Get creative. 💪
Thank you! I appreciate all your videos
Five notes:
1. Midlife weight changes: Hormonal shifts during perimenopause and menopause, specifically the drop in estrogen, drive the redistribution of fat to the belly (03:34 – 05:08).
2. Visceral fat danger: Unlike subcutaneous fat, visceral fat surrounds internal organs and is highly pro-inflammatory, posing greater metabolic risks (06:17 – 07:36).
3. Muscle as metabolic armor: Building muscle through resistance training is critical in midlife because it increases the body's ability to burn fat for energy (08:33 – 09:12).
4. Nutritional strategy: The "30-30-3" framework—30 grams of protein in the first meal, 30 grams of fiber daily, and three probiotic foods—helps stabilize blood sugar and reduce cravings (13:40 – 15:22).
5. The sleep-stress link: Chronic stress and lack of sleep (aim for 7-8 hours) elevate cortisol, which can directly counteract efforts to lose weight or build muscle (32:39 – 34:38).
Main idea:
"Stubborn midlife belly fat is not a personal failure but a complex biological response to hormonal changes, stress, and lifestyle factors that require a shift from restrictive dieting to muscle-building and metabolic support."
Comment: This episode is such a relief; knowing that these physical changes aren't my fault makes me feel so much more empowered to start focusing on protein and strength training rather than just cutting calories!
Thank you for another fantastic video!
❤❤❤❤
This was beyond helpful!! Thanks Tamsen ❤
I loved this episode. Thank you for covering so many topics and featuring so many experts
Les femmes en cette période font de la rétention d 'eau évitez le sel allégé le .et évitez de manger sucré et gras en même temps prenez du bon gras que vous trouverez dans les avocats complément Vitamine D et yaourts Greec car calcium les noix le saumon extra marchez mais oui c est un âge de Merde ! En faite a partir de 40 piges ,🙂↕️🙂↔️
Midi health is terrible
Such a wonderful podcast and thank you so much for putting all those expert segments into one show. Really appreciate you and all you do for women! Thank you!
Hormones is the biggest factor
All the commentators stated what has been proved scientifically.🙏😊
Upping your protein can exacerbate your kidneys. Watch out.
This was a really informative video. Thank you so much!!
These are excuses that have been debunked over and over again.
Calorie deficit for your biology is the answer. Found out what your deficit is and lose the weight. This includes weighing your food. Every single morsel. Sorry the truth hurts and it is not comforting like someone agreeing with all your reason for not losing the weight.
I love those chairs, where can I find chairs like those.
Love your show too. ❤
I’m 58 can’t seem to loose those last 5lbs…. I think it’s sleep….i exercise I eat well. I was in wellness for 20 years now looking for work. I think stress the loss of 3 loved ones , and not sleeping is the issue….i was always slim my entire life but life can effect things
Hey Tamsen! I found you 2 years ago right in the middle of discovering that I had premature ovarian failure and was entering perimenopause at 35. I swear, listening to you on Instagram and here has given me more information and helped me understand what was happening to my body better than most of the doctors I’ve seen. It’s incredibly hard to find someone that brings specialists who truly understands the full picture and looks at us as a whole, instead of treating every organ, symptom, or system separately.
Thank you so much for bringing awareness and education to this. For people like me living in Latin America, where access to this kind of information and specialized care can be very limited, what you share genuinely makes a difference. ❤
Great show Tamsen. From your book to all of these Podcasts, I love that you continue to bring the experts to the table. Please keep up this really good and important work.
Thank you Tamsen❤
Great episode, very informative
belly fat being stubborn doesn’t mean tirz stopped working. if everything else is moving, i’d keep tirz from Aurelius Health Group steady and give it time
As a doctor, ‘The lost secret of healing’ by Noah Rivers is one of the rare books that can truly transform people's lives. Nothing compares
Great video and different perspectives from different women, love that! I have lost 63 pounds on a GLP-1 medication and have been maintaining my current weight as I am in maintenance, I am 57 years old in menopause and I have found that reverse diet has been an absolute game changer in the way my body composition has changed. Also, as long as when you do a "cut" you do not go too low on calories, your body will adjust. My belly fat has reduced significantly through this whole process and I started reverse diet back on December 2025. Progressive overload is a real thing! Thank you for the information! ❤
As a doctor, I appreciate books that encourage people to better understand their health. True Health Made Simple by Alex Richardson presents complex topics in an accessible way.
I LOVE highlight reels like this. So good! Also, unrelated but your hair is getting so long, Tamsen! You look gorgeous!! 🥰💖
It is calories. Check cooking oils
I am 54, 246 lbs, I have a qualified trainer who supports nutrition and creates workout programs for me now for 3 years. Doing 3 weight training sessions a week + 3 cardio sessions a week on days I don’t weight train. Walking 8k-10k steps 5 days a week. Daily protein intake 150g, carbs 140g, fats 50g (1,600 Cals per day for calorie deficit) . After losing 20lbs in the first year, I have stopped losing ANY weight for 2 yrs now! I am on progesterone & for 4 months now & sleep well thanks to a CPap, & been taking thyroid meds – I AM doing all the things; what’s happening? Any advice welcome & thanks 💪🏼💖.