Did you suddenly gain 15-20 pounds in the last 4 years?

by Dr. Shawna Darou, ND in Blood sugar / insulin resistance

Did it seem to come out of nowhere, and you don’t think you changed how you eat at all, and you’re wondering if it’s related to your hormones —perimenopause or menopause?

This is an extremely common scenario I see in practice every single day, and even before doing lab testing I am often certain that this sudden weight gain is the start of insulin resistance.

This is the beginning of the road toward type 2 diabetes, and all of the health consequences associated with it, and it often begins with weight gain around the mid-section.

For many women, the pandemic years were a perfect storm for the onset of insulin resistance: a much more sedentary life, eating comfort foods (remember all of the sourdough bread and baking?), an increase in alcohol intake, and extremely high stress.

The 15–20 pound weight gain that so many people experienced during this time was often the start of metabolic syndrome— high insulin, rising blood sugar, increased inflammation, and more fatigue.

And yes, women in perimenopause and menopause are more sensitive to these changes, but it isn’t all about your estrogen, and hormone replacement therapy will not fix it.

Need more help understanding that connection? Read: Why treating metabolic dysfunction is the first step for perimenopause symptoms

Conditions associated with insulin resistance

Insulin resistance will progress to type 2 diabetes over time, along with more weight gain and an increased risk of cardiovascular disease (high blood pressure, high cholesterol, atherosclerosis, heart attacks), and also increases risk of Alzheimer’s disease (sometimes called Type 3 diabetes) and osteoporosis.

And yes, it appears that many of the so-called age-related health conditions we commonly see initially stem from issues with metabolic health, and if your goal is to age more gracefully and prevent these issues, we start by reversing insulin resistance.

Need more help with the bigger picture? Read: Metabolic Health: The Key to Aging Well and Thriving Through Perimenopause & Menopause

Reversing insulin resistance

It’s important to know that insulin resistance is reversible, but it requires a major shift in your lifestyle to improve metabolic health.

It is essential to reverse insulin resistance, because it is key to not only your weight, but also:

• energy levels

• inflammation

• sleep quality

• mood

In other words, you don’t feel well when you are insulin resistant, and this is the key foundation to address for hormone balance, whether it’s heavy periods, PMS, menopausal night sweats, brain fog, or weight gain.

Need more help understanding the brain connection? Read: Why Brain Fog is a Metabolic Problem (Not Just an Estrogen Problem) in Perimenopause

I’ve written many times about insulin resistance because it truly is epidemic right now, and I want all of you to know the signs, and that it is reversible.

Here are some steps we may take to reverse insulin resistance:

Nutrition

Insulin resistance can be reversed with nutrition changes that focus on whole, real foods, emphasizing:

• protein

• fibre

• vegetables

…and minimizing sugar and refined carbohydrates.

Your ideal carbohydrate intake will depend on how active you are.

Need more help with food timing and fasting? Read: How to tell if fasting is helpful or harmful for you

Movement

Regular movement throughout the day, walking after meals, and starting an exercise routine that includes both cardio and strength training is also necessary to reverse insulin resistance.

A sedentary lifestyle was a very big part of what created insulin resistance, and diet alone won’t reverse it.

Since many people now work from home, they often get significantly less movement in a day, and increasing daily activity is key for metabolic health and energy.

Sleep

Poor quality sleep and not enough hours of sleep also impact blood sugar levels and your response to carbohydrates.

When you sleep less than 6 hours per night, for example, your body is more insulin resistant regardless of your nutritional intake.

Prioritizing sleep is key for reversing insulin resistance.

Stress reduction

Chronic high stress, especially when cortisol levels go high, will add to insulin resistance, along with causing poor food choices and sleep disruption.

I always think of stress as the amplifier to any health condition, so it is important to address stress if we hope to fully reverse insulin resistance and restore metabolic health.

What’s next?

As mentioned above, onset of insulin resistance has become epidemic in women in their 40’s and 50’s especially, and this is probably the most important area to address for longevity and healthy aging.

Please don’t accept a significant weight gain as a normal sign of aging, or blame it on menopause alone — it is almost always a marker of the onset of insulin resistance, and it can be reversed.

As most of you know, I really don’t like to focus on numbers on the scale at all, however a fairly sudden change is always important, and in this case is a marker of a change in metabolic health.

Our lifestyle catches up with us in the 40’s and 50’s, and it becomes non-negotiable to:

• eat well

• exercise and move daily

• address stress

• prioritize sleep

These are all within your control, and I’m always excited to guide you along the way.

Work with me:https://drshawnadarou.com/work-with-me
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Frequently Asked Questions About Sudden Weight Gain and Insulin Resistance

Why did I suddenly gain 15–20 pounds in perimenopause?

Sudden weight gain in perimenopause is often related to insulin resistance and metabolic changes, not just hormones alone. As estrogen starts to fluctuate and decline, the body becomes more sensitive to blood sugar swings, stress, poor sleep, and a sedentary lifestyle, all of which can lead to weight gain—especially around the abdomen.

Is sudden weight gain a sign of insulin resistance?

Yes, in many cases it is. One of the earliest and most common signs of insulin resistance is rapid or stubborn weight gain, particularly around the mid-section. Other common signs can include fatigue, sugar cravings, bloating after meals, poor sleep, and difficulty losing weight.

Why do I gain weight around my stomach in my 40’s and 50’s?

Weight gain around the stomach during your 40’s and 50’s is very commonly linked to insulin resistance, higher cortisol, declining estrogen, and loss of muscle mass. This shift in fat distribution is often a metabolic health warning sign and should not simply be dismissed as “normal aging.”

Can menopause or perimenopause cause insulin resistance?

Yes. During perimenopause and menopause, changing hormone levels—especially declining estrogen—can make the body more prone to insulin resistance, blood sugar instability, and abdominal weight gain. This is why many women notice sudden changes in weight, energy, and body composition during this stage.

How do I know if my weight gain is hormonal or metabolic?

In most cases, it is both. Hormonal changes can trigger metabolic dysfunction, which then drives symptoms like weight gain, fatigue, sleep disruption, cravings, and difficulty losing weight. Bloodwork and a full metabolic assessment can help determine whether insulin resistance, cortisol, thyroid, or other factors are contributing.

Can insulin resistance be reversed?

Yes —insulin resistance is reversible in many cases. Improving nutrition, increasing movement, building muscle, prioritizing sleep, and reducing stress can significantly improve blood sugar balance and restore metabolic health over time.

Will hormone replacement therapy help with sudden weight gain?

Hormone replacement therapy may help some symptoms of perimenopause and menopause, but it usually does not fix insulin resistance or metabolic dysfunction on its own. If the root issue is metabolic, that needs to be addressed directly through nutrition, movement, sleep, and stress support.

What should I do if I suddenly gained weight and can’t lose it?

If you’ve suddenly gained weight and your usual efforts are no longer working, it’s important to look deeper. A proper assessment may include blood sugar, fasting insulin, thyroid testing, stress hormones, sleep quality, and lifestyle factors. The earlier insulin resistance is identified, the easier it is to reverse.

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