Podcast Summary: "How to Make Weight Loss EASY After Menopause"

The Dr. Josh Axe Show | Host: Dr. Josh Axe
Date: October 13, 2025

Episode Overview

In this episode, Dr. Josh Axe addresses one of the most challenging issues for women: weight gain during and after menopause. He explores why weight changes happen at different life stages, especially as we age, and provides science-backed strategies to make weight loss easier, healthier, and more sustainable for women over 40 and beyond. Dr. Axe digs deep into the roles of hormones, metabolism, diet, exercise, stress, and mindset, equipping listeners with actionable advice to achieve and maintain a healthy weight at every age.

Key Discussion Points & Insights

1. Life Stages and Weight Gain

• Three Major Times People Gain Weight:
  • Early college years
  • When starting a family (30s)
  • Menopause/perimenopause (midlife crisis, andropause for men)
• Weight Gain is Not Just Vanity:
  • “Every health condition imaginable—autoimmune disease, cancer, heart disease, diabetes—is tied to weight gain. And so you don’t want to be lean and fit just for vanity’s sake. You also want to do it so you can have a long, healthy, productive life...” (01:53)
• Aging & Metabolism:
  • Metabolism slows with age; habits matter more in later decades.

Breakdown by Decade

• 20s:
  • Peak metabolism, but prone to weight gain due to lifestyle (alcohol, late nights, processed food).
  • Key: Adopt moderate, healthy habits and maintain activity.
    • “The key in your 20s is to adopt healthy lifestyle practices and do things in moderation.” (05:59)
• 30s:
  • Muscle mass starts to decline, stress ramps up due to career/family responsibilities.
  • Rising cortisol & insulin lead to hormonal imbalances.
  • Learning to say “no” and reduce stress is critical.
    • “The most important thing you can do in your 30s... is learn to say no more.” (09:10)
• 40s:
  • Early hormone changes (perimenopause, testosterone decline for men), more abdominal fat.
  • Focus on supplements: women (iron, omega-3, Vitex, black cohosh), men (Panax ginseng, ashwagandha, vitamin D, magnesium).
• 50s and Beyond:
  • Hormonal shifts accelerate, metabolism slows further.
  • Increase protein, strength training, and focus on quality sleep.

2. Menopause & Weight Gain: Why It Happens

• Prevalence: 50–70% of women gain weight during perimenopause and menopause. (14:55)
• Average Weight Gain: 6–8 pounds during this transition, primarily due to declining estrogen and progesterone causing muscle loss and slowed metabolism.
• Hormonal Changes:
  • Declining estrogen → more belly/visceral fat, higher risk for heart disease & diabetes, disrupted hunger hormones (leptin, ghrelin).
  • Progesterone drops → water retention, mood swings, poor sleep.
    • “Now your metabolism slows, and so now you’re going to gain weight.” (17:23)
    • “You might have a 6 to 8% drop in calorie burning capacity and burn about 200 fewer calories per day than you did in your 30s.” (21:11)

3. Lifestyle Factors That Exacerbate Midlife Weight Gain

• Diet Quality Declines: Increased processed foods, sugar, refined carbohydrates, and frequent alcohol intake due to busier lifestyles.
• Alcohol’s Outsize Impact:
  • Regular drinking is a major, underrated cause of weight gain, especially >5 drinks/week.
    • “More than five drinks per week is also the third leading cause of premature death in the United States behind smoking and obesity.” (27:13)
    • “It is not healthy to drink every single day.” (25:32)
• Stress & Overcommitment:
  • Chronic stress boosts cortisol, leading to belly fat, cravings, blood sugar instability.
  • Dr. Axe emphasizes planning and saying “no” to non-essential commitments.
    • “Learn to say no more. If you’re a people pleaser, this is going to be the hardest thing for you.” (33:01)
    • Shares personal strategies for family prioritization and spiritual grounding.
• Low Physical Activity:
  • Only 17% of midlife women meet activity guidelines.
  • Loss of muscle mass with age decreases metabolic rate.
    • “If you have a choice between weight training and cardio, choose weight training every single time.” (43:32)
• Poor Sleep:
  • Sleep disruption further disrupts hunger hormones and increases risk for major weight gain.
    • “Menopausal women who slept fewer than five hours a night had a 32% increased risk of major weight gain...” (47:30)
• Visceral Fat:
  • Increased in midlife, drives systemic inflammation, joint pain, fatigue, and increased chronic disease risk.

4. Science-Backed Strategies for Weight Loss After Menopause

1. Prioritize Protein Intake

• Preserves muscle mass, boosts satiety, increases fat burn (thermogenesis).
• Aim: ~30g protein/meal; up to 0.57-1g per pound bodyweight/day.
  • “More protein, more protein, more protein. That is one of the greatest ways you can lose weight, build muscle and boost your metabolism.” (55:13)
• Favored sources: wild-caught fish, pasture eggs, bone broth, organic chicken, grass-fed beef.
• Studies show ~45% more lean muscle tissue preserved with high-protein diets.

2. Focus on Whole Foods

• Promotes Mediterranean, Biblical (“Biblio”) diets: plenty of meat, fish, fruits, vegetables, olive oil, some whole grains, nuts, seeds.
• Avoids long-term carnivore, ketogenetic diets outside of specific medical needs.
  • “If you want to lose weight the right way and feel great, follow a biblical diet...or Mediterranean diet.” (58:46)

3. Strength Training (and Some Cardio)

• Prioritize weights over cardio; even a few days/week provides major benefits.
• Example schedule: 2 days weights, 1 day cardio, daily walking.
• “The best thing you do is eat more protein...and then do regular strength training.” (01:00:22)
• Exercise helps manage hot flashes as well.

4. Reduce Sugar and Alcohol

• Both increase insulin resistance, disrupt hormones, add hidden calories.
• Keep alcohol to ≤2 drinks/week for most; substitute sweet cravings with healthy alternatives (dark chocolate, protein smoothies).
  • “Alcohol impairs liver detox, and that’s essential for estrogen clearance.” (01:04:37)

5. Consider Intermittent Fasting (With Caution)

• Works best for some, especially men.
• For women: try a 10-hour eating window, do not skip daily protein.
• “One study...showed that time restricted eating reduced body fat, blood pressure, and oxidative stress, all key concerns for postmenopausal women.” (01:08:53)

6. Support Hormone Detoxification

• Liver and gut health are crucial: eat lots of steamed cruciferous and leafy greens, sip on dandelion and milk thistle tea.
• Supplements: Magnesium, methylated B vitamins, ashwagandha, rhodiola, berberine, Ceylon cinnamon, creatine (for muscle).

5. Mindset & Spiritual Health

• Positive attitudes towards menopause result in fewer symptoms, less weight gain.
• Mindset shift: View aging as a time of growing wisdom and contribution.
  • “Studies show that women with positive attitudes towards menopause experience fewer symptoms, less depression, and greater quality of life.” (01:15:40)
• Value and honor older adults; Dr. Axe shares personal stories of aging role models (e.g., his dad, Mark Sisson).
• Spiritual grounding (e.g., time spent with God, attending church, meditation, purposeful living) is vital for stress reduction and maintaining healthy habits for life:
  • “One of the greatest ways to reduce the stress and have a more positive mindset is to spend more time with God...” (01:19:18)

Notable Quotes & Memorable Moments

• On why people gain weight as they age: “So maybe you’re eating the exact same amount of food you’ve always eaten and then all of a sudden you’re like, okay, over the last five years or so, I’ve gained 10 pounds. How did that happen? Your metabolism slowed, your metabolic rate slower.” (20:38)
• On stress and overcommitment:
  • “Say no to the good and only say yes to the great.” (33:54)
• On women’s muscle loss:
  • “A lot of women, statistically starting in their 40s, lose up to 5% of total muscle mass each decade, especially without consistent exercise.” (45:15)
• On perimenopausal mindset:
  • “If you view menopause as a time...where you’re mentoring and leading more...that allows you to have a healthier metabolism and gain less weight.” (01:15:40)
• On the power of spiritual health:
  • “You want to live your best life possible. We all want to get to the end of our life and say, we ran a good race, we had the biggest impact we could possibly have.” (01:19:59)

Timestamps for Important Segments

• [03:50] Why weight gain happens at three key life stages
• [07:00] What happens metabolically in your 20s, 30s, 40s, 50s
• [14:55] The reality and statistics of menopause weight gain
• [17:23] The hormonal mechanics behind menopausal weight gain
• [21:11] Declining metabolism and calorie needs as you age
• [25:32] Alcohol's impact on midlife weight and health
• [33:01] Dr. Axe’s advice: “learn to say no more” to manage stress and priorities
• [43:32] Strength training vs. cardio for menopausal women
• [47:30] Sleep deprivation and increased weight gain risk
• [55:13] Optimal protein intake for maintaining muscle and metabolism
• [58:46] Most effective diets for weight loss after menopause
• [01:00:22] Structuring exercise routines for fat loss and hormonal health
• [01:04:37] Managing sugar and alcohol cravings, healthy swaps
• [01:08:53] Intermittent fasting as a tool for menopausal weight loss
• [01:15:40] Role of mindset and viewing menopause as a positive life stage
• [01:19:18] Spiritual health and lasting change

Recap: Action Steps for Listeners

1. Eat more protein (aim for 30g per meal)
2. Prioritize strength training over cardio
3. Adopt a whole-foods-based Mediterranean or Biblical diet
4. Limit sugar and alcohol intake
5. Set boundaries for stress and over-scheduling
6. Support liver and gut health for hormone detoxification
7. Aim for 7+ hours of sleep nightly
8. Cultivate a positive, purposeful mindset and value spiritual well-being

Final words:
“You can lose weight at any stage of life, especially if you follow the advice I just shared… Not only will you lose the weight, you’ll have more confidence, you’ll have more energy. Whatever disease or medications you’re on, you’ll likely be able to reverse those conditions, get off the medications. I mean, you will feel younger, you’ll look younger, you’ll be like a different person and you can do that with a few of those simple steps.” (01:21:26)