Top 10 tips to lose weight on low carb for women 40+

serious matured woman with crossed arms outdoor

When Samantha Dalby emailed us last month, she was frustrated and confused. The 50-year-old nurse practitioner from Ontario, Canada, had been eating a low-carb diet for more than five years. Originally she had done very well on it, keeping her weight at a healthy and stable 152 lbs (76 kg) on her 5’7″ (174 cm) frame.

But then, about 18 months ago, she went through menopause — her last period was 12 months ago. Suddenly the weight started creeping up. What had worked so well was no longer working for her. “It’s a scary time because it feels like what is happening in your body is out of your control, on so many levels,” Samantha says.

In her health clinic with her patients, and with friends, she has seen women gain a considerable amount of weight over the menopausal change and she did not want that to happen to her.

Nine months ago she decided to try the stricter keto diet and followed our advice to help support this way of eating. By testing her urine with keto stix she could see she was expelling ketones in the low to moderate range. But still her weight was increasing — she gained a total of 7 lbs (3 kg) over nine months of keto eating. And her clothes were feeling tight and uncomfortable. What was she doing wrong?

“I just seem to be gaining no matter what I do,” she lamented in an email to us. “I accept that menopause will come with body changes, but I am frustrated that I can’t seem to stop the weight gain.”

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Samantha and her partner Gary

A common problem

Samantha is not alone. Many women find in the years leading up to and after their final menstrual period that along with other symptoms like hot flashes, night sweats and sleep problems, their abdomens thicken and their weight increases. Some 40 million women in the US, 13 million in the UK, and many more millions around the world are estimated to be going through menopause, which usually occurs between age 49 and 52.1

On Google, typing in “Weight gain in” the word “menopause” is what pops up as the most frequent search term to complete the phrase.

We’d like to help. Many of our readers are women over the age of 45, and we know that the keto low-carb diet for weight loss and improved health over the menopause years is of huge interest for a lot of people. Many women in this age group are happy with the results they have achieved by adopting the low-carb or keto way of eating. But what if you are not achieving the results you want?

Samantha described how she was eating low-carb, high-fat, exercising five times a week, snacking rarely on nuts or cheese, drinking about three to five glasses of alcohol a week (dry red or white wine, prosecco or vodka soda) and drinking bulletproof coffee in the morning. She had been tested for thyroid issues and was fine. What advice could we give her?

The response was to try intermittent fasting — and we go into more detail about that in tip #3 below. But to truly get to the bottom of menopausal weight stalls and challenges, we explored the medical literature about what is known about metabolism changes and physiological energy needs during menopause and also tapped the knowledge and experience of some of our stellar low-carb experts — Dr. Sarah Hallberg, Dr. Jason Fung, Dr. Eric Westman, Dr. Ted Naiman, and Atkins RN Jackie Eberstein. We have come up with nine other actions, along with intermittent fasting, that may help stop menopausal weight issues and to give a boost to weight loss if you are experiencing a plateau while low-carb keto eating.

We shared them with Samantha in advance of this post, and within a few days of adopting them, she saw the scale finally move downward 1.5 lbs (0.7 kg), the first time in months. She was delighted. Her ketones had increased from 1.5 to 4 mg/dl. “I really thank you for this. I am going to keep doing these tips. I will let you know how it goes!”

The ten tips can work, however, for anyone in a stall, not just for menopausal women. “Post menopausal women certainly can have problems with weight gain, but we see it in many others, too,” said Dr. Jason Fung.

The weight-loss challenge in menopause

In fact, whether menopausal women have unique challenges for weight loss is controversial.

Some studies have proposed that women’s weight gain in midlife is more a factor of aging — which impacts both sexes — than of menopausal changes in hormones. Other studies note, however, that declining estrogen (estradiol or E2) at menopause changes women’s energy needs and metabolism, changes their location of body-fat accumulation from the hips to abdomen, and is associated with an increased rate of metabolic syndrome.2

Dr. Wendy Kohrt, of the University of Colorado Denver, leads its IMAGE program (Investigation into Metabolism, Age, Gender and Exercise) and has been studying the impacts of menopause for more than 20 years. She has found that during menopause women’s metabolisms slow by about 50 calories a day and that women experience more food cravings, less movement and more muscle loss, which together create a quadruple whammy for gradual weight gain over time.3 Kohrt notes, however, that menopause itself has been vastly under-researched over the years, a point shared by other commentators, considering the impact it has on the health and wellness of millions of women.4

Dr. Sarah Hallberg notes: “Weight gain happens at menopause — we all know it — but research cannot yet fully explain why. It is not as universal an issue as generally perceived. Why menopausal women eating low carb or keto should stall or even gain weight is not really known either. We intend to try to understand this better.”

Hallberg and colleagues are currently in the midst of a study in which ten overweight mostly menopausal women, who have been doing low carb keto eating but whose weight loss has stalled prematurely, will spend about five days in a monitored environment. During this time the women’s food and activity will be observed and recorded and their metabolism analyzed. While studies like this have been done before, this is the first time the focus has been on women who have stalled in their weight loss on a low carb and high fat diet, Hallberg says. “Most of the other studies found it was overconsumption leading to the problem. We want to see what is happening for these women.”

Results from that study won’t be available for a number of months. Until then, here are our top ten tips from our experts to kick you out of a stall — which applies to women in menopause, or anyone experiencing a weight loss plateau or not having sufficient success on low carb keto eating.

1. Don’t eat too much protein

Don’t eat too much protein: “Number one issue for stalls, in my experience, is too much protein,” says Dr. Hallberg. “Women need less protein and can much more easily over-consume protein compared to men. If you and your husband are eating the same size steak, you are consuming too much.”

Drs. Fung and Westman agree. “Too much protein interferes with ketosis and fat burning,” says Dr. Westman. He suggests testing your blood sugar after you eat protein to see if your blood sugar goes up. “If it goes up, some of that protein is being turned into sugar. And that can slow you down.”

Dr. Naiman is less concerned with keeping protein intake modest. But apart from him, the general advice from our group of experts is to eat between 0.5 to 1.5 g of protein per kilogram of body weight per day. A 70 kg (154 lbs) woman would therefore eat no more than 105 g of protein per day, and perhaps significantly less.

If you’re not really interested in counting grams, you may instead want to try a suggestion from Dr. Hallberg, to do a “mindful week” and retrain your feelings of hunger and fullness. Here’s how Dr. Hallberg puts it:

The problem and the struggle for all the people we see, not just menopausal women, is they don’t know what hunger and fullness really are. They come to us after years and decades of a low fat high carb diet. So they are used to a feeling of fullness that is fuller than full. So we need to retrain ourselves to understand that full enough is the way you should feel.

People always say: OMG I ate so much and I feel so full and disgusting. That is how they are used to feeling “full”… discomfort after eating. So retraining their sensory system to just accept full enough is something you have to work with people on.

So if we are having a plateau and we are struggling with this the first thing people say is “should I go back to counting calories.” No, no, no! Have a mindful week. What that is, in my mind, is that patient is going to dedicate a week to this. They have to dedicate a week because it takes time.

So, if for breakfast they are used to having two eggs and two strips of bacon, during the mindful week you would only bring one egg and one piece of bacon to the table. And you would eat it. Then you have to wait 20 minutes — and that is where the time investment comes. And then ask yourself after 20 minutes, am I actually still hungry?

You have to give yourself time to learn how to feel if you are full or still hungry. And so you do that for each meal, for a week’s time, you realize at some point that you are eating the right amount, you are eating too much, or you are eating too little. You will realize at some meals “I was eating too much. I didn’t need that second egg or whatever.” It is a way to do it without counting calories, to do it based on your body’s need and for you to get in touch with your body’s need.

2. Don’t eat too much fat

Once fat adapted, cut back on extra fat: One of the great joys of low-carb keto eating is adding back fat into our bodies after denying them fat for so long. But a keto diet is not carte blanche to gorge yourself on fat, the experts note. If you want to lose weight, you have to burn your own fat stores for energy, not consume all the energy you need by eating fat. So stop the bulletproof coffee and fat bombs for now.

Dr. Naiman notes that when people first start the low-carb keto diet, when they have previously been consuming lots of carbs and are very glucose dependent, he tells them to eat unlimited healthy fat until they are fully-fat adapted. “You will know you are fat adapted because you can go a long time without eating.”

Once they are primed to burn fat, however, he then scales back on fat so that they will access and burn their own fat stores.

So if you are experiencing a weight-loss stall, our experts recommend you look at how much fat you are consuming and see where you might cut back without harming the tastiness or quality of your food or your feeling of fullness, and without bringing back the cravings and blood sugar swings. Don’t starve yourself, but be mindful of excess fat for now. Samantha decided to cut out her bulletproof coffee for now.

Dr. Hallberg notes that it is easy to over-consume fat in liquids, especially full fat whipping cream. “Someone will come in and say they are in a weight loss plateau. We will look at their diet and see they are consuming six coffees, with two tablespoons of whipping cream in each one.” Cutting back on the whipping cream can get them out of a stall.

“When you are at your ideal weight, you can add the fat back in and eat all the butter you want,” Dr. Naiman says.

Dr. Fung discussed this concept of excess fat consumption, and how it applies to some people, in detail, including the role of leptin resistance in weight loss stalls in a popular earlier post.

3. Intermittent fasting

Add in intermittent fasting: Once you are fat-adapted, hunger pangs diminish and it is easy to go for longer periods without eating. Many people naturally stop eating breakfast — they just aren’t hungry when they wake up. The number one rule of low-carb eating is “eat when you are hungry and stop when you are full.” So if you are not hungry try fasting for 16 hours, and then eating just lunch and dinner in an 8-hour window, called a 16:8 fast. Or try eating dinner one night, than fasting until dinner the next night, doing a 24-hours fast.

Samantha added in a 24 hours fast on our advice and a couple of 16:8 fasts. “I was surprised how easy it was. I wasn’t hungry.”

For Ellen McCormick Martens, 71, of Houston Texas, adding in intermittent fasting, eating only between 11 am and 7 pm did the trick for her stubborn plateaus.”Using IF, I have been able to keep my extra weight off for 1½ years. It is really simple and easy to incorporate [a short fast] into an LCHF lifestyle.”

Dr. Fung suggests not doing the same fasting routine, day after day, but to “switch it up”; 16:8 one day, 24 hours IF the next, then a day of regular eating. That is because the body has a strong physiological drive to seek homeostasis — energy balance. “Whenever the body is exposed to a constant stimulus, it will become acclimated to it,” he says.

Hallberg suggests caution, however, around very long fasts lasting multiple days. “If you are skipping meals because you are not hungry from doing a proper low-carb, high-fat diet that is just fine.” She is concerned, however, about very long fasts in which people are ignoring hunger signals and for the potential for a dangerous physiological fluid and electrolyte imbalance called refeeding syndrome that can arise after very long extended fasts, lasting many days, when normal eating is resumed.5

When people are doing low carb keto eating they are often not hungry for 16, 24 and even 36 hours. Such fasts are safe and healthy.6 Remember: eat when you are hungry (don’t eat when you are not), and stop when you are full.

4. Watch out for the carb creep

Watch for carb creep: If you have been doing low-carb keto eating for a while, carbs can sneak back into your diet, particularly in the form of sauces, condiments, fruits, and nut snacks. If weight loss has stalled, closely examine what you are eating and cut back to under 20 g of carbs again. Nut snacks like cashews, almonds, and pistachios are easy to overeat and can contain enough carbs to contribute to a weight-loss stall. A cup of pistachios, for example, has 34 g of carbs. Avoid carb cycling or cheat meals, too, for now.

“For insulin resistant people, if they are in ketosis but eat one meal of carbohydrates, it can stop the ketosis in some people for up to three weeks,” said Dr. Westman.

Keeping carbs below 20 g will maximize weight loss with more control over hunger and cravings, says Jackie Eberstein.

Samantha cut out her nut snacks and feels that, along with the IF, doing so contributed to getting the scale finally move downward.

5. Cut out alcohol

Cut out the alcohol for now: Many people love the fact that on a low-carb or keto diet you can have a glass of dry white or red wine from time to time. If you are experiencing a weight-loss plateau, or gaining weight, cut out all alcohol for now until weight loss starts again. Even a few drinks a week can cause a stall. “I love my Friday night glass of wine after a hard week, but I will cut it out for now,” says Samantha.

6. Avoid sweeteners

Remove artificial sweeteners: If you have been including artificial sweeteners like aspartame or sucralose in your low-carb or keto diet, our experts recommend you wean yourself off them. “While there are not a whole lot of scientific studies, anecdotally we find when people get rid of artificial sweeetners, they were able to lose weight. Come off them as soon as you can,” advises Dr. Westman.

More on artifical sweeteners and weight

7. Do weight training

Lift weights: While you can’t exercise your way out of a bad diet, adding in weight lifting will build muscle and increase your metabolism. “The more muscle you add, the better your insulin sensitivity, so any sort of resistant strain you can add to your muscle is great for weight loss,” says Dr. Naiman. The weight lifting doesn’t have to be a excessive — 90 seconds, twice a week can do it. But he notes it has to be a heavy enough weight that after about to 10 to 15 lifts (reps) you cannot do another rep. That is called lifting to muscle failure. “It is only if you go to absolute failure that you convince your body that you’re not strong enough. Your body won’t add muscle unless you send the message that it needs more,” Dr. Naiman says. Squats, push-ups and other body resistance methods are just as effective as hand held weights or weight machines.

Dr. Westman never brings up exercise as a first step in weight loss. He wants patients to focus on the diet first. “But later on, if things are no longer working well and there is still significant weight to lose, I bring up the E-word, exercise. But I try to get them back to things that are fun for them. Exercise will help you get through a plateau.”

Dr. Hallberg notes that vigorous exercise can sometimes create a false weight plateau. “If you are exercising to the point of getting sore, you are tearing muscle — which is a good thing, that is how we build muscle, by micro-tears.” But in order to deal with that, the body sets off a small inflammatory response, which causes people to retain fluid. “So after a vigorous workout you can jump up a few pounds overnight. It is not a real plateau, it is a pseudo plateau.”

Make sure you have rest days between heavy exercise for the body to recover.

8. Get enough sleep

Get a good night sleep: During menopause, many women find their quality of sleep sharply deteriorates, often because of hot flashes and night sweats. Drs. Fung and Hallberg really recommend that women in weight loss plateaus aim to improve their sleep. A good night sleep reduces stress and cortisol, the stress hormone that when raised hangs onto abdominal fat.

Tips for better sleep include:

  • Sleep in a cool, dark room.
  • Wear ear plugs and eye shades.
  • Limit screen time and blue light before bed (or try the glasses that block blue light).
  • Go to bed and get up at the same time each day.
  • Stop drinking coffee by noon and limit caffeine consumption in all forms.
  • Avoid alcohol before bed.
  • Get exposure to natural daylight each day.

Read more here: National Sleep Foundation: Sleep Hygiene

This advice struck home for Samantha: “My sleep has been impaired for the last five years because of peri-menopause.”

9. Reduce stress

Try stress reduction techniques: Examine the stresses in your life and see if you can do anything to alleviate any of them. Stress increases cortisol release. But don’t stress about stress — that is no win. Many women during menopause find they are caught in the sandwich of still dependent children but aging or ill parents. Death of loved ones and loss are common during the menopausal years.

“When we see people struggle and hit a plateau, or completely fall off the wagon, the number one cause is a life crisis of some sort,” says Dr. Hallberg. “We all have life crises, men and women — all our lives are managed chaos. We recommend people plan coping mechanisms to deal with stress.”

Stress can cause emotional eating, too, another cause of stalls or weight gain, Dr. Fung notes.
Try yoga, meditation and mindfulness techniques, relaxing walks or other pleasant diversions and hobbies. Dr. Hallberg recommends a week of slow and mindful eating, where you really pay attention to taste, textures, and hunger cues. Eat slowly, deliberately and mindfully.

Dr. Westman notes that even worrying about your weight can be a stressor. While monitoring one’s weight and food intake is usually helpful, if it becomes too stressful, Dr. Westman suggest not monitoring it for a while and just going by how you feel.

10. Be realistic

Set realistic expectations: Both Dr. Hallberg and Jackie Eberstein note this tip is particularly important for women, of all ages. Some women are aiming for an arbitrary number on a scale, perhaps from a long time ago or an idealized weight they have never achieved — a number that has no real bearing or relationship to their actual health and wellness.

“This is one of the really big issues I see for women — it is so much entwined with psychology, self-esteem, and societal pressure, and in many ways outside of women’s control, “says Dr. Hallberg. “They succumb to ways they think they need to be, rather than what is healthy for them. If you see victory as only a number on a scale, you are going to sabotage yourself.”

Jackie Eberstein agrees: “Measure your success by a loss of inches, rather than the scale.” She advises that you accept that weight loss in middle age will be slower than when you were younger. “Remember that you are in this for the long haul. It is an investment in your health as you get older. Have patience. Your long-term goal is to make a permanent lifestyle change as well as lose the excess fat.”

For Samantha, this last tip makes perfect sense.

“In all of this I really try to enjoy the body I’m in. I celebrate my muscles and skin and good hair; that I am healthy and that I look healthy,” she says.

“I feel great on LCHF and keto, with whole food eating — great energy, GI tract, focus. So I’m happy to eat this way regardless of the scale. I really do feel that for women in menopause this is the crux of the issue — balancing the desire to lose (or not gain) weight with a focus on physical and mental health. To age with grace and vitality.”

Anne Mullens


A keto diet for beginners

How to lose weight


All earlier posts by Anne Mullens



Weight loss

Dr. Westman

Dr. Hallberg

Dr. Naiman


Earlier with Anne Mullens

All earlier posts by Anne Mullens



  1. Caroline Barnes
    One item you have not mentioned is Vit D/magnesium deficiency. That can really add to a woman's problems too. So few of us get 10-15 min during the noon time (only time you can make it in winter/fall) on lots of bare skin. Deficiencies lead to depressions etc...probs with bones etc.. Women rarely get enough D from their diets -even low carb. I was just diagnosed with Breast Cancer in June. And, now on Letrozole (Femara) estrogen blocker that gives all the same problems as menopause..including weight gain. Thank you for the article....maybe some of those will help this 65+yr old RN too.
    Reply: #11
  2. Caroline Barnes
    Whoops....Sun on bare skin....(add to previous comment!)
  3. Diane
    Is there a way members can pin this article as a favorite for quick reference? Would love to be able to easily find it when I hit a plateau.
  4. Heather
    Open the post in Safari and then email it to yourself.
  5. Michele
    When you speak of 105g or 3-4oz of protein, is that before cooking or cooked protein?
  6. Anne
    Hi Michele -- as the writer of the article, I can tell you that the experts did not make that distinction and we generally want to get away from incremental measurements and the mind set of counting stuff to the nearest gram. So these are general guidelines. The key take away for me was learning what my body needs in the way for protein by my feelings of hunger and by the movement of the scale. Since this is an issue that impacts me, too, what I am doing now is what Dr. Hallberg recommends: eating half, then waiting 20 minutes. So instead of eating a whole piece of steak I slice it and just eat some slowly, then see how hungry I am (good conversation at dinner helps!), then wait. If not hungry (which is often the case) I save the rest for lunch the next day. I will make one egg first, then a second if I need it. I have lost a few pounds doing this. I am not measuring total grams. So that point #1 was really about obvious and big amounts of over consumption - like eating the same size T-bone as a man, or large amounts of protein at every meal. Take a look at the various proteins you are eating throughout the day and see if there are times where it makes sense to eat less of it because you are not hungry for it. You might then note how many grams a day this generally is for you as it will be individualized. Protein needs will vary between women based on muscle mass, activity, age, height, metabolism or other factors. Does that help? Anne Mullens
  7. Julianne
    I'm a post menopausal woman (58) who has had a little weight gain, I am also a nutritionist (post-grad education) And I do not agree with some of what you say. I would add though - people are individual and lots of trial and error led me to what now works for me. My own experience is that more protein is good, as long as it is lean. I eat 2 grams per kg body weight per day, divided into 3 meals, so each meal has around 30 - 40 grams net protein. I eat some starch and fruit, lots of non-starch veg i.e. lots of fibre. I add very little if any fat to meals. The more I go high fat, low carb, lower protein, the more weight piles on, and the less appetite regulation I have. I do powerlifting training so totally agree with the weight training, I now have the firmest most shapely, strongest body I've ever had, also getting stronger. Protein here makes all the difference, phenomenal recovery and consistent strength gains. Manage inflammation would be the other tip - an anti-inflammatory diet, again all the colour and fiber, a high dose of the best quality omega 3, and a few other supplements. Sleep critical. I take a supplement that gives me the best sleep, and manages hot flushes etc too. With respect to fasting - not for me, it just doesn't work - can't handle the psychological missing of meals. However I have a no snack rule, so go 5 hours between meals, with the right amount of protein and enough but not too many carbs, I dont get hungry. I've put my food into a nutritional analysis and compared to when I was younger, I cannot eat as many calories as I used to without gaining weight, despite now having more muscle. So there must be something to that. The other thing that does not work for me is high saturated fat. My LDL goes through the roof, and not just that the particle numbers and oxidised LDL increase. So I do not touch coconut oil etc, and eat very little dairy fat. Oh and a paleo diet works for me - no joint inflammation with paleo - that has made a massive difference for the last 8 years.
    Replies: #47, #50
  8. Lisa
    Great article. I'm not a fan of wine, so I don't get the hoopla over it. (I'm just not a drinker) Another tip I would offer is Zypan (Standard Process) to assist digestion, esp since once over age 40 stomach acid production is greatly reduced.
  9. Kathryn Fulto
    Great article. Thankyou for posting it as I have been looking for just this information. I would like to add an interesting change in my Vitamin D levels since being on LCHF. I have needed supplements for many years, working indoors but equally enjoying sun when its there! My levels were quite low until about 6 months after beginning LCHF when they dramatically improved to above average! I did not change anything as far as sun/skin exposure just what I ate. An interesting study for someone perhaps? I am thriving on this way of eating but at 52 noticing a little weight gain. I will be trying these tips.
  10. Lyne
    Great article Thank you xx will Google translate and pût on my network with original link. I tough i was un pré ménopause, no périod for 2 or 3 mounts etc... Lost 17 pounds since july, stoped bread potatoes pasta sugar prepared meals for healt All my family died of cancer i said NOT me, and then lurned about keto love it. I now Cook lol been doing IF for 1 year, started to drink bone broth to break y fast 1 mount ago. Dont know what happend i started to be regular again the last 3 periods since i started All that, is it normal? When i started my périodes in july after 3 mounts of no periods i was really scared, it was , 2 days of extream bleeding, and lasted 5 days, August and september 1 day of heavy bleeding and then normal.
  11. Lisa Ann Homic
    That's a good point. Vit D helps the thyroid.

    One item you have not mentioned is Vit D/magnesium deficiency. That can really add to a woman's problems too. So few of us get 10-15 min during the noon time (only time you can make it in winter/fall) on lots of bare skin. Deficiencies lead to depressions etc...probs with bones etc.. Women rarely get enough D from their diets -even low carb. I was just diagnosed with Breast Cancer in June. And, now on Letrozole (Femara) estrogen blocker that gives all the same problems as menopause..including weight gain. Thank you for the article....maybe some of those will help this 65+yr old RN too.

    Reply: #18
  12. Mechelle
    So glad Diet Doctor wrote this article. I became frustrated after 5 1/2 years of LCHF & IF cleared up all my health issues, but left me overweight for the first time in my life! I want to add that I finally figured out the trick to weight loss--I had to bring my protein levels down from 85 grams to 50 grams a day or lower. It was amazing!!! When I did that, I ended up losing almost one pound a day effortlessly. (Of course, I already am very low carb, high fat, and only eat very nutrient dense food, take supplements, intermittent fast daily and do long fasts intermittently, and do exercise daily, yoga&meditation regularly, and build muscle). I was inspired to try to downregulate mTOR after watching Dr. Rosedale's talk. For anyone who is doing everything right, and is still moderate or high protein, please try going low protein at least for a couple of weeks--it might be the magic bullet for you that it was for me! Hope this helps! (BTW, I am a 50 year old woman).
    Reply: #21
  13. Mechelle
    I would like to add one more thing: I am tired of hearing folks say things like, "Oh, you need to learn how to eat less." That was absolutely not my problem. I think Dr. Ron Rosedale has the greatest insight on the issue of middle-aged women and weight issues--we have to drastically cut our protein (50 grams and under per day) to get our insulin levels down. It has to do with mTOR. Remember, younger folks don't have the same mTOR issues that older folks have...
  14. Mariane
    As a woman in menopause I thank you for this. I have hit a plateau myself after initially losing weight on LCHF. I think that there are a few things that are making my weight loss stall. 1. too many coffees with whipped cream 2. snacking on cashews 3. potentially eating too much protein. I will try and change these things and hopefully I can lose a few pounds.
    I really appreciate this post.
  15. Deborah Gordon, MD
    Don't forget the option of replacing lost hormones at menopause. The literature for years has exonerated estradiol's role in breast cancer (it was really the Provera, not even the Premarin in the WHI Study), and found a benefit in brain and mood health, sleep, gum and dental health, bone density, colon cancer risk, and even... a reduced risk of breast cancer. Even in women who have had estrogen receptor positive breast cancer. Last week JAMA published an all-cause mortality article showing no increased mortality at all for women on estradiol.

    Estradiol can help with cravings and metabolism: keep the pear shape and diminish the tendency to the apple shape. We now know that hot flashes last much longer than previously estimated: estradiol can reduce hot flashes and give women the sleep that everyone tells them they should have!

    The world is shifting and I predict that in the future this Google link between weight gain and menopause will link equally strongly to, "speak to a knowledgeable physician about an estrogen prescription!"

  16. Kathy from Maine
    Thanks for this article. A lot of it I've read before, but good to have it all in one place.

    I've been doing LC/HF since I was about 45, and initially lost about 30 pounds (almost effortlessly). At 51 I had my last period, and in the next 18 months gained almost 50 pounds while still eating the same things, and being just as active. Now I'm 62 and have added another 10 pounds to that.

    I think I'm still doing well at LC/HF, yet I know it's not as good as I could be. I have already started IF, mixing it up, as Dr. Fung advises. I struggle with the idea of lowering the protein levels, based on what I've read from Dr. Eades, Phinney & Volek, and others. For me, the range recommended would be 50 - 135 grams of protein daily. I usually get around 100 grams, so maybe I'll trying dropping it to 70 grams or even less and see what happens.

    I've also seen a pattern of menopausal women who have never done LC/HF before have a lot more success in losing weight than menopausal women who have been doing LC/HF for years already.

    As for the advice to reduce stress and get better quality sleep, it's not as easy as it sounds. Just sayin'.

  17. Suzy
    Thank you for this article, it came just when I needed it. I'll be 50 soon (peri-menopausal), but in my early 40's, I gained about 40 lbs, seemingly overnight. Every time I got on the scale, while dieting, I was gaining weight and I've tried all kinds of diets. It was beyond frustrating and a major hit to my self-esteem. Especially when I have successfully lost weight before (post-baby).

    I've done a few turns on LCHF, and would lose no more than 6 lbs, and no more. I found Dietdoctor this last go around and I LOST 10lbs, but that was it. I got frustrated and quit. I gained 7 lbs back and am finally back in the mindset of doing LCHF again. I'm upping my fat intake and lowering my protein, and see how that works. keeping fingers crossed. I already had been doing IF, even when I was off LCHF.

    I'm glad to see hormonal issues finally being addressed. Many of the success stories involve being a diabetic, which did not apply to me. And I only saw one story that reflected difficulty in losing weight, despite adhering to LCHF. Ah hah, THAT gave me hope and tells me I'm not alone.

    Thank you.

  18. Filomena
    Hi Lisa!
    I really appreciated this post. I was also diagnosed with Breast Cancer in 2015. And, now on Zoladex and Aromasin...(estrogen blockers that gives all the same problems as menopause..including weight gain) like you! Thank you for the tip of vitamin D!
    I wish you all the best!
    Best regards from Lisboa-Portugal
  19. Louisa
    I am 41 and still premenopausal but I gained a ton when I hit 40. I had been doing LCHF for a number of years, but just before having babies had to quit due to dairy allergies and being unable to sustain LC without dairy. I did do dairy free hflc for awhile and felt utterly miserable and fatigued and always craving 'something'. I still ate well though when i quit lc and didn't gain at that point. During pregnancy 2 I kept HFLC and afterwards, and just started gaining weight. Then when I hit 40 it got even worse. I finally decided I wasn't going to restrict carbs anymore but eat whole foods and plenty of meat and I am losing some weight. Not sure why that is, but I have more energy with more carbs like fruit and beans. I kept lots of olive oil, some nuts, and cut back out dairy which had crept back in. Only grain is rice which I don't crave much of. Lots of veg seems to help. No calorie restriction though - at least that is something I never did. I think people are all different.
  20. Dee Bradley
    I really enjoy reading the comments and more so the articles. How far we have come from Atkins first controversial book! I am 70 years young and I was diagnosed diabetic 3 years ago. A1c 7. I returned to strict LCHF and although I did not drop any pounds my A1c dropped to 5. Then I read about protein being the villain! I also read about using your body fat instead of eating fat and intermittent fasting. It all seemed to just click into place!! Today I am eating one meal a day, salad( 3oz tuna, romaine, radish, celery, onion, cherry tomatoes and ranch dressing mixed with lemon juice.) It is a plate full and is very satisfying. The snack is before bed and is 3 sticks of string cheese with 3 stalks of celery. Then fasting for 18 hours. This is what saved my sanity and broke my plateau. I enjoy variety and I have used many of the recipes listed here. ALL this information was from the amazing Doctors on this site. Thanks so much!
  21. Karen Mack
    Mechelle, are you referring to the talk by Dr. Rosedale on this site? I definitely want to hear more about what he is saying.

    I related to this article and many of the comments. I have been peri-menopausal since the age of 46. At 55, my last period was in the spring and my fingers are crossed! I did LCHF first 4 years ago, very successfully. Then something happened, fell off, issues multiplied. The way back has taken me through hormone therapy, all kinds of different versions of low carb, different ways of fasting and now iodine protocols, niacin and megadose Vit C (in addition a long list of supplements). Ready to try almost anything at 80 lbs overweight. So many things seem to help for a bit but turn out to be 2 steps forward and 3 back. Experiencing some relief now with the supps plus a weight trainer 2 days a week, about to add yoga and I think I will look into this idea of lower protein than the 100 grams or so I have been consuming. I am feeling better but the weight just will not budge. UGH. I don't need perfection, just something approaching normal for me.

  22. Heide
    While the result of a couple of years of LCHF has been stopping the scary, slowly creaping up of a few pounds of weight each year, it has still been a bit dissapointing not being able to lose any weight at all. I am 57 years old and had menopause a couple of months ago. I would like to lose 35kg. Bulletproof coffee doesn't work for me, I start gaining. I have found out that eating two boiled eggs for breakfast works so much better for me instead of not eating breakfast, although skipping breakfast has always been easy for me. And I must eat pork chops in the evening when I feel hungry or unsatisfied after eating fish, beef, chicken for lunch. Also, I must eat a very satisfiying meal between 7 and 8 pm, so that I do not get hungry in the later evening. I have to make sure, I get an unfeminine amount of protein on my plate regularly. Adding extra fat usually does not work for me. 10% dairy products seem to work best at the moment, instead of 3,5 or 30% products. An exception seems to be after eating more/too many carbs, then a good portion of butter calms the carb cravings and gets me back on track. I am happy to say that in the past months I have finally lost a couple of pounds! I think switching to eating the breakfast eggs brought the turn around. Go figure!
  23. Malena
    Thank you sooooo much for this article!!! PLEASE, PLEASE, PLEASE design a LCHF meal plan specific for us!!! We are a very large group of people. Thanks again!
  24. Sharon
    I am on an anti depressant so not sure that contributes to weight gain... I lost 30 lbs. a couple of years ago...took me ages to loose it on low carb. Now nothing! I have been doing it since April , writing a food diary...clean eating ,cook all my own food but not 1lb have I lost. I've done fasting.......So frustrating . I have my step daughters wedding to attend back in the UK in October and was hoping to feel my best. I'm 61 and never had a weight problem until I hit 50 plus taking the anti depressants. I wouldn't mind if I over eat but I'm not hungry and only eat lunch and dinner. Never had a huge mid section before...l just cannot get rid of it! Rant over!
  25. Brenda
    Just another post menopausal woman (57) so happy with the post and comments. I too have been LCHF for at least 5 years, but have also not been able to lose weight. I started IF this year once Dr. Fung's book came out; I am now down to 1 meal a day so fast for 20 hours. Its what I need to do to not gain weight. As for the last "tip #10, I think it is right on; we have to be realistic. Some of us are not ever going to lose weight but I am thankful I can now eat without gaining weight, and remain healthy.
  26. Samantha
    Just wanted to give everyone an update. Since adopting the recommendations suggested by the DietDoctor team I have lost 5 pounds (in approximately 4 weeks). This is the first time the scales have gone down in a very long time. I think the 24 hour fasts twice per week work for me. I pick days when I'm not feeling very hungry and go with it. The other days I change it up so 16h fast or regular day with a keto breakfast. I'm using the dairy free keto menu plan and I don't have the nut or cheese snacks anymore. I had no alcohol for the first two weeks but now have some wine or vodka/sodas. The interesting thing is that night time hot flashes stopped immediately with the food changes. Coincidence? Who knows. But I am sleeping better. I feel nourished, I have energy, and I'm not hungry. I'm hopeful that I continue to lose weight and yes I am realistic about focusing on health not numbers. Everyone has to eat what works for them - nutrition is not one size fits all. For me the changes listed in this article have been a huge help and the only thing that has worked.
  27. Jeanette
    It is important to monitor your hormone levels. I put on weight when I commenced HRT about 5 years ago, despite being very fit. I went off it when I started LCHF - I lost weight but immediately my hot flushes, night sweats returned, to a point where they were waking me up every hour, and every hour during the day except absent for a couple of hours in the middle. Thyroid tests normal. All other measures the best for years due to the LCHF. After six months of pointless suffering, I returned to HRT (Livial). My weight plateaued, but at least it didn't go up. I am 67 years old on 16:8 fasts. I am beginning to realize that I can remove HRT for about a month, lose a little more, go back on it as soon as the flashes return, plateaux for a while, and repeat. I am hoping that I can stay off it each time for longer periods until one day my weight is down to where I want it to be and the hot flushes do not return. I have lost 8kgs but my goal is to lose another 8kgs. But as proper restful sleep is more important to me than my end weight, I feel this is the best way forward for me.
  28. Anne
    Samantha -- so glad to hear these tips are working for you. As the writer and a post menopausal woman myself, I actually started doing them, too. And in the last two weeks my waist has shrunk another inch, and I have a dropped another pound. For me it was cutting down on the nut snacks and really asking myself how hungry I was for a snack or for seconds at a meal. I realized I sometimes snack on nuts out of boredom and needing a mouth feel. I am making myself a cup of tasty herbal tea instead and it seems to work. Sarah Hallberg's advice about just eating half the amount first at meals, then waiting to see if you wanted or needed more, has also had me consuming much smaller sizes of steaks and casseroles on my plate with the bonus that I have a ready-made lunch the next day.
  29. Samantha
    Hi Anne - Minus 6 lb and counting :-). Feeling much more comfortable. Amazing that your waist measurement changes that much with 1 lb on the scale! Good to know.
  30. 2 comments removed
  31. Brenda G
    Hi. I agree with these steps. I have been post menopausal for years now and I've been over 200 lbs since is was 18. I recently learned that after doing weights and a bit of cardio that I should wait an hour or 1.5 hours so that the maximum amount of Growth Hormone is released. It seems to be helping.

    The upper belly fat that is so hard to get rid off seems to be slowly disappearing now. I've incorporated short fasts and I'm really working at only eating when I'm physically hungry.

    I've cut out most sweeteners and I'm watching how much whipping cream I put in my tea in the evening. At 100 calories/tbsp. it adds up quickly!

    This is the way to go. Love how much energy I have and NO Cravings! Doing weights was a bit of a struggle at first but it's so much better now! And I can still swim 40 laps! At the beginning I was having to stop for a breather every 6 laps.... LOL.... Takes time switching to ketosis! SO hang in there! It's worth it!
    Brenda G Thompson

  32. Brenda G
    Should read, " wait 1 hour to 1.5 hours before eating after a work out so the maximum amount of growth hormone is released."
  33. 1 comment removed
  34. lynda anderson
    I have had less than 20g carbs per day for over a week, my ketone stick shows one movement towards ketosis. I have been taking salt tablets. I feel awful, my muscles are weak and just dont feel good. I started on January 1 and lost 3 kilos, but now nothing. i have cut back on protein and upped my fats (still programmed from my no fat days). Any suggestions Lynda
  35. Barb Lock
    Thank you sooooo much for this article. I'm a 74 year old woman and have been on this diet for almost 2 years. I weighed almost 200 pounds when I started and am now down to 135. I also had other health problems - an arthritic ankle, taking over 1000mg daily for pain and irritable bowel. Both of these are resolved. However, I seemed to have reached a plateau despite intermittent fasting and perhaps I am being unrealistic about losing more, but I will try with some of the suggestions above particularly excess protein and weight lifting. I'm so passionate about this diet, I promote it whenever I can - to the point that my sister will only let me talk about it for five minutes when she's around. LOL.
  36. Elle Rossi
    I have been on a LCHF for a year and slowly lost 8 kilo before reaching the dreaded plateau and then started to regain weight which is horrendous!
    I would like to see what a lower 100gram or less protein, 20gram carb and lower fat diet looks like and I guess it will certainly have to incorporate some IF which is ok.
  37. Anne
    Hi Lynda - I am the author of this article. I am sorry you are not feeling well. I am not sure what is going on with you but I can look into it and perhaps develop a new article that might help shed some light. In my time of writing about LCHF and in coaching perimenopausal women friends 40+ (and being one myself) I have seen some patterns, especially among women who have been calorie restricting all their adult life: it can take time to reset your metabolism and gauge your understanding of hunger signals. You might not be eating enough. Some have found they feel better by carb cycling, adding in maybe every five days or so a bit higher carbs (not eating doughnuts or chips!) but healthy carbs like yams and higher carb veggies. They can do it and still losing weight. I always tell friends "If you don't feel great doing LCHF it might not be the right choice for you." Can you tell us in these comments what a typical day of eating looks like for you, breakfast lunch and dinner? I can ask some experts whether they can discern why you feel so awful.
  38. Samantha Dalby
    Hi all - An update - I have now lost 17 lbs and I am back down to my pre-menopause weight for the first time in 2 1/2 years. I feel great. The ten tips got me rolling and then I was able to tailor the recommendations to suit me and continue losing weight. I still do two 24 hour fasts per week and limit my consumption of nuts, cheese and alcohol to the weekends if I feel like having those things. Just a message to all the readers - I really think changing from 16 hour fasts to two 24 hour fasts per week was what got things going for me. I thought it would be hard and it isn't at all. On fasting days I drink lots of water, some coffee and tea and I have some raw veggies if I am active and feel hungry. Thanks so much for your help Anne and the DD team. I will send some pictures when I get a minute.
    Reply: #46
  39. Anne Mullens
    Wow, fantastic news Samantha! That is really great to hear. I hope your experience can help others in a similar situation. Thanks for sharing the update.
  40. Donna
    I'm 54 - post-menopause due to hysterectomy who takes a hormone replacement. Like others my weight has done the slow creep since about 45 when I tore my first rotator cuff and stopped doing Zumba. I have been on the LCHF/Keto for 2 weeks and while the keto sticks show dark and I feel great, I have not lost One.Single.Pound. I skip breakfast, don't snack and don't do any 'bombs' or cream in my coffee. Lunch at noon, dinner at 7 and nothing else. I take Vitamin D and Magnesium and Potassium. I plan on reducing my protein intake immediately and I readily admit I probably don't drink enough water, but I wonder if anyone else experienced this stall at the very beginning - I expected to lose at least some water weight. It's hard to stick with it with no results. Thanks friends!
  41. Donna
    Hi Its Donna again. 3 weeks now and I'm down ONE POUND. HELP!
  42. Ellen
    Thank You so much for this post. I just turned 60 this past November and all of sudden I have been doing a lot of eating when I am not hungry. This post has renewed my spirit and drive.
  43. Anne
    Hi Donna - As the writer of this post, I know that it can be hard to stick with it early on with no results. I have had lots of post menopausal women talk to me about it this past year. If you otherwise feel good -- if you enjoy the food, like the way your body and head feels, then just try sticking with it and not weighing yourself for a while. One friend was very discouraged by no weight loss at first, but realized her joints and head felt better and her cravings were gone so she stopped weighing herself and just enjoyed feeling better. She didn't weigh herself for more than 3 months, then stepped on the scale a few weeks ago and was down 17lbs. She is not sure what happened. (Her husband lost 10lbs the first two weeks!) I think it can be much slower for women of our age if weight loss is the only goal. And that can be very discouraging. But focus on feeling good and strong, and your weight may eventually "normalize" to what is healthiest for you. I am sorry that I cannot be more helpful than that! Anne
  44. Scott Manuel
    Having a healthy diet is a must especially to those age is 30 and up. Though it's not an easy thing to do, but yeah we need.
  45. Leo
    Liebe Samantha ,

    ganz aufgeregt habe ich Ihre Geschichte gelesen und dachte wow .....das ist ja wie bei mir . Ich bin 57 Jahre alt und hatte meine letzte Periode vor 12 Monaten . 2 Jahre zuvor begann ich mit LCHF und hatte nach anfänglichen Schwierigkeiten gute Erfolge. Schwierigkeiten weil ich aus einer Eßstörung heraus kam und damit verbunden ein absoluter Kontrollfreak war. Mit viel Geduld und gutem Zuspruch und enger Betreuung verlor ich meine Angst Fett zu essen . So verlor ich 24 kg . als ich in die Menopause kam vermehrte sich mein Gewicht zusehends um insgesamt 8 kg . Ich suchte nach einer Möglichkeit dagegen zu steuern, so kam ich zu Keto . Aber auch da gibt es so viele unterschiedlichen Ansichten . In den Gruppen in denen ich bisher auf FB war legen die Makros auf 5% KH , 85% Fett und 25% EW. So habe ich zumindest nicht mehr zugenommen . Aber auch nichts verloren . Dann habe ich vor 2 Monaten begonnen mit IF ohne Frühstück . Essen ab 12 Uhr bis 20 Uhr . Nichts passiert . Ich bin 174 groß und liege bei 94 kg . Versuche jetzt mein Protein herunter zu setzen auf 55 g . Irgendwie komme ich nicht weiter und ich werde langsam müde und deprimiert . Ach ja und nicht wundern mein Mann Leo hat diesen Account für mich eingerichtet deswegen steht sein Name oben ;-)
    Liebe Grüsse Petra

  46. Annette Reeder
    Julianne - I would love to chat with you about your success. Please connect with me via Facebook if possible. Annette Reeder, The Biblical Nutritionist
  47. julieann
    I work the midnight shift and I am 54 years old. Post menopausal. Started LCHF March 5 2018 and can not believe how much better I feel. Did not get on a scale when I started ( I think around 145 ) and still have not got on one. At this point, just feeling less tired because of crazy unnatural sleep I am good with that. If I can lose a few pounds that would be a bonus but just living the crazy midnight shift and feeling great is ok for me at this time.
  48. Maria
    First I would like to thank all the doctors who have educated me on dietdoctor,com!! I am turning 55 next month, and I started Keto on Jan, 10th, 2018. Best day of my life!! I have lost 48 pounds, and have so much energy, I sleep all night, and I keep sharing this web-site with all those who ask me, "What are you doing?" I respond, "Keto, but you first have to educate yourself with these Awesome group of doctors !!! I have learned so much from watching their videos over and over, and it keeps me motivated and inspired daily!! If you ask me how am I doing it, I would say keeping it simple! I have never exercised, and I know to stay away from some good carbs like nuts and cheese because I love them to much and I know I will over eat them!! I have fasted 4 full days since I started. I never eat breakfast, sometimes I skip lunch because I'm just not hungry. I do want to start some kind of regular exercise because I know one day I will hit a plateau, but until then, I enjoy just walking around the malls. I wish everyone the very best on their journey, some might start off slow, but at the end, we are all healthier!!
  49. Kelley
    Sounds like you are doing fine eating that way. Why are you on this website?
  50. Gloria
    I placed a comment about 2-3 days ago and I did not find a answer to my question nor I see my comment. However, I found one post by Dr. Fung “Does eating extra fat make you fat? This could help me understand better the role of fat in the food to be consumed. However, the article said that "if you are obese or overweight then eating more fat will make you fat.” I am surprise with this statement, because the keto-diet is suppose to help lose weight by reducing your fat mass. Is it?. All the site of the diet doctor and that IMD are to treat obesity and diabetes, So How can they conclude that an obese person will turn more fatty if eating fat? should an obese person NOT TO FOLLOW the KETO diet?

    A second comment that I have is that the “physiology of eating fat” (same article) was restricted to long chain FAs which do not “affect the liver” but goes to be deposited into adipose tissue. The KD , may have mostly MCFAs and this are absorbed into the portal circulation going directly to the liver and apparently oxidized, really?.

    What I would like to know whether there are studies demonstrating that FAs in diet are oxidized and not deposited in the adipose tissue (because of the ketogenic state). if the FAs are stored then the fat in any person will increase. this apparently is not so, how can you explain it?

  51. Baldvin Mikaelsson
    Thanks for sharing, this is a fantastic post. thank you! Really Cool.

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