Things to Know When Approaching Weight Management in Menopause, With Caissa Troutman, M.D.

In an interview with The Educated Patient, Caissa Troutman, M.D., physician and founder of Midlife reMDy/Weight reMDy, encourages women — especially those navigating perimenopause, menopause and weight challenges — to view health and weight management through a “four-pillar” framework: nutrition, physical activity, behavior management and medications. This approach helps patients build sustainable strategies while replacing self-blame with self-compassion.

Nutrition

Troutman emphasizes adequate protein intake as a cornerstone for both appetite control and muscle preservation. She explains that protein helps lower hunger-stimulating hormones like ghrelin and is essential for maintaining lean muscle mass — something that naturally declines in midlife. For practical application, she suggests starting the day with at least 30 grams of protein at breakfast, which can help manage hunger for up to eight hours.

Physical Activity

Strength training is especially important during menopause due to muscle loss. Many women may feel intimidated by the idea of going to a gym or committing to long workouts, so Troutman advises redefining exercise expectations. Start small (as little as 10 minutes, three times a week) using body weight, resistance bands or dumbbells if available. The goal is to create a habit that can gradually expand over time.

Behavior Management

A shift in mindset is key. Troutman urges patients to replace self-criticism with self-compassion. Recognizing the biological and physiological changes of midlife helps women approach challenges without guilt. Sleep, often overlooked, is a crucial part of this pillar. As she notes, sleep takes up about a third of our lives, and prioritizing quality rest supports hormonal balance, mood and weight management.

Medications

When appropriate and approved, medications can be a valuable tool for weight management and easing menopause symptoms. Troutman reminds patients that it’s not a failure to use medical support — it’s part of a comprehensive, science-based strategy.

Throughout the interview, Troutman reinforces a central message: It's not your fault if you’re struggling with weight gain or menopause symptoms despite doing what worked in the past. These changes are driven by biology, not personal shortcomings. She also encourages women to advocate for themselves, seek clinicians who are both competent and compassionate, and avoid internalizing dismissive narratives like “it’s just aging.”

Whether you’re adjusting your diet, building strength, improving sleep or exploring medications, midlife health changes can be addressed with the right plan — and there’s no medal for suffering through symptoms without help.

5 Things to Know When Approaching Weight Management in Menopause

• It’s not your fault: Weight and menopause changes are driven by biology and physiology.
• Four pillars matter: Nutrition, movement, behavior and medications work best together.
• Protein is key: Start the day with at least 30 grams of protein to control hunger and protect muscle.
• Self-compassion beats self-criticism: Recognize your challenges without guilt.
• Prioritize sleep: It affects hormones, mood and weight.