Understanding Weight and Menopause Symptoms, With Caissa Troutman M.D.

In an interview with The Educated Patient, Caissa Troutman, M.D., physician and founder of Midlife reMDy/Weight reMDy, wants women to know one thing above all: If you’re gaining weight or experiencing difficult menopause symptoms despite “doing everything right,” it’s not your fault.

Too often, she says, women blame themselves when their bodies change — especially during midlife. Many believe they simply need to push harder, eat less or exercise more, even when those strategies aren’t working. But according to Troutman, these changes are rooted in biology and physiology, not personal failure. Menopause and hormonal shifts can dramatically affect metabolism, fat storage and the body's response to lifestyle habits.

One key problem, she notes, is that women have been underserved in access to effective hormone therapy. Decades of negative publicity and misinformation have left many without potentially life-changing treatment. Her advice: Advocate for yourself. Learn from trusted, qualified professionals, but also seek a clinician who is knowledgeable and compassionate — someone who will listen, take symptoms seriously and not dismiss them as “just aging.”

Troutman hears from countless patients who have been told their symptoms are too minor to matter or that they should simply “push through.” She believes it’s time to change that narrative. Menopause-related symptoms — whether brain fog, joint pain, hot flashes or weight gain — are real, valid and often treatable. “There’s no medal for suffering,” she says. Women shouldn’t feel they have to endure symptoms without support just to prove they can.

She also reminds patients that every woman’s experience is unique. Some may pass through perimenopause and menopause with minimal issues, while others face significant challenges. Just as not everyone gets acne during puberty, not everyone will have severe menopause symptoms — but that doesn’t make anyone’s experience less real or worthy of attention.

For women struggling with weight changes, she encourages understanding that menopause can make weight loss more difficult, even for those who have never struggled before. Seeking help from a qualified health care provider can be a crucial step toward relief.