Menopause Weight Gain Causes

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Women over 50 understanding menopause weight gain causes and evidence-based solutions

Discover the scientific reasons behind menopause weight gain causes. Evidence-based explanations of hormonal changes, along with proven solutions that actually work for women 50+.

If you’ve noticed the scale creeping up despite eating the same way you always have, you’re not imagining things. Menopause weight gain is real, scientifically documented, and affects up to 90% of women during this transition.

But here’s what most doctors won’t tell you: it’s not just about eating less and exercising more. The hormonal changes happening in your body during menopause fundamentally alter how you store fat, burn calories, and respond to food.

Let’s dive deep into the science behind menopause weight gain causes and, more importantly, discover the evidence-based solutions that actually work.

Table of Contents

  1. The Science Behind Menopause Weight Gain
  2. The Hormonal Cascade: What’s Really Happening
  3. How Your Metabolism Changes During Menopause
  4. Why Fat Goes Straight to Your Belly
  5. The Hidden Culprit: Muscle Mass Loss
  6. Insulin Resistance: The Weight Gain Accelerator
  7. Sleep, Stress, and Weight: The Vicious Cycle
  8. What Actually Works: Evidence-Based Solutions
  9. The Truth About Hormone Replacement Therapy
  10. Your Science-Based Action Plan

The Science Behind Menopause Weight Gain

Let’s start with the facts. Research published in PubMed confirms that while weight gain per se cannot be attributed solely to menopause, the hormonal changes during this transition are directly associated with increased total body fat and significant increases in abdominal fat.

Here’s what the science tells us:

The Numbers Don’t Lie

Average Weight Gain:

  • Women gain an average of 1-2 pounds per year during perimenopause
  • Total weight gain ranges from 5-10 pounds during the menopause transition
  • Waist circumference increases by 2-4 inches on average
  • Body fat percentage can increase by 5-8% even without weight changes

Timeline of Changes:

  • Perimenopause (ages 40-51): Gradual hormonal decline begins
  • Menopause transition (1-2 years): Most dramatic changes occur
  • Post-menopause: Weight gain may continue without intervention

Why Traditional Weight Loss Advice Fails

The Mayo Clinic acknowledges that menopause weight gain is different from other types of weight gain. This isn’t about willpower or eating too much—it’s about fundamental biological changes that require a different approach.

Traditional “calories in, calories out” advice fails because:

  • Your metabolic rate decreases by 100-200 calories per day
  • Hormonal changes alter appetite regulation
  • Fat storage patterns shift dramatically
  • Muscle mass naturally decreases, reducing calorie burn
  • Insulin sensitivity changes, affecting how you process food

The Hormonal Cascade: What’s Really Happening

Understanding menopause weight gain requires understanding the complex hormonal symphony that’s changing in your body. It’s not just about estrogen—multiple hormones are shifting simultaneously, creating a perfect storm for weight gain.

Estrogen: The Master Regulator

Medical News Today reports that low estrogen levels can cause weight gain or make it difficult to maintain a moderate weight, and this most commonly happens during menopause and perimenopause.

How Estrogen Affects Weight:

1. Appetite Control

  • Estrogen suppresses appetite by influencing leptin (satiety hormone)
  • As estrogen drops, you feel hungrier more often
  • Cravings for high-calorie foods increase
  • Portion control becomes more difficult

2. Fat Storage Patterns

  • Pre-menopause: Fat stored in hips and thighs (pear shape)
  • Post-menopause: Fat shifts to abdomen and internal organs (apple shape)
  • Visceral fat increases significantly
  • Subcutaneous fat becomes harder to lose

3. Metabolic Rate

  • Estrogen helps maintain metabolic rate
  • Declining estrogen = slower metabolism
  • Energy expenditure decreases even at rest
  • Fewer calories burned throughout the day

Progesterone: The Forgotten Hormone

While estrogen gets most of the attention, progesterone plays a crucial role in weight regulation:

Progesterone’s Weight Effects:

  • Water Retention: Declining progesterone can cause bloating and fluid retention
  • Sleep Quality: Progesterone has calming effects; low levels disrupt sleep
  • Stress Response: Works with cortisol to manage stress and inflammation
  • Thyroid Function: Supports optimal thyroid hormone utilization

Testosterone: Your Muscle-Building Ally

Yes, women have testosterone too, and it’s crucial for maintaining muscle mass:

Testosterone Decline Effects:

  • Muscle mass decreases more rapidly
  • Strength and bone density decline
  • Motivation for physical activity may decrease
  • Fat burning capacity reduces

How Your Metabolism Changes During Menopause

UChicago Medicine explains that the decrease in estrogen and progesterone, along with aging in general, triggers metabolic changes in the body, including a decrease in muscle mass that results in fewer calories being burned.

The Metabolic Slowdown: By the Numbers

Resting Metabolic Rate Changes:

  • Ages 40-49: Metabolism slows by 2-3% per decade
  • Ages 50-59: Additional 5-10% decrease during menopause
  • Post-menopause: Continued decline without intervention
  • Total impact: 100-200 fewer calories burned per day

What This Means Practically:

If you’re burning 200 fewer calories per day and eating the same amount, you’ll gain about 20 pounds per year. This isn’t about lack of willpower—it’s basic math.

The Thermic Effect of Food Changes

The energy cost of digesting, absorbing, and metabolizing food (called the thermic effect of food) also decreases during menopause:

  • Pre-menopause: 8-10% of daily calories burned through digestion
  • Post-menopause: 6-8% of daily calories burned through digestion
  • Impact: 50-75 fewer calories burned daily from eating

Mitochondrial Function Decline

Your cellular powerhouses (mitochondria) become less efficient:

  • Reduced energy production at the cellular level
  • Decreased fat oxidation capacity
  • Impaired glucose metabolism
  • Increased oxidative stress

Why Fat Goes Straight to Your Belly

One of the most frustrating aspects of menopause weight gain is how it changes where you store fat. Research confirms that hormonal changes across perimenopause substantially contribute to increased abdominal obesity.

The Belly Fat Explosion: Understanding Visceral Fat

Pre-Menopause Fat Distribution:

  • Subcutaneous fat (under the skin) on hips and thighs
  • Lower visceral fat levels
  • More favorable metabolic profile
  • “Pear shape” body type

Post-Menopause Fat Distribution:

  • Increased visceral fat around organs
  • More abdominal subcutaneous fat
  • Less fat on hips and thighs
  • “Apple shape” body type

Why This Happens: The Science

1. Estrogen Receptor Changes

  • Abdominal fat cells have fewer estrogen receptors
  • With declining estrogen, these cells become more active
  • They store fat more easily and release it less readily

2. Cortisol Sensitivity Increases

  • Abdominal fat is more sensitive to cortisol (stress hormone)
  • Menopause increases cortisol levels
  • This combination promotes belly fat storage

3. Insulin Resistance Develops

  • Declining estrogen reduces insulin sensitivity
  • Higher insulin levels promote fat storage
  • Abdominal fat is particularly responsive to insulin

The Health Risks of Visceral Fat

This isn’t just about appearance—visceral fat is metabolically active and dangerous:

  • Cardiovascular Disease: Increased risk of heart disease and stroke
  • Diabetes Risk: Higher likelihood of developing type 2 diabetes
  • Inflammation: Visceral fat produces inflammatory compounds
  • Hormone Disruption: Can interfere with remaining hormone production

The Hidden Culprit: Muscle Mass Loss

While everyone focuses on fat gain, the real villain in menopause weight gain might be muscle loss. This process, called sarcopenia, accelerates significantly during menopause.

The Muscle Loss Timeline

General Aging:

  • 3-8% muscle loss per decade after age 30
  • Accelerates to 1-2% per year after age 50
  • Can lose up to 50% of muscle mass by age 80

During Menopause:

  • Muscle loss can double or triple
  • Power and strength decline even faster than mass
  • Recovery from exercise becomes slower

Why Muscle Loss Causes Weight Gain

Metabolic Impact:

  • Muscle tissue burns 7-10 times more calories than fat tissue
  • Losing 5 pounds of muscle = burning ~350 fewer calories daily
  • That’s equivalent to gaining 36 pounds per year without dietary changes

Hormonal Impact:

  • Muscle tissue helps regulate blood sugar
  • Less muscle = higher insulin levels
  • Higher insulin = more fat storage

Activity Impact:

  • Less muscle = feeling weaker and more fatigued
  • Reduced inclination to be active
  • Lower daily calorie expenditure

The Estrogen-Muscle Connection

Estrogen plays a crucial role in muscle maintenance:

  • Protein Synthesis: Estrogen helps build and repair muscle tissue
  • Inflammation Control: Reduces exercise-induced muscle damage
  • Recovery: Speeds up recovery between workouts
  • Bone Health: Works with muscle to maintain bone density

Insulin Resistance: The Weight Gain Accelerator

One of the most significant but underrecognized causes of menopause weight gain is the development of insulin resistance. This metabolic dysfunction can make weight loss extremely difficult and weight gain almost inevitable.

What Is Insulin Resistance?

Insulin resistance occurs when your cells become less responsive to insulin, the hormone that helps move glucose from your blood into your cells for energy. When cells resist insulin’s signals:

  • Blood sugar levels rise
  • Your pancreas produces more insulin
  • High insulin levels promote fat storage
  • Fat burning becomes nearly impossible

How Menopause Triggers Insulin Resistance

1. Estrogen’s Role in Insulin Sensitivity

  • Estrogen helps maintain insulin sensitivity
  • It improves glucose uptake by muscle cells
  • Declining estrogen = declining insulin sensitivity
  • This effect can begin in perimenopause

2. Body Composition Changes

  • Increased visceral fat produces inflammatory compounds
  • These compounds interfere with insulin signaling
  • Less muscle mass = reduced glucose disposal capacity
  • Creates a vicious cycle of worsening insulin resistance

3. Sleep and Stress Factors

  • Poor sleep (common in menopause) worsens insulin sensitivity
  • Elevated cortisol interferes with insulin action
  • Chronic stress becomes more common during menopause

Signs of Insulin Resistance

You might have insulin resistance if you experience:

  • Physical Signs: Belly fat, skin tags, dark patches on skin (acanthosis nigricans)
  • Energy Issues: Fatigue after meals, afternoon energy crashes
  • Cravings: Intense cravings for sweets and refined carbs
  • Blood Work: Elevated fasting glucose, high triglycerides, low HDL
  • Weight Patterns: Difficulty losing weight, especially around the midsection

The Weight Gain Spiral

Insulin resistance creates a self-perpetuating cycle:

  1. High insulin levels promote fat storage
  2. More fat (especially visceral) worsens insulin resistance
  3. Worsening insulin resistance leads to higher insulin levels
  4. Higher insulin makes it nearly impossible to burn stored fat
  5. The cycle continues, making weight gain inevitable

Sleep, Stress, and Weight: The Vicious Cycle

Menopause doesn’t just affect your reproductive hormones—it disrupts your sleep patterns and stress response systems, both of which have profound effects on weight regulation.

The Sleep-Weight Connection

How Menopause Disrupts Sleep:

  • Hot Flashes: Night sweats can wake you multiple times
  • Hormonal Changes: Declining progesterone affects sleep quality
  • Anxiety: Hormonal fluctuations can increase nighttime anxiety
  • Frequent Urination: Changes in bladder function disrupt sleep

How Poor Sleep Causes Weight Gain:

1. Hormone Disruption

  • Leptin (satiety hormone) decreases: You feel less full after eating
  • Ghrelin (hunger hormone) increases: You feel hungrier throughout the day
  • Cortisol increases: Promotes fat storage, especially in the belly
  • Growth hormone decreases: Reduces muscle building and fat burning

2. Behavioral Changes

  • Fatigue leads to reduced physical activity
  • Poor decision-making around food choices
  • Increased reliance on caffeine and sugar for energy
  • Late-night eating becomes more common

3. Metabolic Impact

  • Insulin sensitivity decreases with sleep deprivation
  • Glucose metabolism becomes impaired
  • Fat burning is reduced during sleep
  • Recovery from exercise is compromised

The Stress Factor

Menopause often coincides with other life stressors, creating a perfect storm for weight gain:

Common Menopause-Era Stressors:

  • Career peak and workplace pressures
  • Caring for aging parents
  • Children leaving home (empty nest syndrome)
  • Relationship changes
  • Financial concerns about retirement
  • Health concerns and body image issues

How Chronic Stress Promotes Weight Gain:

1. Cortisol Elevation

  • Promotes fat storage, especially visceral fat
  • Increases appetite, particularly for high-calorie foods
  • Interferes with insulin sensitivity
  • Disrupts other hormones like thyroid and sex hormones

2. Behavioral Patterns

  • Emotional eating becomes more common
  • Exercise may feel like another stressor to avoid
  • Social eating and drinking may increase
  • Self-care often gets deprioritized

What Actually Works: Evidence-Based Solutions

Now that we understand the complex science behind menopause weight gain causes, let’s explore the evidence-based solutions that actually work. These aren’t quick fixes—they’re sustainable approaches that address the root causes we’ve discussed.

1. Strategic Nutrition: Beyond Calories

Forget generic “eat less” advice. Menopause requires a more sophisticated nutritional approach:

Prioritize Protein

  • Target: 1.2-1.6 grams per kilogram of body weight daily
  • Why: Preserves muscle mass, increases satiety, boosts metabolism
  • Sources: Lean meats, fish, eggs, dairy, legumes, protein powders
  • Timing: Include protein at every meal, especially breakfast

Manage Carbohydrates Strategically

  • Focus on timing: Consume carbs around workouts
  • Choose complex carbs: Vegetables, berries, whole grains in moderation
  • Consider lower-carb approaches: Many women benefit from 50-100g carbs daily
  • Monitor response: Track how different carbs affect your energy and weight

Embrace Healthy Fats

  • Why important: Support hormone production, reduce inflammation, increase satiety
  • Best sources: Avocados, olive oil, nuts, seeds, fatty fish
  • Target: 25-35% of daily calories from fat

2. Resistance Training: Your Secret Weapon

If you do only one thing for menopause weight management, make it resistance training:

Why Resistance Training Works:

  • Builds muscle mass: Counteracts age-related muscle loss
  • Boosts metabolism: Increases both resting and active metabolic rate
  • Improves insulin sensitivity: Helps reverse insulin resistance
  • Supports bone health: Crucial for preventing osteoporosis
  • Enhances mood: Reduces depression and anxiety symptoms

Optimal Resistance Training Program:

  • Frequency: 2-3 sessions per week minimum
  • Focus: Compound movements (squats, deadlifts, presses)
  • Progression: Gradually increase weight, reps, or sets
  • Recovery: Allow 48 hours between training same muscle groups

3. Intermittent Fasting: Timing Matters

Research suggests intermittent fasting can be particularly effective for menopausal women:

Benefits for Menopause:

  • Improves insulin sensitivity: Helps reverse insulin resistance
  • Promotes fat burning: Especially helpful for stubborn belly fat
  • Simplifies eating: Reduces decision fatigue around food
  • May improve sleep: When done correctly

Best Approaches for Women:

  • 16:8 Method: Fast for 16 hours, eat within 8-hour window
  • 14:10 Method: More gentle approach for beginners
  • 5:2 Method: Normal eating 5 days, reduced calories 2 days
  • Caution: Stop if sleep, mood, or energy worsens

4. Sleep Optimization

Improving sleep quality can have profound effects on weight management:

Sleep Hygiene Basics:

  • Consistent schedule: Same bedtime and wake time daily
  • Cool environment: 65-68°F helps with hot flashes
  • Dark room: Blackout curtains or eye mask
  • No screens: Avoid blue light 1-2 hours before bed

Menopause-Specific Sleep Strategies:

  • Layered bedding: Easy to remove during hot flashes
  • Cooling mattress pad: Can help regulate temperature
  • Relaxation techniques: Deep breathing, meditation
  • Consider supplements: Magnesium, melatonin (consult healthcare provider)

5. Stress Management

Chronic stress management is crucial for weight control during menopause:

Evidence-Based Stress Reduction:

  • Mindfulness meditation: Just 10 minutes daily can reduce cortisol
  • Regular exercise: Particularly effective for stress relief
  • Social connections: Maintain and build supportive relationships
  • Professional help: Consider therapy during major life transitions

Practical Stress Management:

  • Set boundaries: Learn to say no to excessive demands
  • Prioritize self-care: Schedule it like any other appointment
  • Find enjoyable activities: Hobbies, creative pursuits
  • Consider adaptogenic herbs: Ashwagandha, rhodiola (consult healthcare provider)

The Truth About Hormone Replacement Therapy

One of the most contentious topics in menopause weight management is hormone replacement therapy (HRT). Let’s examine what the current science actually says.

The Weight Gain Myth

Recent research from Essex Menopause Clinic confirms there is a widespread misconception that Hormone Replacement Therapy (HRT) causes weight gain. However, research does not support this view.

In fact, unpublished ZOE research found that postmenopausal women who take HRT tend to have less visceral fat than those who don’t take HRT.

How HRT May Help With Weight Management

Potential Benefits:

  • Preserves muscle mass: Estrogen helps maintain lean body mass
  • Improves fat distribution: May prevent shift to visceral fat storage
  • Maintains metabolic rate: Can help prevent metabolic slowdown
  • Improves sleep: Better sleep supports weight management
  • Reduces inflammation: May improve insulin sensitivity

Research Evidence:

Studies show there is strong evidence that estrogen therapy may partly prevent menopause-related changes in body composition and the associated increase in abdominal obesity.

Important Considerations

HRT Isn’t Right for Everyone:

  • History of breast cancer, blood clots, or stroke
  • Unexplained vaginal bleeding
  • Active liver disease
  • Personal preference against hormone therapy

Types of HRT:

  • Systemic HRT: Pills, patches, gels affecting whole body
  • Local HRT: Vaginal creams or rings for localized symptoms
  • Bioidentical hormones: Structurally identical to human hormones
  • Compounded hormones: Custom-mixed preparations

Bottom Line on HRT:

HRT can be a valuable tool for weight management during menopause, but it’s not a magic bullet. The decision should be made with a knowledgeable healthcare provider who can assess your individual risk-benefit profile.

Your Science-Based Action Plan

Now that you understand the complex causes of menopause weight gain, here’s a practical, evidence-based action plan you can start implementing today.

Phase 1: Foundation Building (Weeks 1-4)

Week 1: Assessment and Goal Setting

  • Get baseline measurements: Weight, waist circumference, body fat percentage
  • Track your patterns: Food intake, sleep quality, energy levels, mood
  • Blood work: Request comprehensive panel including glucose, insulin, thyroid, lipids
  • Set realistic goals: Focus on health markers, not just weight loss

Week 2: Nutrition Foundation

  • Calculate protein needs: Aim for 1.2-1.6g per kg body weight
  • Plan meal timing: Consider 14-16 hour overnight fast
  • Stock your kitchen: Remove processed foods, add whole food options
  • Start food tracking: Use an app to monitor macronutrients

Week 3: Movement Introduction

  • Begin resistance training: 2x per week, focus on major muscle groups
  • Add daily walks: Start with 20-30 minutes
  • Include flexibility work: Yoga or stretching 2-3x per week
  • Track your workouts: Note exercises, weights, reps

Week 4: Sleep and Stress Optimization

  • Establish sleep routine: Consistent bedtime and wake time
  • Create sleep sanctuary: Cool, dark, quiet environment
  • Start stress management: 10 minutes daily meditation or breathing
  • Evaluate progress: Reassess measurements and energy levels

Phase 2: Optimization (Weeks 5-12)

Nutrition Refinements:

  • Adjust macronutrient ratios based on your response
  • Experiment with meal timing (intermittent fasting approaches)
  • Consider targeted supplements (omega-3s, vitamin D, magnesium)
  • Address food sensitivities that may cause inflammation

Exercise Progression:

  • Increase resistance training to 3x per week
  • Add high-intensity intervals 1-2x per week
  • Focus on progressive overload in strength training
  • Include functional movements for daily life activities

Lifestyle Optimization:

  • Fine-tune sleep environment for better quality
  • Expand stress management toolkit with multiple techniques
  • Build social support systems for accountability
  • Consider working with professionals (nutritionist, trainer, therapist)

Phase 3: Long-Term Sustainability (Week 13+)

Creating Lasting Habits:

  • Identify your non-negotiables: Which practices make the biggest difference?
  • Build flexibility into your system: 80/20 approach for sustainability
  • Regular reassessment: Monthly check-ins with measurements and adjustments
  • Celebrate non-scale victories: Energy, strength, sleep quality, mood

Troubleshooting Common Challenges

Challenge: “I’m doing everything right but not losing weight”

Solutions:

  • Check for hidden insulin resistance (may need medical evaluation)
  • Ensure you’re eating enough calories (under-eating can slow metabolism)
  • Consider food sensitivities causing inflammation
  • Evaluate stress levels and cortisol patterns
  • Be patient—hormonal weight loss takes longer than typical weight loss

Challenge: “I can’t stick to the plan consistently”

Solutions:

  • Start with just one change at a time
  • Focus on systems rather than outcomes
  • Build in flexibility for real life
  • Find an accountability partner or support group
  • Consider working with a coach or counselor

Challenge: “I don’t have time for all these changes”

Solutions:

  • Prioritize the highest-impact activities first
  • Batch prep meals and workouts
  • Use efficient exercise methods (compound movements, circuits)
  • Integrate movement into daily activities
  • Start with 10-15 minute time blocks

Red Flags: When to Seek Professional Help

Consult with healthcare providers if you experience:

  • Sudden, unexplained weight gain (more than 5 pounds in a month)
  • Severe fatigue that doesn’t improve with lifestyle changes
  • Depression or anxiety that interferes with daily life
  • Sleep disturbances that don’t respond to sleep hygiene
  • Digestive issues or food intolerances
  • Joint pain or mobility issues that limit exercise
  • Signs of diabetes (excessive thirst, frequent urination, blurred vision)

The Mindset Shift: Redefining Success

Perhaps the most important aspect of addressing menopause weight gain is changing how we define success. The scale is just one measure—and often not the most important one.

Focus on Health Markers, Not Just Weight

Metabolic Health Indicators:

  • Waist circumference: More important than total weight
  • Blood sugar stability: Energy levels throughout the day
  • Blood pressure: Cardiovascular health marker
  • Sleep quality: Restorative sleep patterns
  • Energy levels: Sustained energy without crashes

Functional Improvements:

  • Strength gains: Can you lift heavier, climb stairs easier?
  • Endurance improvements: Can you walk farther without fatigue?
  • Flexibility and mobility: Better range of motion, less stiffness
  • Balance and coordination: Reduced fall risk

Quality of Life Measures:

  • Mood stability: Less anxiety, depression, irritability
  • Cognitive function: Better memory, focus, mental clarity
  • Relationship quality: More energy for social connections
  • Confidence: Feeling strong and capable in your body

Understanding Your Individual Journey

Every woman’s menopause experience is unique. Factors that influence your individual journey include:

  • Genetics: Family history of weight patterns and health conditions
  • Medical history: Previous health conditions, medications
  • Lifestyle factors: Stress levels, sleep quality, activity history
  • Timing of menopause: Early, typical, or late onset
  • Type of menopause: Natural vs. surgical menopause

Be Patient with the Process:

Hormonal weight gain often takes 6-12 months to address effectively. This isn’t like the weight loss you might have experienced in your 20s or 30s. Your body is going through a major transition, and sustainable changes take time.

Conclusion: Taking Control of Your Menopause Journey

Menopause weight gain isn’t inevitable, and it’s definitely not your fault. The hormonal changes happening in your body are real, scientifically documented, and require a different approach than traditional weight loss methods.

Key Takeaways:

  • It’s about hormones, not willpower: Declining estrogen, progesterone, and testosterone create a perfect storm for weight gain
  • Muscle loss is the hidden culprit: Preserving and building muscle through resistance training is crucial
  • Insulin resistance accelerates weight gain: Managing blood sugar through nutrition and lifestyle is essential
  • Sleep and stress matter enormously: These factors can make or break your weight management efforts
  • One-size-fits-all doesn’t work: You need a personalized approach based on your individual situation

Your Next Steps:

  1. Start with the foundation: Prioritize protein, begin resistance training, optimize sleep
  2. Be patient with the process: Sustainable changes take time, especially during menopause
  3. Focus on health, not just weight: Celebrate improvements in energy, strength, and wellbeing
  4. Seek professional support when needed: Don’t hesitate to work with healthcare providers, trainers, or nutritionists
  5. Connect with other women: Find a supportive community going through similar experiences

Remember: You’re not broken, you’re not lazy, and you’re not destined to gain weight during menopause. With the right knowledge and approach, you can maintain a healthy weight and feel strong, energetic, and confident during this life transition and beyond.

For more comprehensive guidance on implementing these strategies, check out our Ultimate Guide to Keto Diet for Menopause Weight Loss, which provides a detailed meal plan and step-by-step implementation guide.

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Disclaimer: This article is for educational purposes only and should not replace medical advice. Always consult with your healthcare provider before making significant dietary or lifestyle changes, especially if you have underlying health conditions or take medications.