Is HRT enough to lose weight in menopause?

On Ep. 324, Dr. Brighten, who has prescribed menopause hormone therapy for over a dozen years, is blunt: HRT is not enough, no matter how many people talk about it like the gospel. She says nutrition and lifestyle go a long way and that the way you show up every day has a tremendous impact on your outcomes. She also pushes back on the idea that you should just suffer through perimenopause. Hormones are one option, and she says there are natural therapies and non-hormonal medication options if you'd rather not go that route.

On Ep. 221, Alicia Erickson shares that she started bioidentical HRT at 51 because hot flashes were wrecking her sleep, and she gets blood work with a functional medicine doctor about every six months. She feels much better, but she says HRT doesn't let you off the hook. You can't settle for "this is just my body now." Her emphasis is on putting a layer of muscle on your body, and if a doctor tells you weight gain is simply what happens at this stage, she suggests finding a new one.

The woman featured in the video "Quit Cardio, Ate More, Lost 60 Pounds in Menopause" puts it most clearly. She started HRT a couple of years in and says it helped, but mostly her results came from the foundation she already had: eating enough, lifting with progressive overload, and recovering. In her words, the hormones supported what she had built. They didn't build it for her.

So if you've started HRT and the scale hasn't moved, that's not a sign you're broken. It's a sign the plan needs the pieces hormones can't supply. Whether HRT is right for you is a conversation to have with your doctor, ideally one who will take your symptoms seriously.