Ever feel like your weight loss always stalls at a certain point? And no matter what you do, your weight just won’t budge during perimenopause? You’re not imagining it! The answer may lie in understanding your body’s 'weight set point.' Let’s explore why this happens, and how you can naturally reset it for sustainable weight management.

What is a weight set point?

Your body’s weight set point is like a thermostat for your weight — a default range that your body strives to maintain.

Your weight set point isn’t solely determined by what you do in the present. Genetics and early life nutrition play significant roles in setting a baseline for your body’s natural weight range. Factors such as what your mother ate during pregnancy or the types of foods you consumed in early childhood, and your dieting history can influence your set point later in life. While these elements are beyond our control, it’s empowering to know that current lifestyle choices, such as balanced nutrition, and building muscle mass with regular exercise, can still positively impact your set point.

The weight set point theory suggests that your body has a preferred weight range it defends, making it challenging to lose weight past a certain point, and/or keep it off through dieting. For women in perimenopause, understanding this concept is key to navigating weight changes effectively.

I've noticed this shift in my own weight set point. For many years, my comfortable weight was around 62 kilos. This was the weight I could maintain with ease while still enjoying life’s pleasures, like a glass of wine or a meal out. However, as I moved through perimenopause, I realized that my comfortable range had shifted slightly to 65 kilos. Initially, this change was frustrating, but understanding that my body was adjusting to a new set point helped me accept this as my new normal. It wasn’t about the number on the scale; it was about finding a balance that felt sustainable and healthy for me.

How to work out where your set point sits

Understanding your weight set point can be tricky because it’s not a specific number but rather a range your body naturally gravitates towards. Imbalances in your appetite hormones [LINK TO PAST BLOG ON HOW HORMONES MAKE YOU GAIN WEIGHT], and your body’s biochemistry through your adult life (eg PCOS), can make it harder to see what it might be. Here are some ways to estimate your set point:

Observe your natural weight stability

Think back to a time in your adult life when your weight remained stable without extreme dieting or exercise. This stable range is likely close to your set point. (Or was at that point, it could be a little higher now, which we’ll talk about below)

Pay attention to hunger and satiety signals

Notice if your body naturally regulates hunger when you attempt to lose weight (EG you feel significantly hungrier and have stronger cravings when you reduce your food or calorie intake past a certain point, to try and lose more weight). This could be a sign that your body is defending its set point.

Monitor changes over time

Track your weight over several months while eating intuitively. If your weight stabilises at a certain point, despite normal eating and exercise, this might indicate your set point range. Please note that I firmly feel intuitive eating is extremely difficult to achieve when your biochemistry and hormones are out of balance. These imbalances can drive cravings, confusing what you intuitively feel your body may need. You need to be very aware of what drives cravings for you, to be able to eat intuitively.

Why your set point rises in perimenopause

During perimenopause, the body's hormonal environment undergoes significant changes, affecting everything from mood to metabolism. One of the most frustrating changes many women experience is a shift in their weight set point, making weight loss more challenging. Here’s why this happens:

1. Hormonal changes

• Estrogen decline: As estrogen levels drop, the body becomes more resistant to insulin, and prone to storing fat, particularly in the abdominal region. This shift can raise your weight set point.
• Cortisol fluctuations: Cortisol, one of your body’s stress response hormones, tends to increase during perimenopause, with the added stressors many women face during this phase of life, and a reduction in natural stress resilience as progesterone declines.
• Increased stress levels: Stress management is crucial because chronic stress elevates cortisol levels, which not only promotes fat storage around the abdomen but also increases cravings for high-sugar, high-fat foods that can further elevate the set point. Cortisol may impact the weight set point as it reduces the body’s feeling of safety. Your body needs to feel safe and nourished to release fat mass and lower your weight set point.

2. Sleep disruption and poor sleep quality

Sleep disruptions are common in perimenopause, and poor sleep can lower leptin levels (the hormone that signals fullness) while increasing ghrelin (the hormone that triggers hunger), promoting weight gain and a higher set point.

It can feel impossible to get to sleep or stay asleep in perimenopause. I get it, I’ve had my fair share of sleep issues through perimenopause, however, they have always come when I have not been caring for myself, and my stress hormones have been too high. Check out my blogs on sleep to get some ideas on how you can get to sleep, despite perimenopause hormone changes.

3. Past dieting and calorie restriction

• Reduced Muscle Mass: When dieting, especially without strength training, the body may lose muscle mass alongside the fat mass. Since muscle burns more energy than fat, losing muscle can decrease your overall calorie burn, making it harder to maintain weight loss and contributing to a higher set point. This is compounded in perimenopause when we are more prone to lose muscle mass, and it is harder to rebuild.
• Metabolic Adaptations: The body is incredible. And incredibly adaptive, it’s always seeking to return to balance - ‘homeostasis.’ However, where balance is, it can be negatively influenced by what we’re putting into our bodies, our lifestyle, and the environment around us.

When faced with repeated cycles of dieting and calorie restriction, it makes several metabolic adjustments to protect against what it perceives as starvation or famine, which impact your body composition and set point:

• Lower Basal Metabolic Rate (BMR): Calorie and nutrient restriction can slow down the BMR, the number of calories or amount of energy (glucose) your body needs to function when at rest. This means your body learns to operate on less glucose overall, even if you increase your food quantity, this persists, making weight loss more challenging, and increasing your weight set point.
• Increased Efficiency at Storing Fat: When food intake is limited, the body becomes more efficient at storing any extra food (glucose) consumed as fat to prepare for future periods of scarcity. This efficiency can persist even after normal eating is resumed, contributing to a higher fat mass, and weight set point.

The combination of lower BMR and increased fat storage is called adaptive thermogenesis.

• Adaptive thermogenesis: This is the process where the body reduces its energy expenditure in response to lower energy intake. It may have long term impact on your thyroid. Even after the restriction has ended, and weight is regained, this reduced energy expenditure can persist, making it easier to gain weight and harder to lose it.
• Hormonal Changes: Dieting can disrupt hunger hormones, increasing ghrelin and reducing leptin, making you feel hungrier and less satisfied. This combination drives increased appetite and cravings, which can raise your set point as your body tries to maintain what it perceives as its ‘safe’ weight.

Metabolic adaptation and your set point

When the body undergoes calorie and nutrient restriction, it reacts by conserving energy and becoming more efficient at storing fat — a survival mechanism from our ancestors' days when food scarcity was common. Both of which can push the set point higher, because your body wants to protect you in case of pregnancy or if the famine continues, so you have stored energy to allow you to keep functioning and stay alive, until food resources are more available again. This is why, after a diet, many women experience a slower metabolism, and increased appetite until you have gained more weight to get back to your set point (or higher).

The psychological side

Repeated dieting can also create a cycle of psychological deprivation, where your brain is more likely to fixate on food, cravings increase, and willpower wanes. This cycle can lead to overeating once the diet ends, pushing the set point higher.

Why the usual weight loss methods make it worse

Traditional weight loss methods often miss the mark because they don’t consider the concept of the set point, leading to frustration and often more weight gain in the long run.

Calorie-restrictive diets

Drastically cutting calories slows down your metabolism. When your body senses a lack of food, it conserves energy, making you burn fewer calories. This metabolic slowdown persists even after you resume normal eating, which can result in weight regain, sometimes more than what you initially lost.

Weight loss surgery

Weight-loss surgery is similar to calorie-restrictive diets in that after the surgery there is rapid weight loss because you are not able to eat the quantity of food. There is also high risk of nutrient deficiency.

I see many clients who have not changed their food intake, food-related behaviours, or lifestyle, post-weight-loss surgery; who then put the weight back on again over time. Their body is triggered by the rapid loss to drive them back towards their weight set point. It’s important to weigh up the pros and cons of this extreme surgery, and avoid thinking of it as a quick fix, because it does have life long repercussions, and may not be maintainable for you.

Shake diets and meal replacements

These methods can provide a quick fix but don't address the underlying issues that contribute to a higher set point. They often lack sufficient nutrients to support hormonal balance and metabolic health, which is critical during perimenopause.

Intermittent fasting

While intermittent fasting has become a popular weight loss strategy, it can be problematic for women in perimenopause. Fasting can lead to increased cortisol production, adding stress to the body’s already fluctuating hormonal environment. For many women, this can exacerbate weight gain rather than aid in weight loss. Intermittent fasting also has the risk of insufficient nutrient intake, which triggers your body to encourage you to eat, in an effort to lift nutrient levels.

For a more in-depth look at this, check out my blog on Fasting in Your 40s.

Where GLP-1 medications fit

No conversation about weight in midlife is complete without this now, so let’s have it properly.

GLP-1 medications such as semaglutide and tirzepatide work on genuinely relevant machinery. They slow gastric emptying, act on appetite signalling in the brain, and improve insulin sensitivity. For a woman whose set point has drifted upward on the back of years of insulin resistance, that is not nothing, and I am not going to pretend otherwise.

Here is the honest set point question, though: do they lower your set point, or do they hold you below it?

The evidence so far suggests mostly the second. Which is why weight regain after stopping is common, and why these are increasingly discussed as long-term medications rather than a course of treatment. If the underlying settings have not changed, the body goes back to defending the number it was defending before.

That is not an argument against them. It is an argument for what you do alongside them. If you are taking a GLP-1, the work that actually moves your set point becomes more important, not less:

• Protein at every meal. Rapid weight loss on reduced appetite costs muscle, and muscle is one of the few things that lowers your set point rather than defending it.
• Resistance training, for the same reason. Losing weight while losing muscle leaves you lighter with a higher set point than when you started.
• Nutrient density, because you are eating considerably less food and still need the same vitamins and minerals.
• Slow and steady, since rapid weight loss is its own trigger for metabolic adaptation, and for gallstones.

Worth knowing too: GLP-1s do come with real digestive effects. A 2025 meta-analysis found they roughly doubled the risk of reflux and modestly increased the risk of gallstones, which makes sense given they slow gastric and gallbladder emptying and drive fast weight loss.

I have written more fully about where I land on these in my post on Ozempic for weight loss.

Why what works for her may not work for you

This is the part I most want you to take away, because it explains so much of the confusion.

Two women, same age, same symptoms, same set point problem. One starts fasting until midday and feels sharp, light and in control, and the weight starts shifting. The other tries exactly the same thing and gains weight, feels wired and exhausted at the same time, and cannot understand why she is failing at something that is supposed to be simple.

She is not failing. Fasting is a stressor. For a body with capacity to spare, a well-managed stressor produces a good adaptation. For a body already running on cortisol, disrupted sleep and a full life, it is one demand too many, and the response is to hold onto weight more tightly, not less.

The same is true of intense morning exercise. For some women a hard session before breakfast is genuinely energising and sets the day up well. For others, training hard first thing on an empty stomach spikes cortisol at exactly the wrong moment and changes how their body handles food for the rest of the day: higher insulin, more fat storage, more cravings by mid-afternoon. Same exercise, opposite outcome.

Neither woman is doing it wrong. They have different bodies, in different states, with different capacity on that particular day.

This is why I am so wary of universal advice about weight in perimenopause, and why "just fast, just train harder" is such poor counsel for so many women. The question is never "is this a good strategy?" It is "is this a good strategy for this body, right now?"

How to tell, practically:

• Watch what happens for two to three weeks, not two to three days. The first few days of any change feel odd regardless.
• Energy is the signal, not the scales. If a strategy leaves you steadily energised, sleeping well and not ravenous, it suits you. If it leaves you wired, tired, waking at 3am or eating the pantry by 4pm, it does not, no matter what the scales say in week one.
• Notice the day after. A morning session that suits you leaves you good the following morning too. One that does not shows up as broken sleep and afternoon cravings.
• Be willing to stop something that works for everyone else. This is the hard bit, and it is where most women get stuck.

What actually lowers your set point

Resetting your weight set point involves making holistic and sustainable changes that support your body’s unique needs during perimenopause. Here’s how you can do it:

1. Meet your nutritional needs

Focus on a balanced diet rich in whole foods, lean proteins, healthy fats, and a variety of non-starchy vegetables. Avoid processed foods and refined sugars that can disrupt insulin levels, increase fat storage, and impact your weight set point. Make sure to include enough protein to preserve muscle mass and support metabolic health. More muscle mass will help lower your weight set point.

2. Support your hormone metabolism and help your body adapt

Your body is not broken and it does not need rebalancing. What it needs is support for the work it is already doing: metabolising hormones efficiently, clearing them properly once they have done their job, and adapting to a genuinely new hormonal environment.

Practically, that means looking after your two master hormones, insulin and cortisol, because they are the ones with the most direct say over fat storage. Fibre, protein and quality fat at meals steady your blood sugar and reduce the insulin load. Gentle, regular movement improves insulin sensitivity without adding to the stress bill. And supporting the pathways that clear used oestrogen, through the liver, the bile and the bowel, means the hormones you do have are handled cleanly rather than recirculating.

Phytoestrogen-containing foods such as freshly ground flaxseed, legumes and fermented soy can help buffer the swings. Cruciferous vegetables support the liver’s clearance pathways. Enough fibre keeps the exit route open.

None of this forces your hormones to do anything. It gives your body what it needs to handle the transition well, which is a very different proposition and a much more achievable one.

3. Build stress resilience

Rather than trying to eliminate stress, which isn’t always possible, especially during this busy phase of life, focus on building resilience. Establish self-care routines that nourish your body and mind. Prioritise nutrient-dense foods, stay hydrated, ensure quality sleep, engage in gentle movements like yoga or walking, and find joy and connection in your relationships. Practices like mindfulness, meditation, and maintaining a sense of purpose can help manage stress. Reducing stimulants such as sugar, alcohol, and caffeine also supports hormonal balance and stress resilience.

4. Build and keep muscle

Worth pulling out on its own, because it is the single most underrated lever here. Muscle is metabolically expensive tissue. More of it genuinely lowers the weight your body settles at, and it protects you against the loss of lean mass that accelerates through perimenopause.

This is also why losing weight quickly through severe restriction is so counterproductive: a good share of what comes off is muscle, and you arrive lighter with a higher set point than you started with.

Resistance training twice a week and enough protein to support it does more for your set point over a year than any amount of cardio.

5. Set realistic expectations

Understand that your body’s needs change over time, and the goal should be health and wellness rather than returning to a weight you maintained decades ago. Focus on how you feel — your energy levels, mood, and overall health markers on your blood tests — rather than a specific number on the scale. Accept that your body's set point may not be what it was in your 20s or 30s, and that's okay.

6. Acknowledge your body’s changes

Embrace where you are now. Focus on how you feel, and what you can control: your nutrition, exercise, stress management, and self-care. By nurturing your body and mind, you promote overall health and well-being, which can naturally help in adjusting your set point.

The bottom line

It’s time to move away from focusing solely on weight loss as the ultimate goal. Instead, consider gaining health and well-being as your primary objective. This mindset shift allows you to work with your body’s natural tendencies rather than against them, fostering a more compassionate and sustainable approach to health. When you focus on nourishing your body and mind, weight loss becomes a natural side effect rather than the main pursuit. And your body feels safe, supported, and nurtured, and more likely to release fat mass.

Resetting your weight set point during perimenopause isn’t about quick fixes or extreme diets. It’s about nurturing your body, supporting how it metabolises and clears hormones, and building resilience through sustainable lifestyle changes. By focusing on overall health and well-being, you can achieve a weight that is both healthy and maintainable for you.

If your weight has settled somewhere you did not choose, and nothing you have tried is shifting it, the answer is almost certainly not to try harder at the things that have not worked.

If you are not sure which of these is holding you back, my free Perimenopause Blockers Quiz takes two minutes and will point you at the one worth tackling first.

PerimenoGO is four weeks of eating and living in a way that suits a perimenopausal body rather than fighting it, with the nutrition plan and recipes done for you. Let’s PerimenoGO.

And if you have a long history behind you, whether that is years of dieting, weight loss surgery, or a current GLP-1 prescription, that deserves a proper conversation rather than a generic plan. My free Clarity Call is 20 minutes. Book a Clarity Call here.

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