Insulin Resistance in Perimenopause: Why Belly Fat, Cravings and Energy Crashes Happen

If you’re in perimenopause and suddenly gaining weight around your middle, craving carbs like crazy, crashing in the afternoon, or feeling like the things that used to work for your body just… don’t anymore — insulin may be part of the conversation.

And this is one I really want women to understand.

Because during perimenopause, changing estrogen and progesterone levels can affect how sensitive your body is to insulin. Add in stress, poor sleep, less muscle, a packed schedule, and years of grabbing whatever is easiest to eat between work, kids and everything else you’re managing — and your blood sugar regulation can start to struggle.

That doesn’t mean you need another restrictive diet.

It means your body may need a different strategy than it did at 30.

Why chronically high insulin matters

It makes accessing stored body fat harder.

Insulin is a storage hormone. When it stays elevated too often, your body gets the message to store energy rather than easily access stored fat for fuel. This is one reason women can feel like they’re eating reasonably well but suddenly accumulating more weight around the middle.

It can contribute to inflammation.

Insulin resistance and chronic blood sugar dysregulation often travel alongside increased inflammation — something we already want to be paying attention to as we move through perimenopause and toward our postmenopausal years.

It can leave you riding the energy roller coaster.
You eat → blood sugar rises → insulin rises → blood sugar drops → and suddenly you’re tired, foggy, hungry and looking for something sweet at 3 p.m.

Sound familiar?

And over time, it matters for your future health.
Insulin resistance is associated with a higher risk of type 2 diabetes, cardiovascular disease and cognitive decline.

This isn’t just about losing belly fat.

This is longevity work.

Some clues your insulin and blood sugar may need more attention

You might notice:

• More weight accumulating around your abdomen
• Feeling hungry again shortly after eating
• Strong cravings for sugar, bread or starchy foods
• Afternoon energy crashes
• Brain fog or difficulty concentrating
• Feeling shaky, irritable or “hangry” when you haven’t eaten
• New skin tags or darker patches of skin, particularly around the neck or underarms

None of these individually prove insulin resistance, but they’re signs worth paying attention to.

The good news? There is A LOT you can do.

And most of it isn’t complicated.

Start with protein.

Build meals around a meaningful serving of protein. For many women, working toward roughly 30–50 grams at a meal can dramatically change satiety, blood sugar stability and the ability to maintain muscle through perimenopause.

Add healthy fats, fibre and colourful plants.

Think whole, real food most of the time. We’re trying to create meals that keep blood sugar steady rather than sending it on a roller coaster.

Reduce the obvious sugar and ultra-processed carbs.

Sugary drinks, sweets, refined grains and highly processed snack foods make insulin regulation much harder when they’re showing up frequently.

And no, this does not mean you can never eat a carb again.

Which brings me to one of my favourite rules…

No naked carbs.

If you’re having carbohydrates, pair them with protein, healthy fat and/or fibre.

Apple? Add some nut butter.
Crackers? Add turkey or cheese.
Fruit? Pair it with Greek yogurt.

You’re simply changing the way that food lands in your bloodstream.

Walk after you eat.
This might be one of the simplest metabolic tools available to us.

Even a 10–15 minute walk after a meal encourages your muscles to pull glucose out of the bloodstream and use it for energy.

No workout clothes required. No gym required.

Walk the dog. Walk around the block. Clean the kitchen. Move your body.

And yes, fasting can be incredibly helpful — when we use it appropriately.

Intermittent fasting can help lower insulin exposure, improve metabolic flexibility and encourage your body to become better at switching between glucose and stored fuel.

But this is where I want women in perimenopause to be smart.

More fasting is not always better.

Your fasting strategy needs to take your hormones, stress load, sleep, nutrition, activity and stage of perimenopause into account.

Because the woman already running on cortisol does not need another stressor disguised as a health strategy.

That’s the piece that often gets missed.

The goal isn’t to eat less and exercise harder.

The goal is to teach your body to handle glucose well, keep insulin appropriately low between meals, maintain muscle, improve metabolic flexibility and create a body that feels safe enough to use the energy it has stored.

And that is a very different approach to perimenopause.

Disclaimer: The information provided in this post is not intended as medical or health advice. Always consult with your healthcare provider before making any decisions regarding your health or well-being.