The years surrounding menopause are associated with weight gain, increased central adiposity, and decreased physical activity. The weight changes reflect aging rather than menopausal status. Increased central adiposity and its negative consequences may be caused by hormonal changes that occur in the menopausal transition. Weight management before entering the menopause transition may be an effective preventive strategy. Dietary counseling and life-style programs that assist women in weight management strategies, including decreasing caloric intake and maintaining or increasing physical activity, can moderate weight gain and limit increases in lipids, blood sugar, and blood pressure. The role of medications in limiting body fat redistribution and weight loss is still under investigation.