Women have an increased tendency to gain weight after menopause. The increase of body fat and central obesity may be due to hormonal changes occurring during or after the menopausal transition. The decline of endogenous estrogen and decreased physical activity are the major causes of these phenomena. The insufficiency of estrogen? leads to decreased basal metabolic rate and energy expenditure. Postmenopausal overweight and obesity increases the risk of hypertension, coronary artery disease, diabetes, and mortality. Weight control can reduce the obesity-related diseases. Lifestyle modification is essential in managing postmenopausal overweight and obesity. Diet, behavioral modifications, and physical activity are the major elements to reduce body fat and central fat distribution. Hormone replacement therapy helps to reduce the body fatness and to attenuate the accumulation of central fat in postmenopausal women. Antiobesity drugs are also selectively used in menopausal women. In conclusion, low-calorie diet, regular physical activity and estrogen replacement are likely to provide metabolic benefits for postmenopausal women's health.