Weight gain typically occurs between the ages of 40 and 65 as both men and women lose muscle mass and experience a slowdown in metabolism.
However, doctors and researchers indicate that for women, hormonal changes linked to the onset of menopause in midlife exacerbate the situation.
A report from the Wall Street Journal indicates that hormone therapy, when combined with strength training and dietary modifications, can lead to improved outcomes.
Increase during the forties and fifties
Researchers note that many women in their 40s and 50s observe that their weight begins to rise, even when their daily routines remain unchanged, and that losing weight becomes increasingly challenging.
Daniela Hurtado, an obesity physician and assistant professor of medicine at the Mayo Clinic in Florida, explains, referencing studies, that starting in middle age, women gain on average between 300 and 650 grams each year.
According to Dr. Kathleen Jordan, chief medical officer at MediHealth, a virtual care clinic for women over 40, hormonal changes during menopause, which typically start in the 40s when menstrual cycles become erratic, are linked to an average weight gain of about 3 kg.
The estrogen issue
Doctors and researchers clarify that the primary factor is the decline in estrogen levels that occurs with menopause.
Research has also established that estrogen plays a critical role in regulating body weight. One study concentrated on women over 40 and found that those who took medication to inhibit their ovaries from producing estrogen for 24 weeks gained over 3.5 pounds (1.5 kg) of fat.
Some studies suggest that estrogen may impact motivation to engage in physical activity. One study noted that women with estrogen were more inclined to exercise regularly and vigorously than those on estrogen-blocking medications.
Risk of diabetes
Low estrogen levels are also associated with diminished insulin sensitivity and elevated cholesterol levels, which can complicate efforts for women to maintain or achieve a healthy weight, increasing their risk for type 2 diabetes, according to Dr. Jordan.
“These findings imply that there could be a biological factor contributing to why middle-aged women gain weight, and it’s not solely based on their choices,” remarks Wendy Kuhrt, a professor of medicine at the University of Colorado and lead researcher on both studies.
A decrease in estrogen exacerbates the loss of muscle mass that both men and women undergo as they age.
Burning calories
The body utilizes calories through muscle; thus, when muscle mass declines, caloric expenditure decreases, whether at rest or during physical activities, states Dr. Ekta Kapoor, an assistant professor of medicine at the Mayo Clinic in Minnesota and an endocrinologist.
Metabolic and bodily changes in women during menopause also increase susceptibility to complications like hypertension and high cholesterol.
A recent study published in EBioMedicine examined over 600 women following a high-fat, high-carb diet for two weeks. Women aged 50 and over exhibited poorer metabolic health compared to premenopausal women, showing higher cholesterol and blood pressure, greater glucose and insulin resistance, and increased inflammation.
Expert recommendations
For overweight middle-aged women, menopausal hormone therapy, a form of estrogen often prescribed alongside progesterone to alleviate common symptoms like hot flashes, can be beneficial, according to doctors.
There is also some evidence that it can help mitigate the redistribution of fat to the abdomen commonly observed during menopause.
Hormone therapy can alleviate issues such as sleep disturbances and mood disorders that may indirectly contribute to weight gain.
However, hormone therapy alone is not sufficient to prevent midlife weight gain. Doctors stress that women also need to incorporate exercise and strength training into their routines. Weightlifting and other forms of resistance training can counteract muscle mass loss.
Resistance exercises
“While many individuals prefer cardiovascular workouts, it’s essential to aim for a balance of at least 50 percent cardiovascular and 50 percent resistance exercise,” advises Dr. Sylvia Johnsahne-Poli, a Maryland-based dietitian.
To tackle belly fat, Dr. Gunsahne-Poli recommends high-intensity interval training (HIIT) as a useful method. To lose weight and maintain that loss, women should target at least 150 minutes of exercise each week, though some might need closer to 300 to 420 minutes.
Dietary modifications
Dietary changes that involve increasing protein intake and reducing sugar can also be effective. Dr. Jordan suggests that consuming more fiber can improve cholesterol levels and slow food digestion, promoting a feeling of fullness.
A simple way to enhance fiber intake is to add a few tablespoons of chia or flax seeds to yogurt or cereal.
Additionally, Dr. Johnsahne-Poli emphasizes that managing stress levels is crucial for controlling body weight, as chronic stress elevates cortisol levels, which can increase insulin resistance and make weight loss more challenging.
Women under the age of 40
Dr. Kapoor recommends that women under 40 should aim to enter menopause at a healthy weight, and consulting a doctor can assist in achieving this goal.
For women attempting to lose weight during the transitional phase, it’s important to set realistic expectations, as losing weight can be particularly difficult during this time.
Understanding Weight Gain in Midlife: The Impact of Hormones and Lifestyle
Weight Gain and Midlife Changes
Weight gain peaks between the ages of 40 and 65 as both men and women experience a loss of muscle mass and a slowing metabolism. However, for women, the onset of menopause introduces additional hormonal changes that exacerbate weight gain, according to healthcare professionals and researchers.
Hormonal Changes and Their Effects
The midlife transition brings about significant hormonal shifts, particularly during menopause, which often begins in a woman’s 40s with irregular menstrual cycles. This phase is linked with an average weight gain of approximately 3 kg, as highlighted by Dr. Kathleen Jordan, chief medical officer at MediHealth.
Estrogen Withdrawal and Weight Gain
One of the primary drivers of weight gain during menopause is the decrease in estrogen levels. Research indicates that estrogen plays a vital role in managing body weight and fat distribution. For instance, a study involving women over 40 found that those on medications to block ovarian estrogen production gained over 1.5 kg of fat in just 24 weeks.
Changes in Metabolism and Muscle Mass
As women age, they experience a natural decline in muscle mass, which can further decrease their metabolic rate. Ekta Kapoor, MD, an endocrinologist at the Mayo Clinic, explains that muscle tissue burns more calories than fat tissue, making it essential to maintain muscle for effective weight management.
Complications Linked to Low Estrogen Levels
Low estrogen levels are associated with decreased insulin sensitivity and elevated cholesterol levels, increasing the risk of developing type 2 diabetes, as noted by Dr. Jordan. Research shows that metabolic health deteriorates during the menopause transition, leading to higher levels of inflammation, cholesterol, and blood pressure.
Expert Recommendations for Weight Management
Incorporating Hormone Therapy
For middle-aged women struggling with weight management, menopausal hormone therapy may be beneficial. This therapy often involves the administration of estrogen, sometimes in combination with progesterone, to alleviate menopausal symptoms such as hot flashes and night sweats.
Recent studies suggest that hormone therapy can also aid in reversing abdominal fat redistribution, which is common during menopause. Additionally, it can address mood disturbances and sleep disorders that may contribute to weight gain.
The Role of Exercise
While hormone therapy can help, it is not a standalone solution for preventing weight gain. Regular exercise, particularly strength training and resistance workouts, is crucial for combating muscle loss. Women’s healthcare professionals recommend a balanced exercise routine: approximately 50% cardiovascular and 50% resistance training.
Effective Exercise Strategies
- High-Intensity Interval Training (HIIT): Effective for targeting belly fat and improving overall fitness.
- Strength Training: Weightlifting or resistance exercises should be included at least twice a week.
- Cardiovascular Exercise: Aim for at least 150 minutes of moderate-intensity cardio each week.
Dietary Changes to Support Weight Management
Dietary modifications are equally vital. Increasing protein intake while reducing sugar can support weight loss. Dr. Jordan emphasizes the importance of fiber in the diet, which aids in cholesterol management and promotes satiety. Using chia or flax seeds in meals can boost fiber intake effectively.
Additional Dietary Tips
- Include a variety of fruits and vegetables in daily meals.
- Prioritize whole grains over refined carbohydrates.
- Manage portion sizes to avoid overeating.
Impact of Stress on Weight Management
Chronic stress can hinder weight loss efforts by elevating cortisol levels, which have been linked to increased insulin resistance. Dr. Sylvia Johnsahne-Poli recommends incorporating stress management techniques as part of a holistic weight management plan, including:
- Meditation and mindfulness practices.
- Regular physical activity.
- Engaging in hobbies that promote relaxation.
Advice for Women Under 40
Dr. Kapoor stresses the importance of approaching menopause at a healthy weight. Women under 40 should seek guidance from healthcare professionals to create a weight management plan that prepares them for the changes that come with aging.
Setting Realistic Expectations
For women navigating weight loss during this transitional period, setting realistic goals is essential. Weight loss tends to be more challenging during perimenopause and menopause; therefore, a gradual, sustainable approach is advised.
Conclusion
Understanding the physiological changes that accompany midlife can empower women to take proactive steps in managing their weight. By leveraging hormone therapy, adopting an active lifestyle, and making mindful dietary choices, women can navigate the challenges of aging while maintaining a healthy weight.
