Weight Gain

Many women struggle with their weight in midlife, gaining an average of 1.5 pounds per year between the ages of 40 and 60. While this might not sound like much, it quickly adds up: About two-thirds of women ages 40 to 59 and nearly three-quarters of women older than 60 are overweight (with a BMI greater than 25). Such a BMI carries a higher risk for type 2 diabetes, high blood pressure, certain cancers (including breast and uterine cancers), symptoms of menopause like hot flashes and night sweats, osteoarthritis and heart disease.

There are several reasons for weight gain among women in midlife—hormonal changes, the aging process, lifestyle changes, genetics or a combination of factors. The common belief that weight gain is a direct result of menopause is not supported by scientific evidence. Weight gain is more directly related to aging and lifestyle changes. Changes in body composition and fat distribution, however, may be related to menopause. This time in a woman’s life is associated with increased fat in the abdomen as well as decreased lean body mass. Hence the transition from a pear-shaped body to an apple-shaped body. We all lose muscle mass as we age, with women losing roughly 1% of their muscle mass each year, starting around age 30. With less muscle mass, we burn fewer calories at rest and also when we exercise. This, combined with a more sedentary lifestyle as we age, is a recipe for packing on the pounds—even if we keep to the same diet and exercise routines that used to work for us.
Behavior:
  • Reduce your screen time. While some days might be easier than others, try to set a daily goal and stick to it. Spending long periods of time sitting is hard on our bodies and, over time, can contribute to a slower metabolism.
  • Consider keeping a food diary, not so much to track what you eat as to track why you eat. Many people eat in response to difficult emotions or boredom rather than genuine hunger. A diary can help you discover if this is happening for you.

Diet:
  • Skip the soda and fruit juice. These can be huge sources of extra calories without providing any nutritional benefit. Instead, reach for low-fat dairy, almond or soy milk; water; or unsweetened tea.
  • Eat in moderation. Generally speaking, as we age, we need fewer calories to maintain a healthy weight. Pay attention to your body and its internal cues. You likely won’t need as much food on your plate at 50 in order to feel full as you did at 30.
  • Don’t buy foods you know you shouldn’t eat. If you know you can’t resist chips and ice cream, don’t buy them. If you’re buying them for others in your household, they’ll learn to live without them. They may even be healthier as a result, too.
  • Focus on nutrition. Eating a healthy, balanced diet rich in whole fruits, vegetables, grains and lean proteins promotes overall health.
  • Don’t skip meals, including breakfast. In longitudinal studies, women who made time for breakfast every day gained fewer pounds from year to year than women who skipped breakfast.

Exercise:
  • Take a walk after eating. Walking as little as 5-10 minutes after a meal helps direct blood flow to your extremities, slows digestion, keeps you feeling fuller longer and helps balance your blood sugar.
  • Exercise regularly. Exercise not only burns calories, it promotes improved sleep and brighter mood—so you’ll be less likely to grab a candy bar or soda for a shot of energy during a “down” time.
  • Keep track of your daily steps with a phone app, wearable fitness tracker or pedometer. While many authorities cite 10,000 steps a day as optimal, studies indicate that any amount of daily activity, sustained over time, can help ward off weight gain.

Lifestyle:
  • Get plenty of sleep—at least seven to eight hours a night. Research indicates that chronic lack of sleep fundamentally changes how the body processes calories and where it stores them.
  • Schedule at least three hours a week for yourself. This is time you’re not driving the kids, not cleaning the house, not at work—not doing anything to please anyone except yourself. Believe it or not, stress busters like this help reduce the amount of stress hormones we carry in our bodies: hormones that sap our energy and drive, as well as pack on the fat around our middles.
In most cases, weight gain can be reduced and reversed through lifestyle changes, diet and exercise. Occasionally, addressing undesired weight gain requires other forms of intervention, such as medication or surgery.

Treatments for Weight Gain
  • Medicine: The FDA has approved several medicines for long-term use for weight loss, with solid data on long-term efficacy and safety. Your health care provider can work with you to discuss your options.
  • Surgery: Balloons are changing the surgical strategies for weight reduction.
    - Endoscopic intragastric balloons are inflatable medical devices made of silicone that are placed in the stomach to make the patient feel full and achieve weight loss. The duration for most gastric balloons is typically six to twelve months. This option has the advantage of being less invasive and more affordable than surgical procedures such as gastric bypass surgery.
 
Invasive and medication treatment options are handled with our partners in the bariatric surgery center.
Why am I gaining weight if I haven’t started menopause yet?
Most women experience menopause between the ages of 45 and 55. For many women, these years also correspond to a time when their metabolism starts to slow in response to factors such as decreasing muscle mass, less physical activity, lack of sleep and chronic stress. Additionally, as the ovaries ramp down their production of estrogen and progesterone, this can have an impact on metabolism and where the body stores excess calories (in the midsection vs. hips and thighs).

What can I do to stop gaining weight?
If you haven’t made any changes to your diet and exercise routines, try making some. The diet and exercise habits that worked for you in your 20s and 30s are likely now providing you with more calories than your body needs. Take a look at what you’re eating on a daily basis. Read food labels. Where are your extra calories coming from? Soda? Sugar in your coffee? Your favorite brand of salad dressing? Find ways to cut down on your calories consumed by swapping in healthier alternatives.

In similar fashion, take a look at what you’re doing for exercise. Even if you work out regularly, are you spending more time in front of the TV or hunched over your smartphone than you used to? Make a point of upping your amount of physical activity, aiming for at least 30 minutes of moderate exercise three times a week.

I’ve done all that, and I still can’t lose weight. What is going on?
If you’ve cut calories and increased your physical activity but are still gaining weight, check whether you’re on any medications that list weight gain as a possible side effect. If medications aren’t the answer, it’s time to talk to a health care provider. Unexplained weight gain can be an indication of an underlying medical condition. A medical professional can help rule out conditions like hypothyroidism, and also advise on how best to address weight gain going forward.