Gaining Weight in Your 40s? Tips From a GYN

 "I have gained 10 pounds over the past 2 years!" There must be something wrong. "Please check my hormones!" This is a common request from 40-year-old patients. As I give them answers they probably won't like, I brace myself.

Your metabolism starts to decline as you age (a better term than "aging"). Your metabolism will begin to decline if you eat and exercise the same way in your 30s as in your 20s. You may also start to gain weight. As you approach perimenopause (usually in your mid-40s), this happens more quickly. You will lose muscle mass due to the decrease in estrogen levels during perimenopause. Muscle has a higher metabolism than fat. The menopause officially occurs (described as no period for one year), and weight gain starts to occur in the belly.

Why not prescribe hormones to stop weight gain if it is caused by hormone changes? It's not that simple, or I would be wearing seven estrogen patch right now. Although postmenopausal hormone therapy has been shown to reduce abdominal fat distribution, it does not prevent weight gain and has other risks so it should not be used for weight control. Weight gain has not been proven to be a result of perimenopausal hormone therapy.

It's not all bad news. You can still maintain a healthy weight even after menopause by making healthy food choices and changing your exercise routine. Here are some things I tell my patients.

Order a Physical

A complete physical is the first step. You should have a checkup with your primary doctor every two years in your 40s to make sure you are not suffering from conditions such as high cholesterol or heart disease. Your doctor may check for metabolic problems such as diabetes or thyroid issues in your routine blood work.

Move your body and pump some iron

Everybody should move at least 30 minutes per day. You can exercise by running, spinning, walking, Zumba, cycling, aerobics or biking. Exercise improves your mood, fitness, and helps you avoid osteoporosis.

You will lose muscle if you do cardio only. This is why you should add weight training to your workouts to increase your metabolism and build muscle. There are other options if lifting weights is too daunting, boring, or impossible to fit into your busy schedule. High-intensity interval Training (HIIT), which uses weights, is my personal recommendation. It combines cardio and weight training. Although it may seem daunting at first, it is easily adaptable to all fitness levels and ages. Yoga may be more for you. Yoga that engages your core muscles and muscles (such as vinyasa or power yoga) can help increase your metabolism and strength. It has been proven that yoga can reduce symptoms such as brain fog, hot flashes and insomnia.

You can also try body-weight exercises, which are available in many YouTube videos, Pilates, and barre workouts. Finding a workout you love, or at least enjoy, and sticking with it is the key to success.

Check Your Refrigerator

Although exercise can improve your metabolism and help you maintain your weight, it is not a way to get rid of bad eating habits. When I'm marathon training (running 40-50 kilometres per week), I can often gain 3-5 pounds. This is because I am hungry and eat all the time. In my 20s I could eat whatever I wanted, provided I exercised every day. But when I reached my 30s I had to be more careful about my diet. To maintain a healthy weight, I had to be intentional about my diet and exercise by the time I was 40. Many of us have fallen behind in healthy habits over the past year 2020. It's time for us to make a change and get our health back on track.

First, cut down on alcohol and sugar. These empty calories are not necessary for your body and have no nutritional value. My metabolism doesn't love wine and cookies as much as I do. They will be more enjoyable if you treat them as a special occasion and not as a daily habit. The next step is to ensure you eat five to seven portions of fruits and veggies per day. It is important to limit the consumption of processed foods, fried foods, and red meat. I don't recommend any particular "diet," but instead suggest that you find a healthy way of eating that you can integrate into your daily life over the long-term.

The book The Obesity Code is one resource I recommend to my patients. This type of eating plan is particularly helpful for patients with a tendency to have their weight in the abdomen, have PCOS or suffer from prediabetes and metabolic syndrome. I recommend the book Better than Before and One Simple Step Can Change Your Live to patients who have difficulty forming new healthy habits.

Acceptance

It's unfair. It used to be possible to lose 10 pounds by cutting back for a few weeks. But that didn't work anymore. This is what I hear from frustrated 40-somethings every week. Perimenopause is not a quick fix. It is not the time to resort to fad diets or popping pills in an attempt to lose weight for a special occasion. It's a good time to focus on your health.

Some patients may be in a very unhealthy state. You need to make healthy lifestyle changes if your BMI exceeds 30. Your quality of life will be greatly affected by the choices you make in your health today.

Other patients may find the extra 10 lbs of perimenopause more of a vanity issue. If you have a healthy body mass index and have no medical issues, you need to decide if you are ready to do the extreme workouts and diets necessary to reach your goal weight. Or can you accept what you now have. Many of us in our 40s aren't able to exercise for 2 hours per day or count every calorie we eat. Focusing on your health is a better approach than focusing on the numbers on the scale.

Perimenopause can be a great opportunity to set a healthy pace for the second half your life. This is not the time for self-loathing and yo-yo dieting. It's a time to look at your health objectively and make the best decisions. Get more vegetables, reduce your alcohol intake, do some weight training, and visit your doctor for a checkup. You only get one chance to live and you want it to be an amazing, healthy, and fulfilling experience.

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