Stop the Middle Age Spread!
Why am I gaining weight? Perimenopause and Menopause?
Last week, one of my patients, Debbie, came in distraught and frustrated. She had always been fit, on the thinner side and able to lose weight at a snap of her finger. Now at age 48, perimenopausal, and having irregular cycles, she is completely irritated and at wits end as to why she can’t lose weight and complaining about a new roll of fatty tissue in her abdominal area (belly fat).
What might be some of the reasons for this weight gain now in her life?
With COVID affecting Debbie’s work/home schedule, she is finding less time for exercise, noticing less healthy eating habits and more stress. With this, she’s also noticing poorer sleep quality due to anxiety – waking up at 3:00AM to go to the bathroom and not being able to fall back asleep. Too many thoughts racing in her head – she can’t seem to shut it off. All of these, in addition, to other lifestyle habits and genetics can lead to weight gain.
But what about perimenopause? Does this transition cause weight gain?
The interesting answer is that the hormonal changes do NOT cause weight gain, but may cause weight to redistribute itself. Let me explain further. As we age, our metabolisms slow down, burning less calories and causing more fat to be deposited in our bodies. We lose muscle mass and gain fat mass, which burns less calories than muscle meaning a slower metabolism. In addition, if sleep is interrupted, many of us tend to snack more and consume more calories. Thus, trying to stay the same weight, much less trying to lose weight, can be a huge challenge!
With fluctuations in estrogen and progesterone levels in perimenopause, weight is redistributed from being in the thighs/hip area to the abdominal area.

How can we combat this middle age spread? Here are 6 Tips!
- Move More! Recently, I invested in myself and bought a Peloton bike. Yes, it took 3 months to get to my home, but it has been a life saver! I reshaped my living room into the dining room and converted the previous dining space into a home gym. Wow, it’s crazy how much it’s helped me stay in shape – plus a mirror alongside my bike reminds me why I’m working out!
- Build Muscle Mass – lose fat mass. Strength training using weights or bands can help increase muscle mass and burn fat. This also increases your metabolic rate, which means you are burning more calories.
- Eat Less. Watch your portion size. Changing from an 11 inch plate to an 8 inch plate can help you do this.
- Watch Your Sugar Intake. Avoid sodas, cookies, cakes, and other sugar laden foods. Yes, it may be difficult to kick this habit, but you’ll be glad you did. Click HERE for a blog about sugar addiction.
- Limit the Booze. This is one of my challenges – I do love a glass of wine when I get home and settle in. Now, I’m trying to just drink on the weekends and limit it to 1-2 glasses at a time.
- Commit to Yourself and Your Health. I made the choice to invest in a Peloton because the monthly rate for me to pay it off/keep subscription was less than my monthly gym membership. Find ways where you can find ways to keep fit. One of my patients has a neighborhood group of women who do work-outs outside one of the neighbor’s garages 3 mornings a week. It saves money and builds support to stay motivated and accountable.
What are some other ways that you are finding to stop the middle age spread? Please share with our Amazing Over 40 Community!
In health and happiness, Dr. Diana