Managing Midlife Weight Gain | Corewell Health

It doesn’t happen overnight.

But as women enter their 40s and even into their late 30s, excess pounds often migrate to the midsection.

The culprit: A gradual decrease in estrogen, the hormone that affects women’s skin, metabolism, temperature regulation and body shape.

Beyond the nuisance factor of tighter belts, increased belly fat also increases the risk of diabetes and cardiovascular disease.

The good news: Women can take steps to mitigate risk.

“There are things we can do to counteract these changes,” registered dietitian Jessica Corwin, MPH, RPN, said with Corewell Health Women’s Health and Wellness Center in western Michigan, said.

Among them: managing stress, prioritizing good sleep, eating well, and exercising regularly, especially weight resistance training.

Belly Fat Basics

When and why does belly fat increase?

The timing varies, but “perimenopause is when the transition and hormonal changes really begin,” Corwin said. During the 10 to 15 years leading up to menopause, estrogen declines.

“Estrogen is what gives us our feminine shape,” Corwin said.

For younger women, the extra fat moves to the hips and breasts.

“When estrogen goes away, it starts moving from our hips to our stomach, to our heart,” she said.

At the same time, women in their late 30s and 40s enter a demanding and often stressful phase of life.

“We take care of our children, our parents, work,” Corwin said. “We may have less time to take care of ourselves by exercising, eating well, sleeping and managing stress.”

That, in turn, can lead to more weight gain, “and it’s all going straight to that core area,” she said.

Left unchecked, these changes put women at higher risk for type 2 diabetes and cardiovascular disease, Corwin said.

“We don’t want our fat to go to the heart and stomach,” she said.

Visceral fat, located deep in the abdomen, can become embedded around organs and cause inflammation. This can put women at increased risk of cardiovascular disease.

A decrease in estrogen can also reduce sensitivity to insulin, a hormone that regulates blood sugar.

“Insulin doesn’t work as well without estrogen,” Corwin said. Insulin resistance can lead to higher blood sugar and prediabetes.

Although we can’t go back, lifestyle changes can counteract the effects of lower estrogen.

You do not know where to start ? Here are some suggestions:

1. Manage stress

“Abdominal or visceral fat contains more cortisol receptors than peripheral fat closer to skin level,” Corwin said. Stress increases cortisol, which fuels fat and inflammation. “We want to manage stress so we don’t pump out so much cortisol.”

A practical way to reduce cortisol would be to wait until 9:30 a.m. to indulge in that first cup of coffee. Cortisol naturally increases in the morning, and caffeine can amplify this effect, Corwin said.

Women can also be stretched between work, family, and volunteer commitments.

“At some point we have to think about what’s realistic and learn to say ‘no,'” she said.

2. Sleep better

Set the stage by making your bedroom a peaceful retreat. Avoid screens and spicy foods about an hour before bed. Try meditation or deep breathing.

If you’re having trouble staying asleep, putting a “worry diary” on your bedside table can be helpful, Corwin said. Note the task or anxiety that presents itself; it will keep until morning.

3. Exercise

Strength training can help women build muscle and build strong bones, countering the effects of low estrogen, Corwin said. Try Pilates, yoga or dumbbells.

Finding time to exercise between work and family responsibilities can seem difficult, said Silvia Veri, RD, nutrition supervisor at Corewell Health Weight Control Center in eastern Michigan.

She advises patients to pack their gym bag and get changed at work or ask a friend to meet for a class.

4. Eat healthy

Avoid added sugars and “white carbs”. Divide your plate to include one-quarter lean protein like poultry or fish, one-quarter starch or whole grains like sweet potato, acorn squash, or bean-based pasta, and half non-starchy vegetables. Corwin said.

“There’s no magic pill,” Veri said.

She recommends that her patients fill up on plant-based foods like fruits, vegetables, whole grains and legumes.

Try creative carbohydrate substitutes: cauliflower in rice instead of white rice, lettuce wraps instead of bread, zucchini noodles or spaghetti squash instead of pasta, vegetables with hummus instead of fries.

“The first week of cutting carbs can be tough,” Veri said. “But, if you can get through it, you’ll start to feel better and your carb cravings will go down. You’ll start to see some weight loss, which will be motivating and give you the confidence to keep going.

5. Start small

Feeling overwhelmed? Take one step at a time.

“My goal is to see women find one small change they can handle, create a new habit, and feel more confident as a result,” Corwin said. “Once that’s accomplished, they can then move on to their next little change until they’ve mastered that.”

For example, if stress is your biggest problem, try meditation or deep breathing techniques.

If you can’t fall asleep, turn off the TV and grab a book instead. Need more exercise? Watch a new exercise video on YouTube or go to a gym.

If you want to develop better nutrition, talk to a dietitian or pick up a new cookbook for inspiration, Corwin said.

“One step at a time…it seems more realistic to create lifestyle change. When that happens, blood sugar drops, energy improves, hot flashes decrease, sleep improves,” she said.

“Each area builds on the next and we need all of these factors in play for our overall well-being.”