Management of weight gain in midlife | Corewell Health

It didn’t happen overnight.

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

The culprit: A gradual decline in estrogen, the hormone that affects a woman’s complexion, metabolism, thermoregulation, and body shape.

In addition to the inconvenience factor of tightening waist belts, excess belly fat also increases the risk of diabetes and cardiovascular disease.

The good news: Women can take steps to mitigate the risks.

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

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

Belly fat basics

When and why does belly fat increase?

Timing varies, Corwin said, but “perimenopause is when the transition and hormonal changes really start.” During the 10 to 15 years before menopause, estrogen declines.

“Estrogen is what gives us the female figure,” 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 — our core,” she said.

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

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

This, in turn, can lead to weight gain, “and everything goes straight to that core area,” she said.

Left unchecked, Corwin said, these changes make women more likely to develop type 2 diabetes and cardiovascular disease.

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

Visceral fat, located deep in the abdomen, can build up around the organs and cause inflammation. This can increase a woman’s risk of developing cardiovascular disease.

Decreased 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 high blood sugar levels and prediabetes.

While we can’t turn back the clock, lifestyle changes can reverse the effects of low estrogen.

Don’t know where to start? Here are some suggestions:

1. Managing stress

“Abdominal or visceral fat that is deep within has more cortisol receptors than peripheral fat that is closer to the level of the skin,” Corwin said. Stress increases the hormone cortisol, which fuels fat and inflammation. “We want to manage stress so we don’t pump out as much cortisol.”

One practical way to reduce cortisol is to wait until 9:30 in the morning to enjoy your first cup of coffee. And cortisol levels naturally rise in the morning, Corwin said, and caffeine can amplify this effect.

Women can also be severely squeezed between work and family commitments and volunteering.

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

2. Sleep better

Set the stage by making your bedroom a peaceful haven. Avoid screens and spicy foods an hour or so before your turn. Try meditation or deep breathing.

If you’re having trouble staying asleep, Corwin said, keeping a “notebook” on your nightstand might help. Write down any task or concern that comes up; You will stay until the morning.

3. Exercise

Corwin said weight training can help women build muscle and strengthen bones, counteracting the effects of lower estrogen. Try Pilates, yoga, or hand weights.

Finding time to exercise between work and family responsibilities can seem difficult, said Sylvia Ferri, RD, supervising nutritionist. Corewell Health Weight Control Center in eastern Michigan.

She advises patients to pack their gym bags and change at work or bring a friend to a class.

4. Eat healthy

Avoid added sugars and “white carbs.” Divide your plate to include a quarter of a lean protein such as poultry or fish, a quarter of a starch or whole grain such as sweet potato, squash or bean-based pasta, and half of a non-starchy vegetable, Corwin said.

“There is no magic pill,” said Ferry.

She recommends that her patients eat plant-based foods such as fruits, vegetables, whole grains, and legumes.

Try innovative carb substitutions: shredded cauliflower instead of white rice, lettuce wraps instead of bread, zucchini noodles or spaghetti squash instead of pasta, or greens with hummus instead of chips.

“The first week of carb-reduction can be tough,” said Ferry. “But, if you can get past it, you will start to feel better and your carb cravings will decrease. You will start to see weight loss, which will be motivating and give you the confidence to keep going.”

5. Start small

I feel tired? Take one step at a time.

“My goal is to see women find one small change they can manage, create a new habit out of it and feel more confident as a result,” Corwin said. “Once they achieve that, they can then move on to the next small change until they’ve mastered it.”

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

If you can’t sleep, turn off the TV and get a book instead. Need more exercise? Check out a new workout video on YouTube or visit the gym.

Corwin said if you want to develop better nutrition, talk to a dietitian or get a new cookbook for inspiration.

“One step at a time… This feels more realistic about making a lifestyle change. While this is happening, blood sugar levels drop, energy improves, hot flashes decrease, and sleep improves.”

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