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Fit and Forty: What Every Woman Needs To Know About Weight Control At This Age

Mar 24, 2009 - 21 comments





over 40


Weight Loss



Women in their 40’s are at an advantage when it comes to weight control and fitness. How so? I asked three of my favorite medical experts to explain what it means to be fit and forty, and how you can get there.

Myth-busting With Dr. Dickerson

Dr. Val: I know that many women in their 40’s complain of having gained weight. What causes that weight gain? Is it inevitable?

Dr. Dickerson: Many women don’t gain weight in their 40’s so it’s certainly not inevitable. There are a few common misconceptions about weight gain and aging that I’d like to address.

First, hormone supplements don’t cause weight gain - menopause, in general, with or without hormones, is associated with about a 10 pound gain. This often starts in perimenopause so it could occur as early as the 40’s.

Second, lean muscle mass decreases slowly from mid-30’s probably until menopause when it decreases more steeply. So women in their 40’s don’t experience too large a change in their metabolism.

Third, the weight that women have in their 40’s is often about how many babies they have had. Data show us that women retain about 10 pounds per pregnancy. Weight begins to shift as the perimenopause era begins - more towards the abdomen and the hips and thighs.

And finally, weight gain is not due to hormonal or metabolic changes, but may be more about emotional eating. Women often experience the empty nest syndrome in their late 40’s and change their eating habits to constant “snacking” - they tend not to count these calories when adding things up

Dr. Vivian Dickerson, Past President of the American College of Obstetricians and Gynecologists, Medical Director, women’s health programs and care, Hoag Hospital, Newport Beach, CA.

Increasing physical activity is the key to success

Dr. Val: How can women in their 40’s counteract potential weight gain? What’s the most effective strategy to stay trim and fit?

Dr. Hall: While it is true that body remodeling and loss of muscle mass probably starts in the late 30’s it is almost completely a matter of now much physical activity is taking place. Much of the perceived change in body image, (gravity-dependent “sagging”) is also accentuated with decreased muscle tone in the sedentary woman. Weight gain, on the other hand is quite related to caloric intake. It is greatly modulated by the degree of physical activity as well.

My general feeling is that most diets do not work, and the older you are, the truer that is. After age 40 women cannot consistently lose weight and keep it off without a plan of regular physical activity (aerobic) plus some resistance work (weights, bands) to improve body tone.

Dr. Bill Hall, Past President of the American College of Physicians and Director of the Center for Healthy Aging, Rochester, NY.

The 40’s: no better time to get trim and fit

Dr. Val: Do women in their 40’s have an advantage in losing weight?

Dr. Dansinger: Your 40’s are a great time to take lifestyle changes to new heights. Whether for weight loss, or prevention of diabetes or other related medical problems, many women who struggled in their 20’s and 30’s finally find success in their 40’s. For many women at this age, previously insurmountable logistical barriers such as raising preschool age children, or inflexible work schedules, often improve somewhat. Such expertise in schedule-juggling, when combined with a renewed commitment toward preventing health problems, often gives such ambitious women the strength and experience to finally achieve consistency with an effective exercise and healthy eating routine that produces long-lasting results.

Although the metabolism slows gradually throughout adulthood, the effectiveness of lifestyle changes for health improvements remains strong throughout life, and may actually become most beneficial as we grow older. Gaining muscle and bone strength through weight-lifting type exercise may help a woman in her 40’s reduce the risk of muscle and bone loss that typically affected women of her mother’s generation.

Dr. Michael Dansinger, Lifestyle Medicine Physician/Researcher, Tufts Medical Center, Boston. Nutrition and fitness advisor to NBC’s Biggest Loser.

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393685 tn?1425812522
by stella5349, Mar 25, 2009
Sorry -

Many thyroid patients have this told to them repeatedly at doctors visits and still fail at every attempt to drop weight.

Sugar = insulin is a hormone. Cortisol issues/adrenal - thyroid - metobolism/Free T3 are all issues for weight gain.

As agreed, exercise and fitness and proper diet must be done to maintain or lose weight, but when a body's hormonal balance is not running optimal -

1. The person is left not able to exercise and if pushed - let's say with adrenal fatigue - that can damage the function/body further- if left untreated.

2. Diets won't work if thyroid metobolism is not running appropriately. a thyroid patient can deplete caloric intake to 800 a day and still pack on weight ( whether bloat or fat).  Hormones must be preforming at optimal levels, maintaining metobolism to succeed in weight loss. basal temp and energy levels.

3. Cortisol issues/ stress levels play a huge role on weight imbalances. High stress will fight the body's natural way of burning calorie intake or fat. Some require counseling to achieve weight lost. Again - not drugs ( anti depressants ) but counseling, to create a positive well being for the person to lower stress.

4. The release of estrogen/progesterone and testosterone all change in the peri stage and proper testing and results/treatments are very important to maintain women's health and weight. There are 3 different testosterones and estrogens within the human body.

5. Proper knowlegde of foods - when hormonal imbalances are present - needs to be encouraged to lose weight. Soy is very estrogenic and not suitable for women at any age. Alcohol will increase conversions of testosterone into estrogen/estrodiol. Refined carbs increases insulin. There are many more that pack on weight due to hormones.

On a personal level and thyroid/adrenal patient. I lost my thyroid function due to Grave's/RAI in 2003 and packed a whooping 40 pounds on.  I went to dozens of doctors expressing the pain and depression I was in - trying to lose weight on top of dealing with horrible hypothyroidism issues. Always told until this year I was just fat and lazy and needed to get my body up and moving. I was one of those on the 800 calorie diet and did as much exercise I could to "try" and lose "anything" in failure. I was even told to try and starve myself for days. Ummmm.. what??

Finally this year a doctor I consider a miracle that walked into my life, really stepped up and is treating me appropriately for my personal issues of hormonal imbalance. I have lost a total of 15 pounds in two months. I have vitality back and able to maintain my daily living again which now includes a walk 3 times a week which I was unable to do prior to seeing her from pure exhaustion.

I am not a watcher of the Biggest Loser - I don't believe in beating the body into a pulp to lose weight without appropriate testing. A person should not have to go to those extremes to drop a few pounds. Our bodies were not created to be beat like a horse to achieve weight lost. Chinese decendants were not involved in this type of treatment as American's are brainwashed into thinking. They follow special eating rituals and believe that a constant balance of hormones/Qi is critical in healthy living.

Thank for your article, but I choose to live a healthy lifestyle of hormonal balance and total happiness instead of participating in a TV shows skeem I know I will fail.

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by Taybey, Mar 25, 2009
I have gained about 30 pounds since my 30s.   I am 53 now and been through menopause.  I also take ativan, and an antidepresssant paxil, which is known to cause weight gain. I also quit smoking two years ago and dont get to exercise much. So everything is stacked against me, any suggestions?

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by Taybey, Mar 25, 2009
I just started on Estronatural this is a supplement of nature hormones.  

Avatar universal
by ProactiveCaretaker, Mar 25, 2009
Thank you stella5349's.  Like you I had a thyroid disorder (Follicular variant Papillary Cancer).  I was always very physically fit until the cancer and put on a whopping 80 lbs while I was undergoing diagnosis and treatment.  Since I've had my thyroid removed (about 5 years now) I've been able to take off about 30 lbs but seem to be stuck.   I am very physically active and have actually been advised that perhaps I am too active.  My diet could use some improvement but is pretty good.  

I thank you because I am sick to death of "experts" who say it is all as simple as eating right and staying active.  It's not so simple and their assertion that it is, is well insulting, condiscending and wrong.   A true expert knows there are some general guidelines to follow in health and weight management, but that there is much more depth to the issue.  Articles asserting otherwise are more of an advertisement to brand the doctor or product name than an aid to consumers.

Avatar universal
by jmcacdon, Mar 25, 2009
I don't think you have to do really strenuous exercise.  I have found that 40 minutes of walking/treadmill/eliptical and some stretches do it for me. I also attend Tai Chi class once a week so I try to practice at least one more day during the week as well.  I lift light weights about twice a week, too.  I find that when I do these light workouts I feel soooo much better physically and mentally.  I am 56 and went through menopause about 4 years ago.  I gained 25 lbs during that time, but have since lost it.  What I did was just get back to good eating habits...3 moderate healthy meals, stay away from fats and white carbs(bread, rice, sugar) mostly.  I also have a small ice cream cone every night as a reward! (low fat of course)...oh and I quit drinking wine every night. Life is not perfect, and I don't look like I did when I was 35, but most days I feel pretty good. Oh, and I am on bioidentical hormones!

Avatar universal
by Bttrfly, Mar 25, 2009
Hi Stella5349,

Thank you for sharing your story for i am walking the same path as you with doctors telling me i am fat and lazy and need to exercise and diet and dont believe me when i tell them that i do and i see the smirk on their faces...she even tells me my hypothyroid isn't high enough for treatment and said nothing about my adrenal which is way to low as suggested by another doctor who told me to take adrenal support from a healthfood store.I am hoping to find my miracle doctor.
I have gotten worse by hating what i see in the mirror and i struggle to bring myself out of the house and am robbing my girls of a mom who should be enjoying taking them shopping at the doesn't just hurt me but my family as well.I even went to another doctor outside my insurance plan but was told that she couldn't help because i have to make her my primary doctor and it would be costly without insurance.
You gave me hope.
Thank You!!!

Avatar universal
by fusion456, Mar 25, 2009
Hi Bttrfly,

Find you another doctor definitely!! Don't give up, I have thyroid disease and have taken medication. I did lose some weight but not much. I found that watching the amount I eat does help and I try to move around the house instead of being a couch potato. All of us are different and takes different steps to lose weight. Please don't let it get you down, I also suffer from depression, which does not help the situation. I don't even feel like going grocery shopping much less shopping at the mall. Good luck in your search for a miracle doctor, they are few and far between. Try to keep happy thoughts, laughter is the best medicine. I beleive in that, it has helped me.

773189 tn?1238002776
by marcebaker, Mar 25, 2009
hello !!! Is marcella s from conway sc, please i need help , Im 46 ys old , im start to be depressed about my weight , never in my life i been so fat , i believe i gained around 44 pounds , im so active person , i do work out , aerobics , i play tennis , i eat healthy i don t know , what i need to do ? please i need help , i want to be pretty again !!!! i feel discusted about myself !!!!
s.o.s ///help

Avatar universal
by Bttrfly, Mar 25, 2009
Thank You Fusion456 :o)

I was reading about how some  just wants meds for weight loss...i actually like working out on the tredmill and taking walks by the lake...i have high cholesterol and want to live to be there for my girls when they become mommy's.I just want to feel better and i try and try and i wont give up!I have Kaiser Permante and they go by the old guidlines so no matter what doctor i see i get the same results"not high enough for meds".
My weight is all in the tummy like a beer gut and my hubby is smaller than me and boy the comments and bad remarks and giggles get me down,almost everytime ...i think how stupid it is to let others stupidity get me down. I  also read that someone said they feel like wearing a shirt saying "I am fat but its not my fault"...i agree!
I have the cold feet,leg cramps,dry heels and hair that falls out cannot lose weight and when i do its like 6 pounds that just comes back  plus 3 more pounds*sigh*.I know i brought this condition on by trying to starve myself to be thin when i was a teen wanting to be thin to be i just want to feel better.
I need to rent some comedies!!! :D
Thanks Again Fusion!!!!

Avatar universal
by mayfly2, Mar 25, 2009
In the article it says that HRT does NOT cause weight gain.  I disagree with that.  2 months ago I started on an estrogen patch as I had started having hot-flashes - (I'm 48).   After being on the patch for 6 weeks I put on 10 pounds!   My doctor said it was the menopause causing the weight gain and not the patch.  Well, I took the patch off and threw it away 2 weeks ago and have now dropped 6 of those pounds.  I have been on bio-identical hormones for a few years - transdermal progesterone cream and DHA cream -- and have done fine.  It wasn't till the estrogen was added that the weight gain began.  I also started feeling depression while I was on that patch too.  I feel much better now that I'm off of it.

I'm not sure what I should do if the hot-flashes come back.  

Avatar universal
by fusion456, Mar 25, 2009
To bttrfly,
I always have that want "to feel better". Some days are worse than others, but I rarely feel "good".
I have read a lot of articles that women tend to gain weight in their bellies due to stress. If you are stressing about your weight it will only get worse. As far as the giggles about your weight, tell them it hurts your felings and you do not like it, if they care about you they will stop. You are not stupid for letting it get you down, it hurts, I know. You need encouragement and support not to be ridiculed.
I don't think starving when you were younger brought this on. Personally I think you may have a little depression because of the comments and the continious weight gain, not acute depression just depressed because of weight gain. Kinda down on yourself.
If it is not high enough for meds, what about some suggestions on how to help the weight gain. We pay them they should be able to give you advice instead of "it isn't high enough". I really get frustrated with doctors!!
Good luck and keep hope!

To marcebaker,
I just turned 45 today and I weigh 50 pounds more than I did when I was 40. I was 70 pounds heavier but i have lost 20. Not many years ago i was a size 7 i am now double that. Don't feel disgusted even though that is tough. I stay away from full body mirrors. I can't say it enough, stress and depression are the worst things on weight gain. Try to keep a positive attitude and don't give up. Support and encouragement are two things you need.

Avatar universal
by Bttrfly, Mar 25, 2009
Happy Birthday Fushion456 :o) and thank you for your support!!!

Also thank you for the herbal recipe link doeyoo,looks very interesting.

393685 tn?1425812522
by stella5349, Mar 25, 2009
It breaks my heart to read this stuff on menopause and hypothyroid patients. I was just reading an article on weight issues out of a readers digest just this morning written by Steven Blair / Profession of Exercise Science and Epidemilogy from the University of South Carolina. He stated many facts about hormonal imbalances and weight gain - and used to consider this epidemic as does the MD who started this blog, but now - due to reseach - definately sees hormones playing a huge role on weight issues with us.

This doesn't mean to go out and pig out - Be a couch potatoe and think you will lose weight. It does however suggest to look outside the box - when many attempts are made and weight still is an issue.

Avatar universal
by heart sick, Mar 25, 2009
We all have so much in common. I was always very slim my whole life then 6 yrs ago my Dr. put me on loppressor for psvt. It felt like I gained 10 # right away. Now I am 50 and have gained another 10 #. I work out 5 days a week 3 days of cardio for one hour and 2 days of pilates and weight training I eat 6 small meals a day keeping my daily calorie intake at no more than 1575 a day. I realy just want to lose 10-12 # so my clothes fit better and I feel better about how I look. Please help me figure out what I AM DOING WRONG..:(

Avatar universal
by GeorgieGirl1717, Mar 25, 2009
Is that a typo in the FIRST sentence?  Women generally DON'T gain weight in their 40's?  Are you kidding?  I don't know a woman in their 40's who hasn't gained weight!  Also, isn't it funny how a MALE thinks he knows women and their weight problems.  I also have to say that people on the biggest loser don't seem to be doing weight loss in a healthy way...they are exercising way too vigorously for their own good.  It's not good for the heart to endure that kind of shock to the system.  I wonder how they screen these people for the show so they don't pass out or get real sick.  Although an ambulance picks up one of them on next week's show.  I've noticed that losing weight involves eating in moderation and also just getting fed up once and for all about the weight.  

I was on Paxil once in my late 20's and went from 100 pounds to 180.  I had anxiety, not depression but I was depressed for the weight gain and the doctor said it was me.  Nice.  My gyno said, "get off that drug it is making your metabolism nose dive"  The doctor who gave it to me didn't even know that?  You have to really research your meds and be proactive in your own healthcare too.  I lost 10 pounds in ONE week going off Paxil after having severe withdrawl, that was enough never to touch that class of drugs ever again.  Menopause doesn't always make you gain weight or taking hormones.  I started working out on an elliptical four days a week and lost 10 pounds.  I'm still on Premarin and it's a God send for hot flashes.  To help lose weight I find that getting together with others and encouraging each other helps a lot.  

this article gave me no new information or helpful information.  

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by Rach67, Mar 25, 2009
Sorry Geogie girl but you can't assume that what happens to you happens to everyone.  I have lost weight since turning forty because I am not tied down by toddlers and can exercise, I am also on Paxil.  If you are emotional eating it is not because of the depression medication but probably the depression!  I have plenty of slim freinds in their forties, we all lead active lives.

It is impossilbe to gain weight if your energy output is greater than/equal your input, and obviously if your energy input exceeds your output the reverse is true!!   Although having had borderline adrenal failure from post viral syndrome, I agree overdoing exercise when you are not well is dangerous.  Light exercise is really good for depression though.  Nothing like a brisk walk to put you in a good mood, particularly if you are leaving the kids/husband at home and going with a bunch of fun ladies (a skinny chino after wont hurt!)

Avatar universal
by Pegasus24, Mar 25, 2009
by Pegasus24

I have been battleing with my weight for over 5 years now, because of my medical condition called Stiff-Person Syndrome.
Finding difficult to control appetit, exercise, and getting out of my bed at times. Someone with this same medical condition, please respond back to me and help me.

I feel so alone at times, moody, and depress. Can someone out their share their story and solutions with me. Please
thank you until I hear from you.

Avatar universal
by methamorphosis, Mar 26, 2009
after i graduated in college i gain so much weight i use to be 97lbs. now im almost 200lbs, im 5'3 in height so its to much for me... i was used to be depress, and i must admited i change my life, i dont go out much and i dont even buy dresses, not like i used to be  i dont put make up anymore... i find it hard to find sizes for me... and prior to that i hate the sales lady or sales man saying its only free size, no bigger size available... i try slimming teas, even slimming pills but still i continiously gaining weight for almost 9yrs, recently i was diagnose of having a ovarian cystic mass in my left ovary thats why i under go operation last january my left ovary was removed at age of 29 without having my own child yet...  a single female lady w/o having her own family.... its sad and scary becoz i did not know if i could still bare a child.... i know my right ovary was also have a small cystic mass and im taking meds to help it stop to grow, scary! ...but  a strong faith in god and  reminding myself always that im still lucky coz my cyst is benigh.. lucky becoz i have my relatives and friends lucky im alive!... that im a filipina...that i live in the philippines with strong family strings...tighten with gods love....
still i did not know where i will go BUT i live my life 1 day at a time... im maybe scared? but hopeful... i maybe continously gain weight and have this cyst?... i maybe ugly coz im fat?  but in my mind beauty is skin deep... i maybe a big sick ugly package outside but my hearth is full w/ gods simlicity and love.... so why should i keep myself if i have him w/ me?? ITS A HAPPY BATTLE OF LIFE  thats what my icon said.

Avatar universal
by Steven Y Park, MDBlank, Mar 26, 2009

I agree with you that in your situation, adding estrogen did make you gain weight. This is an overly simplistic explanation, since there are so many other variables, but as women enter perimenopause in their early 40s, progesterone slowly drops. Estrogen remains steady until much later. One little known property of progesterone is that it's a respiratory stimulant. It also increase muscle tone in your breathing passageways, especially your tongue. As you slowly take away progesterone, you begin to lose rigidity of your tongue muscle. When on your back, your tongue falls back to some degree in all people. But the less progesterone you have, the more it falls back, leading to partial or total obstruction, preventing you from staying in deep sleep. This becomes much worse when in deep sleep or REM sleep, as your muscles naturally relax more. Many people prefer to sleep on their sides of stomachs to compensate, but as progesterone falls, they get less efficient sleep due to this mechanism. This leads to a low-grade physiologic stress state, increasing cortisol, making you more hungry, lowering thyroid levels, and ultimately gaining weight.

So by taking estrogen by itself, it altered the estrogen to progesterone ratio, which in effect lowers your progesterone functioning. Then you don't sleep as well, leading to increased weight gain. When you started bioidentical progesterone, you started to feel better. It's no coincidence that in East Asian cultures, women are told not to eat soy products just after delivery. In retrospect, there's a scientific basis for this: progesterone is very high during pregnancy, and helps to partially protect against the added weight. But just after delivery, progesterone drops, but the weight is still there. My wife went through a full year of post-partum depression after our first son. It finally went away only after she lost all the weight.

Whenever I see any discussion on weight, I never see any emphasis placed on good quality sleep. In a recent issue of Glamour magazine, they recruited volunteers to increase their total sleep time only. After a few months, they all lost a significant amount of weight. No other changes to their diet or lifestyles. In addition to quantity, what I'm talking about is quality. Most modern humans upper airways are susceptible to obstruction and arousal to various degrees. And I'm not talking about obstructive sleep apnea, until you get to the extreme end of the spectrum.

Avatar universal
by cho37, Mar 31, 2009
well, i"m a woman in late 30s and interested in all kinds of diet either it's a pills,a tea, a juice,a milk,a fruits etc. will it ruin my health?  i take it sometimes in one time.

Avatar universal
by Todd29, May 28, 2009
Diets and diet aids do not help anyone.  The only way to successfully lose weight and get the body that you want is by using the right information.  This information can be found in the book Lose Weight Using Four Easy Steps which can be ordered through the website  Everyone who has gotten a copy of this book is now healthier.

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