Expert Q&A: Fighting Midlife Weight Gain

An interview with Pamela Peeke, MD

From the WebMD Archives

First, you notice shopping for clothes isn't as fun or simple as it used to be. Next comes the "muffin top" spilling over the jeans. Then the scale delivers dire news: You're 10, 15, maybe 20 pounds beyond your "normal" weight.

Midlife weight gain is common. Many Americans gain a pound or so every year as they make their way through young adulthood, ending up fat and flabby at age 40 and beyond.

But it is not inevitable, says Pamela Peeke, MD, MPH, the author of the best-seller Fight FatAfter Forty. Peeke also serves as the chief medical correspondent for Discovery Health TV and often appears as a medical commentator on television news and talk shows.

Why do so many people gain weight in midlife?

Blame it on hormones in convergence with poor lifestyle choices, overeating, not exercising enough, and stress.

But hormones only account for about 2 to 5 pounds. The rest is the result of overeating, poor lifestyle choices -- such as not exercising enough -- and stress.

How can I not be one of those people who gains?

The keys are three: mind, mouth, muscle.

Use your mind to control stress. If you walk around and everything is stressful, you have a problem. You may respond to stress by making poorer lifestyle choices, such as not eating healthfully and not exercising enough.

Look at your nutrition -- in terms of quality, quantity, and frequency of eating. You should eat often.

Quality is all about eating whole foods, fruits, and vegetables, whole grains, lean protein.

Processed foods are bad. Anything that comes in a family-size bag, turn in the opposite direction and run.

Quantity is where a lot of people fall. The majority are baffled by what a serving size should look like. When eating out, and in doubt, eat half of it or less.

Be accountable for calories. You need a general idea of how many calories you need. An average woman, not an athlete, in her 40s or 50s, needs about 1,500 to 1,600 calories a day, on average, if she is exercising. A middle-aged man, average height and not an athlete but exercising, needs about 1,800 to 2,000.

Muscle, of course, refers to the need to exercise and, of course, to weight train.

Continued

Should my goal weight increase when I hit midlife?

A better goal than focusing on scale weight is to keep track of body fat. The goals should be to decrease body fat and optimize bone strength.

For a man, a body fat percentage of 18% to 25% is not bad for 40-plus. For women 40-plus, 22% to 27% is not bad.

To get that body fat percentage, you need to have excellent fitness to maintain a good muscle base.

Also, a man should have a waist circumference below 40 inches and a woman below 35 inches.

I'm 40-plus, eating right, and exercising but not losing weight. Why do I have midlife weight gain?

If you have tailored your portion sizes to ones that are appropriate, look at the frequency of your eating. Eat every three or four hours. But not too late at night. The later you eat, the lighter you eat is a good rule.

Eat a balance of lean protein, fats, and carbs. Make the fat good fat, not palm oil or hydrogenated oil, but high-quality good fats [such as those in nuts]. The protein should be lean -- a turkey burger or a veggie burger.

Most people have been doing the same exercise routine for years, and your body acclimates. Fat cells at 40 are reticent to give it up. Mix up the exercise routine. Exercise at least five times a week, and I mean cardio.

Add intensity. Add some level of weight training, and challenge yourself with the weights. [Getting professional instruction is advised if you're a novice.] Weight train two or three times a week.

Building muscle gives you that metabolic edge, since muscle mass burns more calories than fat.

Does HRT cause midlife weight gain, is that the culprit?

You can't blame the low doses of HRT in use today for midlife weight gain, at least not for any more than a few pounds. You do get a little more bloated on it, but it does not cause body fat accumulation. Overeating, not exercising, and stress do.

Continued

What's up with this belly? I never ever had one before.

I call it the menopot. On a man, it's the manopot.

Excess body fat occurring in the lower abdomen is associated with aging, after 40. This excess body fat in the normal range is usually only 2 to 5 pounds. And you do get a little pooch.

How can I lose this belly?

You minimize it by following the mind-mouth-muscle concepts.

But it's probably unrealistic to expect a stomach as flat as your 20-something stomach.

Can I boost my metabolism?

Absolutely. You can optimize your metabolism throughout life relative to your age by maintaining the highest level of training you can, within the limits and constraints of your life.

If you lose muscle mass [by not exercising], obviously your metabolism is going to drop.

Of course strength or weight training is crucial.

What workout or workouts are best for midlife people?

Creative cardio. Burn 400 to 500 calories a day in cardio. On the elliptical, for instance, you can burn about 400 calories in about 35 minutes. Cross train as much as you can. Burn the 400 to 500 calories all at once or accrue it.

And don't forget the weight training.

What's your weakness? What's the hardest part, for you, of staying on track and fighting flab after 40?

Because of long days and all my commitments, getting enough sleep. I remind myself: the poorer your sleep, the wider your girth.

Eating dinner not too late. Sometimes I am on a plane or a train, I don't have the control I want over how late I eat. In general, do not eat dinner past 8:30. I like to eat right about 7.

WebMD Feature Reviewed by Louise Chang, MD on November 25, 2008

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SOURCE:

Pamela Peeke, MD, MPH; author of Fight Fat After Forty.

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