As you enter your forties, you are also entering perimenopause, when levels of your sex hormones progesterone and estrogen decline. Besides regulating your menstrual cycle and reproductive functions, these hormones also impact restful sleep and relaxation. A decrease in progesterone and estrogen levels may lead to sleep disturbances, restlessness, and insomnia.1 Because changes in sleep patterns have been associated with weight gain, sleepless nights may make weight loss increasingly difficult.2
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Additionally, attempts to lose weight on low-calorie diets can lead to even more lost muscle. Studies have found that regular resistance or strength training may be a better alternative than your daily runs to preserve and gain muscle — even when coupled with a low-calorie diet. Aerobic exercise is still important, just don’t make it your only form of activity.
It’s usually not just due to losing muscle mass over time (more on that later). "It's multifactorial," says Fatima Stanford, MD, MPH, obesity medicine physician scientist at Massachusetts General Hospital and Harvard Medical School. Numerous factors can sneak up on you and help you gain or hold onto weight, including your lifestyle, your food, your biology, and your sleep habits. The good news in that is that there are also numerous ways to tackle getting your weight to where you want it—you don't have to force yourself into one approach, and you get to choose what works for you.

Alcohol adds unnecessary calories and sugar to your diet. Drinking alcohol may also increase your appetite, leading you to consume more calories.30 When you’re under the influence of alcohol, you may also be tempted to choose less nutritious options, such as processed junk foods. I recommend reducing your alcohol consumption to an occasional glass of wine or eliminating it completely.


Very soon, I’ll stand up in front of the graduating class of my former high school and give the commencement speech. I’ll focus on the usual “work hard” and “follow your dream” themes, but, in reality, I just want to shout out to all those 17-year-olds — “have that ice cream cone, you’ll still fit into your skinny jeans tomorrow! ” Or “it’s OK to skip a workout, your muscle mass will help you bounce back!”

Amy Myers, MD is a two-time New York Times bestselling author and an internationally acclaimed functional medicine physician. Dr. Myers specializes in empowering those with autoimmune, thyroid, and digestive issues to reverse their conditions and take back their health. In addition, she is a wife, mother, and the successful founder and CEO of Amy Myers MD®.
People naturally lose muscle after 40, especially women after menopause. Because muscle burns more calories than fat, this can slow down your metabolism and make it harder to shake those stubborn pounds. Strength-training exercises -- lifting weights or doing body-weight exercises, like push-ups and squats -- at least twice a week can help you keep those muscles.
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