As we age, we tend to become more insulin resistant which can put us at risk for type 2 diabetes. When you eat foods that break down into sugar, the pancreas pumps out insulin to escort the sugar out of your blood.  People with Insulin resistance don’t use insulin effectively so that cells have trouble absorbing sugar which causes a buildup of sugar and insulin in the blood.  Researchers still aren’t 100% in agreement as to why, but at the end of the day, people with insulin resistance gain weight, particularly around the middle.  And some research shows that lack of estrogen may cause insulin resistance.
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Have you noticed a little extra cushioning on your bottom, belly, and hips and increased difficulty losing those stubborn extra pounds? You are not alone. This is a common problem that women face as they are entering perimenopause and menopause. As a woman over 40 (and turning 50 this year), I understand your concerns. However, as a physician, I know that it is possible to achieve a healthy weight at this time of our lives.
One of the main culprits for weight gain is, of course, our hormones, which start to change right around the mid-30s and into the 40s. This change in hormones, less estrogen for women and less testosterone for men, cause the fat in our bodies fat to shift to the middle of the body while abandoning other areas of the body you could care less about. That's one reason you may get a little fluffier around the middle while other parts of you actually get smaller.
Many women have trouble sleeping during menopause due to hot flashes, night sweats, stress and the other fun stuff that goes along with low estrogen levels.  Migraines anyone??  The bummer is poor sleep is linked to hunger and weight gain because of two more hormones:  ghrelin (the “feed me” hormone) and leptin (the “I’m full” hormone).  Here’s a short blog I wrote on that topic.  If you’re sleep deprived, these hormones get out of whack.

“There are many eating patterns that can be used to lose weight,” says William Samuel Yancy, M.D., director of the Duke Diet and Fitness Center and associate professor of medicine at Duke University. Many have evidence behind them, whether that’s keto, Paleo, Mediterranean, vegan, or anything else. Interestingly, there’s not as much research on what works for men as there is on women, but “for men, sometimes it’s as simple as shortening the time in which you are eating to an 8- to 10-hour window a day,” says Kristin Kirkpatrick, R.D.N., consultant for Integrative and Lifestyle Medicine for the Cleveland Clinic. Even something as straightforward as not eating after 6 PM can make a big difference—one of her male clients who lost 150 pounds found that to be especially helpful, she says.

Your muscles are important for bone density, strength, and overall health. However, your body starts to lose muscle as you age. Building muscle can increase your metabolism and help you burn more calories at rest. Muscle also takes up less space than fat, so you can feel leaner and toned as you increase your muscle mass. Good options to increase your muscle mass include light weightlifting, body weight exercises, and Pilates.
What does that mean for you? That the weight loss process naturally becomes harder as you get older...that's just a fact and accepting it means you can stop punishing yourself or feeling ashamed about your body. Instead of focusing on the negative, focus on the things you can control: Your workouts, activity levels, diet, stress management, sleep management and, most important, your attitude.

Pay attention to what you are eating. Read labels and ensure your foods are organic, nutrient-dense, and anti-inflammatory. Avoid eating in front of the TV, while standing up, and when busy with other tasks. Keep a regular eating schedule. If you are craving something, check-in with yourself to see if you are truly hungry or just thirsty, stressed, or bored.
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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